BACKGROUND: In Germany, police custody is used to prevent danger. An arrested person’s medical fitness for police custody must be assessed by a physician if it is in doubt. The frequency of such examinations among arrested persons in Germany ranges from 5.5% to 66.0%. There are currently no binding guidelines for the assessment of fitness for police custody.

METHODS: Current police custody regulations across Germany were obtained from the internet and from the interior ministries of the German federal states. Epidemiological features and risk profiles were determined from relevant publications retrieved by a selective search and from the authors’ own current data. Practical recommendations were derived from this information.

RESULTS: Regulations concerning police custody vary widely across German states. The main indications for medical assessment are intoxication (36.8–65.7%) and withdrawal syndromes (14.4–24.7%). Medical assessment usually results in a determination of unrestricted fitness for police custody (32.5–64.6%) or of restricted fitness subject to certain conditions (16.7–75.4%). Mental illness (21.7–25.0%) is a common reason for being unfit for police custody.

CONCLUSION: In Germany, no particular individual or body is specified by law as being responsible or qualified for assessing fitness for police custody. When such an assessment is to be made, the state regulations should be known, and a state-specific assessment form and certificate of fitness for police custody should be developed if the legal basis is inadequate. A standard operating procedure (SOP) should be created for use in hospitals as well. It should be stated in the certificate whether the person in question is fully fit for police custody, fit for police custody with restrictions, or unfit for police custody.