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⚖️ Patient rights and second opinion

Since the Patientenrechtegesetz (Patients' Rights Act), key rights in the treatment relationship are regulated in the BGB: information, consent, access to records – and, for certain planned procedures, a claim to an independent medical second opinion.

Patientenrechtegesetz Treatment contract Duty to inform Access to records Second opinion § 630a BGB § 27b SGB V

In brief

Since the Patientenrechtegesetz of 2013, the key rights in the relationship with doctors and clinics have been expressly regulated in the Bürgerliches Gesetzbuch (German Civil Code, §§ 630a to 630h BGB): the right to understandable information, effective consent, careful documentation and access to your own treatment records. In addition, people with statutory health insurance have, for certain planned procedures, a claim to an independent medical second opinion before deciding (§ 27b SGB V).

Step by step

  1. Insist on being informedBefore any treatment you are entitled to understandable, timely information about the diagnosis, treatment alternatives and risks.
  2. Give or refuse consent consciouslyWithout your effective consent, a procedure is in principle not permitted; you can also refuse treatment.
  3. Check for a second opinion on planned proceduresFor certain planned procedures prone to over-use (e.g. certain operations), you are entitled to an independent second opinion funded by the insurer before deciding.
  4. Request access to your recordsYou can at any time request access to your complete treatment records without delay, also electronically, and have copies made.
  5. Seek support if you suspect a treatment errorIf you suspect a treatment error, you can ask free of charge for an expert opinion from your health insurer or the Medizinischer Dienst, or turn to a patient advice centre.

Deadlines

without delay
Right of access to patient records, in principle without culpable delay after the request§ 630g BGB
Watch out – common mistakes
  • The right to a second opinion under § 27b SGB V applies only to the procedures prone to over-use specified by the Federal Joint Committee – not across the board to every treatment. Which procedures these are specifically changes with G-BA decisions.
  • The burden of proof in treatment errors lies in principle with the treated person; only in the case of gross treatment errors is the burden of proof reversed under § 630h BGB.
  • A second opinion does not replace the decision of the treating practice but serves your own informed decision.
In depth · legal basis, figures and practice – for advisers and professionals

Treatment contract law in the BGB

With the Patientenrechtegesetz (in force since 26 February 2013), §§ 630a to 630h were inserted into the BGB and expressly regulate the treatment contract: duties of the treating party (§ 630a), duties to cooperate (§ 630c), consent (§ 630d), duties to inform (§ 630e), duty to document (§ 630f), right of access to patient records (§ 630g) and burden of proof in liability (§ 630h).

Right to a second opinion

§ 27b SGB V gives people with statutory health insurance the right to obtain an independent medical second opinion before certain planned procedures specified by the Federal Joint Committee in the Zweitmeinungs-Richtlinie. The costs are borne by the health insurer; the transmission of necessary findings to the practice giving the second opinion is also funded by the insurer (§ 27b Abs. 5 SGB V).

Burden of proof in treatment errors

In principle, the patient must prove a treatment error and its causality for harm. In the case of a gross treatment error, the burden of proof for causality is reversed in favour of the patient under § 630h Abs. 5 BGB.

Who is responsible
  • Treating practice or clinic
  • Statutory health insurer (second opinion, expert opinion if a treatment error is suspected)
  • Patient advice centres
Further reading
Advice and contact pointsAids and appliances and therapies: prescription and cost coverage

Quick questions

Worum geht es bei „Patient rights and second opinion“?
Since the Patientenrechtegesetz (Patients' Rights Act), key rights in the treatment relationship are regulated in the BGB: information, consent, access to records – and, for certain planned procedures, a claim to an independent medical second opinion.
Which deadlines and figures matter?
without delay: Right of access to patient records, in principle without culpable delay after the request (§ 630g BGB)
What should I do first?
  • Insist on being informed: Before any treatment you are entitled to understandable, timely information about the diagnosis, treatment alternatives and risks.
  • Give or refuse consent consciously: Without your effective consent, a procedure is in principle not permitted; you can also refuse treatment.
  • Check for a second opinion on planned procedures: For certain planned procedures prone to over-use (e.g. certain operations), you are entitled to an independent second opinion funded by the insurer before deciding.
What do I need to watch out for?
  • The right to a second opinion under § 27b SGB V applies only to the procedures prone to over-use specified by the Federal Joint Committee – not across the board to every treatment. Which procedures these are specifically changes with G-BA decisions.
  • The burden of proof in treatment errors lies in principle with the treated person; only in the case of gross treatment errors is the burden of proof reversed under § 630h BGB.
  • A second opinion does not replace the decision of the treating practice but serves your own informed decision.
Evidence
  • §§ 630a–630h BGB (gesetze-im-internet.de)
  • § 27b SGB V (gesetze-im-internet.de)
  • Zweitmeinungs-Richtlinie of the G-BA (g-ba.de)
As of

As of: September 2026. · Sources and method

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