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HEALTH

Bundestag votes to reform law that bans doctors from ‘advertising’ abortion

The German Bundestag has approved a reform of the Nazi-era law that bans doctors from providing information on abortions.

Bundestag votes to reform law that bans doctors from 'advertising' abortion
Campaigners for the removal of paragraph 219a. Photo: DPA

But the controversial paragraph 219a will not be abolished, despite calls by politicians and pro-choice campaigners.

A total of 371 members of parliament voted in favour of the reform, 277 were against and four abstained, German media reported.

SEE ALSO: Explained: Germany's plans to change controversial abortion laws

SEE ALSO: What you need to know about the abortion law battle that divides Germany

The reforms stipulate that doctors may inform members of the public, on their websites for example, that they carry out terminations of pregnancies. If people want further information, however, they must refer to authorities, advice centres and medical associations.

In addition, the German Medical Association (Bundesärztekammer) is to keep a list of doctors who offer abortions. A study on the psychological effects of abortions is also planned, reported Zeit.

The coalition, made up of the centre-right CDU/CSU and centre-left SPD had already reached an agreement dubbed the “compromise” to relax abortion laws.

This was read by many as a defeat for the SPD, as they had previously wanted to completely scrap the paragraph, a demand backed by leftist opposition parties the Greens and The Left (Die Linke).

German law allows abortions but effectively discourages them through various hurdles, including the law in question, article 219a, which dates to May 1933, shortly after Hitler assumed full powers of Nazi Germany.

According to the Federal Statistical Office, around 101,000 pregnancies were terminated in Germany in 2017.

Chancellor Angela Merkel and the AfD's Beatrix von Storch vote in the Bundestag on Thursday. Photo: DPA

Hänel's actions would still be illegal

Last year Gießen doctor Kristina Hänel was fined €6,000 for breaking the law by publishing information on abortion services on her website.

As reported in The Local, it is likely that under the reforms, Hänel's actions would still be illegal.

Pro-choice campaigners say the softening of the ban is not enough and that the clause should be completely scrapped.

SEE ALSO: Five things to know about abortion in Germany

They say that the changes to paragraph 219a still mean that women are still not trusted to make their own decisions with readily available information.

The Hänel case revived debate in Germany and among the coalition government led by Chancellor Angela Merkel's conservative Christian Democrats.  

Strict conservative and Catholic Annegret Kramp-Karrenbauer, who took over as leader of the CDU in December, has spoken out in favour of keeping the law in place.

'Women's expectations massively disappointed'

Reaction to the vote has been mixed.

The Union praised the reform as a successful compromise. Deputy faction leader of the CDU/CSU, Nadine Schön, said it was a good compromise between the different positions, reported Zeit.

It is important to the CDU/CSU that the advertising ban is not scrapped, she said: “In this way we make it clear that an abortion is not a medical service like any other,” she added.

Beatrix von Storch, deputy faction leader of the far-right Alternative for Germany (AfD), described the reform in the Bundestag as “impertinence”.

With the compromise, the CDU/CSU had abandoned its own values, she said. Storch called abortions illegal and demanded that the government protect “unborn life” and added that the reform of paragraph 219a would normalize abortions.

Free Democrats MP Nicole Bauer accused the coalition of using the issue as a power play in politics, saying the SPD and Union had postponed the reform for far too long. In addition, the compromise continues to discriminate against women and criminalize doctors, she said.

“They have massively disappointed the expectations of women in this country,” said The Left politician Cornelia Möhring. Information on abortions remains limited and women would continue to be reprimanded and the mistrust of doctors would continue, she added, saying that paragraph 219a continues to equate advertising with information.

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HEALTH

What you should know about Germany’s plans to roll out e-prescriptions

Germany is taking a big step towards a more digital-friendly health system, with plans to roll out e-prescriptions nationwide. Here's what you should know.

A person holds the e-Rezept app in a pharmacy in Oldenburg, Lower Saxony.
A person holds the e-Rezept app in a pharmacy in Oldenburg, Lower Saxony. Photo: picture alliance/dpa | Mohssen Assanimoghaddam

What’s happening?

From January 1st 2022, people in Germany will receive their prescriptions digitally (known in Germany as an ‘e-Rezept’) from healthcare providers.

Patients should be able to get their prescription from their doctor via a QR code sent to an app, which can then be transmitted to a pharmacy. The pharmacy can then let the patient know whether their medicine is in stock (or if they want to order it), and when it is ready for collection. 

This model is to be mandatory for people with statutory health insurance from the start of 2022, replacing the good old paper prescription.

However, the QR code can also be given to the patient by the doctor on a piece of paper if a patient does not have access to or doesn’t want to use a smartphone. 

READ ALSO: The changes around doctors notes in Germany you should know 

How exactly will it work?

In theory this is the plan – you’ll visit the doctor or have a video consultation. After the examination, the doctor will issue you with an electronic prescription for the medication that has been prescribed to you. 

A prescription code is automatically created for each ‘e-Rezept’, which you will need so you can get the medicine at the pharmacy. As we mentioned above, patients in Germany can either open this QR code in the free e-prescription app developed by Gematik and the Health Ministry, or receive it as a printout from the doctor. 

Next, you can take the prescription QR code (either in the app or as a printout) to your pharmacy of choice to get the medication needed.

One of the major differences and timesavers under the new system is that you can also select the pharmacy you want to get the prescription from digitally, order the medication (if needed) and you’ll be alerted when the prescription is ready. You can also arrange to have it delivered if needed. 

A doctor’s signature is not required, as e-prescriptions are digitally signed. 

The aim is that it will save on paperwork, time at the medical office and trips to the pharmacy. 

Some patients have already been receiving digital prescriptions. The ‘e-Rezept’ was tested out successfully in selected practices and pharmacies with a focus on the Berlin-Brandenburg region of Germany. The test phase started on July 1st this year.

Pharmacies and doctors’ offices nationwide have also been given the opportunity to test the new system from the start of December. 

“This will enable practice providers and pharmacy management systems to better prepare for the mandatory launch on January 2022 1st,” said aponet.de, the official health portal site for German pharmacies

The new e-prescription app.
The new e-prescription app. Photo: picture alliance/dpa | Mohssen Assanimoghaddam

READ ALSO: 10 rules to know if you get sick in Germany

There is some leeway though – if there are technical difficulties, paper prescriptions can still be issued in individual cases until the end of June next year.

The National Association of Statutory Health Insurance Physicians estimates that it could take until mid-2022 until all users are equipped with e-prescription applications nationwide.

The obligation does not apply to privately insured people from January next year. Private insurance companies can decide voluntarily to make the preparations for their customers to use the e-prescription.

What’s this about an app?

To be able to receive and redeem prescriptions electronically, people with statutory health insurance need the Gematik ‘das e-Rezept’ app. 

One issue is that the app appears to only be available at the moment in German app stores. We’ll try and find out if there are plans to change this and widen out the access, but it seems likely for that to happen. 

Germany’s Covid-Warn app, for example, was initially only open to German app stores but was gradually widened out to many others. 

As mentioned above though, those who don’t have access to an app will be able to use the paper with the code on it to access their prescriptions. 

READ ALSO: Everything you need to know about making a doctor’s appointment in Germany

Has it all gone smoothly?

As you might expect, there have been a few hiccups. 

Originally, the introduction nationwide was planned for October but was postponed due to many providers not having all the tech requirements set up. 

Now though, more than 90 percent of the practice management systems have been certified by the Association of Statutory Health Insurance Physicians – a prerequisite to issue the e-prescriptions.

The e-prescription is part of Germany’s far-reaching plans to digitise and streamline the health care system.

The head of Gematik GmbH, Markus Leyck Dieken, recently spoke of a “new era” that is “finally starting for doctors and patients” in Germany. 

Useful vocabulary:

Prescription – (das) Rezept

Doctor’s office/practice – (die) Arztpraxis

To order – bestellen 

Pharmacy – (die) Apotheke

Video consultation – (die) Videosprechstunde

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