ICF and the Term "Substantial Disability" in the German Bundesteilhabegesetz (BTHG)

Abstract

The new law, called "Bundesteilhabegesetz" was rapidly approved by the German legislative institutions in December 2016. It was supposed to be a milestone demonstrating the change from paternalistic care to the right of autonomous participation in all parts of social life. This new law sought to offer new ways, but actually there remains a big space for interpretations in the implementation. The law proposal wanted to claim 5 from the nine areas of life from the ICF. That was not accepted. Until December 2019 there must be found a definition of "substantial disability". It must be clear, that this is no mathematical aspect. Each medical officer/doctor gives his expert decision to his best knowledge and belief. No other instrument would really respect the human dignity and could better guarantee justified social personal support. It must closely be observed until the year 2023 what will be realized in the implementation of this law. Each wrong headed development, which possibly prioritize financial aspects, should be acutely opposed. In this part all medical directors/doctors are required not only in the social medical but in the social political discussion, too.