In June 2012, the German Federal Court of Justice (Bundesgerichtshof, BGH) dealt with the question of coercive treatment according to the guardianship law. The results showed no legal foundation for coercive treatment of patients who lack the ability to form an opinion due to their condition. As a consequence of that lack of ability those patients might not be able to understand the acute necessity of treatment. This situation usually occurs when dealing with patients who are unable to make a decision on the need for treatment because they are suffering from a mental illness. Since any use of coercion resembles a massive infringement of both the patient’s mental and physical integrity this use of coercion must be justified not only from a medical but also from an ethical and legal perspective. As a result of that the Parliament of the Federal Republic of Germany (Bundestag) created a legal foundation for coercive medication called “Law Regulating the Consent to Coercive Medical Treatment” on 17 January 2013. In accordance to the new regulation there are high legal obstacles to be overcome by a coercive treatment. This aims at protecting the patient’s self-determination. First of all his or her consent to the treatment is to be requested. Secondly treatments are only to be considered necessary if they can prevent major harm which the patient would be in danger of if he or she was not treated. This does not compromise the patient’s option of deciding on the way he or she wants to be treated in advance in case he or she might temporarily be incapable of making decisions. In the event of a patient suffering from psychiatric disease making use of a specifically designed psychiatric advance decision is recommended. Wearing a “crisis ID” or predetermining a treatment agreement can be helpful to identify the patient’s volition in an emergency situation (suitable i.e. for psychotic patients). There have been ethical guidelines for medical behavior during a coercive treatment of patients who are suffering from a psychiatric illness put forward by the Central Ethics Commission of the German Medical Association.