Inheritance disputes often end up in court.

A curious deal between a now-deceased man and his family doctor is currently before the Federal Court of Justice (BGH) in Karlsruhe. In return for medical advice and treatment, the man promised his doctor a piece of land after his death. Germany's highest civil court is now examining whether this agreement is legal.

In January 2016, the later testator and the family doctor from North Rhine-Westphalia entered into a "care, support, and inheritance agreement" before a notary. One of them committed to providing medical services such as home visits and telephone availability, while the other guaranteed him ownership of a property he owned after his death. Two years later, the patient died.

When the family doctor subsequently went bankrupt, the insolvency administrator wanted the promised property transferred to the insolvency estate. However, he was unable to enforce this in court. The Bielefeld Regional Court dismissed the lawsuit, and the appeal to the Hamm Higher Regional Court was also unsuccessful.

The problem: The professional code of conduct of the relevant Westphalia-Lippe Medical Association states that physicians may not request or accept gifts or other benefits if doing so creates the impression that their medical independence would be compromised. The courts ruled that the family doctor violated this rule with the agreement regarding the property. The legacy is therefore invalid.

The regulation originates from the German Medical Association's model professional code, which is voted on and adopted at the German Medical Association. While this code is not binding in itself, the majority of state medical associations have implemented the model regulation on unauthorized gifts in one form or another in their own professional code, explains the German Medical Association.

The medical profession recognized early on that a very special relationship exists between them and the patients they treat, says Torsten Münnch, a specialist lawyer for medical law. After all, sick patients depend on medical treatment—and the success of that treatment, in turn, depends significantly on the patient's trust in the doctor. Therefore, doctors imposed ethical rules on themselves early on.

For example, the regulation on gifts and donations, which will be discussed in Karlsruhe on Wednesday. It's important that this standard doesn't depend on whether there is actually any influence, Münnch emphasizes. "It only matters whether the impression is created that the independence of the doctor's decision is being influenced." A bouquet of flowers probably doesn't reach the limit – "but the value at stake here is very high."

Violations of the professional codes of conduct of the medical associations are often monitored and punished by the associations themselves, according to Münnch. "Only if the association wishes to impose a serious measure, such as a fine, does it have to initiate disciplinary proceedings." Therefore, there have been few court decisions on the issue to date – and these usually relate to gifts from the pharmaceutical industry rather than from patients.

However, the Federal Court of Justice case has another unique feature, says Münnch. Namely, that the property was promised as part of an inheritance contract, not in the patient's will. The freedom of testamentary conduct, protected by the Basic Law, states that one is generally entitled to decide for oneself what happens to one's own property, even in the event of one's death. Referring to this, the Frankfurt Higher Regional Court ruled in another case two years ago that a will in which a man bequeathed a piece of land to his doctor was valid.

The plaintiff, the insolvency administrator of the family doctor, also relied on the Frankfurt ruling in the current proceedings, according to Münnch. "But that argument didn't hold water because we don't have a will here, but rather a contract in which the patient commits to something." The Karlsruhe court will now determine whether the Federal Court of Justice shares the assessment of the lower courts. Whether a ruling will be issued on Wednesday remains unclear.