National Preventive Mechanism to self-determination. With the coming into force of the Parent and Child Amendment Act (Kindschaftsrechts-Änderungsgesetz) 2001, consent to a medical treatment by minors who have reached the age of discretion was regulated by Section 173 of the Austrian Civil Code; in case of doubt, the legislators presume that 14-year-olds have the necessary cognitive faculties and power of judgement. Administration of medication by undertaken by laypersons is permissible with the consent of minors, if specialist medical or nursing knowledge need not be presumed to ensure that this task is properly carried out. The decision of whether the administration of certain medicines, considering their composition and effect, may be carried out by laypersons is up to the prescribing doctors. In the interest of the minors, it is then even more important that instructions by a doctor with regard to time, number of pills, form and dosage of the medication be clear and unambiguous. Off-lable use The use of psychotropic drugs, neuroleptics and anti-psychotic drugs, which have not been approved for children, is particularly sensitive. They are prescribed off-label, which doctors may do, if – according to state-ofthe-art knowledge – the intended therapeutic success presumably cannot be achieved by another method. When these drugs are being administered, strict psychiatric monitoring and observation of any side-effects are immensely important. Under no circumstances may use of such drugs be increased due to staff shortages and tight staffing resources, as long-term damage and resulting consequences cannot be predicted. Prescription for PRN medications According to the Federal Ministry of Health, the administration of PRN medication by social pedagogues, which was objected to by the commissions, is also not permitted. Social pedagogues do not acquire any basic nursing knowledge during their training. Therefore – as opposed to the social services professions, whose training takes place on the statutory basis of health and nursing care in accordance with Section 3a of the Healthcare and Nursing Act – they are prohibited from access to training modules on basic care and assisting in intake of medication under the supervision of qualified health care and nursing staff. Anyone who undertakes a higher level health care or nursing activity without being authorised to do so under the Healthcare and Nursing Act or another statutory provision is punishable under the law (Section 105 of the Healthcare and Nursing Act). ¾¾ Negligent handling of medication ¾¾ Particular caution with regard to drugs being used off-label. ¾¾ PRN medication may not be administered by pedagogic staff. 108