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.
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-of-the-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.
Off-label use
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).
Prescriptions for PRN
medications
Negligent handling of medication
Particular caution with regard to drugs being used off-label.
PRN medication may not be administered by pedagogic staff.
2.3.2.4 Expansion of assistance for young adults necessary
During their visits to facilities, the commissions are regularly informed
about problems that arise when the young adults under care reach
their majority. Under the Children’s and Youth Service Act 2013 and the
implementation laws of the Laender, once majority has been reached,
there is no legal entitlement to assistance from child and youth welfare
organisations. In the consultation process with the Laender, clear
58
Entitlement to
assistance ends at the
age of 18
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