Table 4 Legal consequences of a contraindication of nitrous oxide

From the perspective of legal economics, it should be noted that anchoring a medical contraindication of nitrous oxide in the guidelines of anaesthesiologic professional societies can lead to health care providers refraining from its use to avoid liability risks.[1] The reason is that professional guidelines indirectly influence the assessment of the medical standard according to which treatment must be carried out to avoid claims for damages (in Germany: section 630a (2) of the German Civil Code). In addition, effects on financing law in the area of statutory and private health insurance are to be expected in the medium term, as the determination of standards in these legal fields follows comparable criteria with regard to the necessity of a medical intervention.[2] As an effect, a significant emission reduction through nitrous oxide would be probable.

[1] Cf. Prütting, J. (2020). Rechtsgebietsübergreifende Normenkollisionen (Conflicts Of Norms Across Legal Fields), Mohr Siebeck, pp. 256, 259

[2] Section 2 (1) sentence 3 and section 12 (1) of Book V of the German Social Code as well as section 192 (1) of the German Insurance Contract Act; cf. Peters (2021), Kasseler Kommentar zum Sozialgesetzbuch V (Kassel Commentary on Book V of the Social Code), C.H.Beck, section 2, margin note 4; Kalis (2017), Münchener Kommentar zum Versicherungsvertragsgesetz (Munich Commentary on the Insurance Contract Act). 2nd edition. C.H.Beck, section 192, margin note 23 et seq.