advance directive
noun · Patientenverfügung
A Patientenverfügung is the written declaration by which an adult capable of consenting settles in advance whether to consent to or refuse particular examinations, treatments or interventions not yet imminent. Two points date a translation: the provision moved from § 1901a to § 1827 BGB with the guardianship reform on 1 January 2023, and blanket wording does not bind.
Which translation, when
Why
Advance directive translates as Patientenverfügung, and a current translation has to get two things right, the content and the date. On content, § 1827 Abs. 1 BGB lets an adult who is capable of consenting lay down in writing, for the event that he loses that capacity, whether he consents to or refuses particular examinations of his state of health, curative treatments or medical interventions that are not yet immediately impending. If those provisions fit the actual situation of life and treatment, the representative must give the patient’s will effect; if no directive exists or none fits, he must establish the treatment wishes or the presumed will and decide on that basis. Writing is required for the directive itself, but revocation is possible at any time and without any form, which surprises readers used to formal revocation clauses. Two practical limits belong in the picture. The declaration must be concrete enough: the Bundesgerichtshof has held that a blanket refusal of life-prolonging measures does not by itself produce binding effect, so useful directives name situations and measures. And the instrument must not be confused with its neighbours, the Vorsorgevollmacht, which appoints someone to act, and the Betreuungsverfügung, which proposes whom a court should appoint. On the date, the provision was renumbered: until the end of 2022 it stood in § 1901a BGB, and the reform of guardianship law moved it to § 1827 BGB from 1 January 2023, adjusting the reference in § 630d BGB at the same time. Forms and older commentary still cite the old number, so a translator meeting § 1901a in a source is looking at a text written before 2023.
Typical mistakes
- The provision is § 1827 BGB since 1 January 2023 and was § 1901a BGB before, so a source citing the old number is dated even where the substance still holds.
- Blanket wording such as no life-prolonging measures does not by itself bind, so a translation should not present any written wish as decisive.
- A Vorsorgevollmacht appoints a representative and a Betreuungsverfügung proposes one, so neither renders advance directive.
What matters
Rendering a German advance directive for use abroad: the translation should cite § 1827 BGB, note that revocation is possible at any time without form, and keep Vorsorgevollmacht and Betreuungsverfügung apart from the directive itself.
What the machine misses
A machine version of advance directive produces Vorausverfügung or confuses the instrument with the Vorsorgevollmacht, and the German term is the Patientenverfügung of § 1827 BGB, renumbered from § 1901a with effect from 2023; the wrong word also suggests that any written wish binds, while the courts require concrete situations and measures.
Examples
| an advance directive | eine Patientenverfügung |
| capable of giving consent | einwilligungsfähig |
| may be revoked at any time without any formality | kann jederzeit formlos widerrufen werden |
| a health care power of attorney | eine Vorsorgevollmacht |