„Medizinische Notwendigkeit“: Herausforderungen eines unscharfen Begriffs

Translated title of the contribution: “Medical necessity”: challenges of a fuzzy concept

Bettina Schöne-Seifert*, Daniel R. Friedrich, Anke Harney, Stefan Huster, Heiner Raspe

*Corresponding author for this work


Definition of the problem: “Medical necessity” (MedN) is the central regulatory concept for decisions about which services are covered by German statutory health insurance. Despite its seeming objectivity and dependence on physicians’ expert judgment, the concept is by no means clearly defined. Arguments: In this first of five planned papers on the conceptual analysis of MedN from the perspectives of philosophy and ethics of medicine, law, and (social) medicine, the focus lies on systemizing ongoing controversies. Conclusion: Our goal is to come up with a so far missing foundation for detailed debates. We aim to clarify MedN’s conceptual structure, function, contextuality, and ambiguities as well as the fundamental limits of conceptual investigations for the normative questions at issue of regulating medical services.

Translated title of the contribution“Medical necessity”: challenges of a fuzzy concept
Original languageGerman
JournalEthik in der Medizin
Issue number4
Pages (from-to)325-341
Number of pages17
Publication statusPublished - 01.12.2018

Research Areas and Centers

  • Research Area: Center for Population Medicine and Public Health (ZBV)


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