[Compulsory organ donation-a controversial topic]. / Verpflichtung zur Organspende ­ ein kontroverses Thema.

The number of organ donations in Germany has continuously fallen in recent years. The proposed Transplantation Act stipulates that every German citizen is considered an organ donor if he/she has not objected during his/her lifetime. This proposal has received wide approval, but also much criticism. The German Society for Urology, the German Society for Surgery, the German Society for Nephrology and the German Transplantation Society have all spoken out in press releases in favor of the introduction of an opt out (presumed consent) solution. The German Bundestag will decide on the proposed bill in autumn.

[Psychosocial stress in patients with prostate cancer : Experiences by using psychooncological screening questionnaires]. / Psychosoziale Belastungen bei Patienten mit Prostatakarzinom : Erfahrungen im Einsatz mit psychoonkologischen Screeningfragebögen.

BACKGROUND: Prostate cancer is the most common malignancy in men and accounts for most surgical procedures in uro-oncology. Stressful sequelae of radical prostatectomy are incontinence and erectile dysfunction. Hormone ablation and radiation therapy are also known stressors. Mental stress has a low prevalence compared to other tumor entities. It is highly probable that there is an underexpression of verbally reported emotional experiences. Therefore, a low-threshold access to psycho-oncological services and accurate identification of patients with mental comorbidities is important. The aim of this study was to identify the distress level with clarification of the stress in patients with prostate cancer. MATERIALS AND METHODS: Prospective evaluation of prostate cancer patients (n = 81, mean age 69 years) with regard to stress level, stress factors and the need for care using the Distress Thermometer, a standardized ultrashort stress-screening questionnaire. RESULTS: The mean stress level was 4.4 points. In total, 56% of patients indicated a stress level ≥5, i. e. a clinically relevant psychological burden was indicated. Main stressors were sexual problems (35%), reduced mobility (30%), pain (27.5%), tingling paresthesia (26%) and worries (26%). CONCLUSION: The psychological burden of prostate cancer patients is not as high as in other solid organ malignancies. However, some patients have a significantly increased psychosocial stress level. Identifying this subgroup and clarifying the correlation with specific stress and risk factors are important tasks of clinical care.

[Diagnosis-related groups for kidney transplantation]. / DRG für die Nierentransplantation.

Renal transplantation is a cost-effective form of renal replacement therapy which prolongs life and improves the quality of life. The representation in the German DRG system is, however, not cost-covering in all cases. Cost-effectiveness must also be considered in view of long-term transplant survival which relates to overall costs to the health care system and goes beyond hospital costs.

[The bought patient : The ethical value of per capita flat rates from a medical viewpoint]. / Der verkaufte Patient : Zum ethischen Wert von Kopfprämien aus medizinischer Sicht.

Payments received by private physicians per patient sent for hospital treatment are a relatively new phenomenon in the German medical system. This practice has been made possible by the currently aggressive competition between hospitals. The practice of such regular payments has several legal as well as ethical aspects. It needs to be clarified whether and in which cases such payments constitute a justified fee for a valuable and necessary service or whether they simply represent an element of corruption which is used to generate case numbers in a competitive market situation.