1. If the patient is totally incapacitated or incapable of expressing his consent a substitute consent is required. This subsitute consent may be given by the patient and his legal representative or the guardianship courts. When an incapacitated, mentally ill or retarded patient with sufficient discernment refuses to accept medical acts, the consent of the guardianship court is required, regardless of the consent of his legal representative.
2. If a patient who is not capable of expressing his consent has no legal representative or guardian-in-fact and is not communicating with these possible persons, the physician may start further medical interventions only after the guardianship court has given its consent, except in case of necessity.
3. If a legal representative of an incapacitated patient or a patient who is incapable to express his consent does not permit the physician to perform an operation or to apply a treatment method or diagnostic tests which create an aggravated risk for the patient, but which are necessary to remove a risk that endangers the patient's life or exposes him to possible grave bodily injury or other dangerous health disturbance, then the physician may perform such interventions with the consent of the guardianship court.
4. If a patient being of age with full capacity to enter into legal transactions is unconscious or incapable of expressing his consent consciously, the physician must obtain the consent of the guardianship court to perform the operation or to apply treatment methods or diagnostic tests which create aggravated risk for the patient, unless there are circumstances which aJJow him to act without such a consent, in an emergency. However, in the case of an ordinary examination or medical acts with an ordinary risk, it is sufficient to obtain the consent of the guardian-in-fact (for instance: the spouse, parents, brothers and sisters).

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