Doctors who accompany people being forcibly deported and assess their fitness to travel act in an expert role. Doctors who treat patients in detention pending deportation have a different role as, in the context of a planned forcible deportation, they identify any contraindications which would present an obstacle to deportation, but they are not responsible for assessing the patient's fitness for travel.
The Central Ethics Committee (CEC) published a statement in October 2013 on the medical aspects of forcible deportations and called for a change to the system by abandoning the "Fit to Fly" scheme. It was criticised because of the pressure on doctors to assess patients for medical fitness to travel and the inadequate exchange of information during this process between the medical professionals involved.
Since April 2015, the decision as to whether people in detention pending deportation are fit to travel is no longer made by the attending doctor in the detention centre, but instead by the doctor who accompanies them on the flight. However, the attending doctor (in the detention centre) assesses whether there are any contraindications that would present an obstacle to deportation and passes on any findings, provided that he or she has been released from his or her duty of confidentiality.
The doctor in the detention centre has access to the list of contraindications to forcible deportation by air. This document (available in French and in German) contains the most important diagnoses which are relevant for air travel.
A document for communicating contraindications is now available with the updated form for medical reports in cases of return/enforcement of removal orders, which has been prepared by the Swiss Medical Association (FMH), Swiss Academy of Medical Sciences (SAMS) and the Swiss Conference of Prison Doctors (KSG). This takes account of the necessary division of roles between the doctor in the detention centre and accompanying doctor.
The doctor in the detention centre may only pass on information about any contraindications with the patient's consent. If the patient refuses to release the doctor from doctor-patient confidentiality, even though contraindications are present, the superior authority can release the doctor from their duty of confidentiality upon request. The procedure is described in detail in Appendix G to the SAMS Guidelines "Medical practice in respect of detained persons".
For more information, please visit the State Secretariat for Migration (SEM) website (in German).