An organ transplant can be life-saving and can significantly improve the recipient’s quality of life. Apart from the medical questions, numerous legal and ethical aspects need to be taken into account.
In deceased organ donation, it is essential to determine death in a reliable manner, to respect the wishes of the deceased person, and to support the relatives during this difficult time.
In May 2022, the Swiss citizens approved the principle of presumed consent with regard to organ donation. The respective updated law is expected to enter into force 2025.
Medical-ethical guidelines on organ transplantation
The SAMS guidelines «Determination of death with regard to organ transplantation and preparations for organ removal» (2017) provide technical instructions for the determination of death and the performance of preparatory medical measures. However, they also cover in detail many other aspects of deceased organ donation, such as the procedure for ascertaining the patient’s wishes, discussions with relatives, guidance for difficult decision situations, and management of the dying patient and the cadaver. Given the changeover to the presumed consent, the guidelines need to be updated. To this end, a subcommittee has been created that currently revises the guidelines.
The removal of an organ from a living donor, i.e. living donation, represents a breach of personal and physical integrity and is only legally permissible with the donor’s explicit consent. Special importance attaches to the provision of comprehensive information to enable informed consent. In particular, it must be ensured that the donor’s decision is voluntary. The SAMS guidelines «Living donation of solid organs» (2023) provide guidance for physicians and treatment teams involved in the medical and psychosocial assessment of donors and in their aftercare.