Organ transplantation is an established and promising form of treatment that does, however, place considerable strain on the people affected, their family members and the medical team. Numerous legal and ethical aspects must be taken into account.
In the case of the transplantation of organs from deceased persons it is imperative from an ethical and legal perspective to establish death in a reliable and secure manner, to respect the wishes of the deceased person and to support their family members during this difficult time. Numerous ethical questions are likewise raised by living organ donation. The guidelines issued by the Swiss Academy of Medical Sciences (SAMS) explain the medical-ethical aspects in detail and thus provide guidance for doctors and medical teams.
Establishing death in the context of organ transplantation
Since 2007, the legal preconditions for organ transplantations have been laid down in the Federal Act on the Transplantation of Organs, Tissues and Cells (Transplantation Act). In order to establish death, the Transplantation Act refers to the following SAMS guidelines:
Living organ donation
Because of the stagnating number of donors in cases of death and improved prospects of success, the living donation of solid organs has gained importance. From an ethical point of view, three medical-ethical principles must be taken into account when it comes to living organ donation: beneficence, non-maleficence and patient autonomy.
These guidelines will be aligned with the revised Transplantation Act in 2018, with the experience of clinicians and their need for improvements to be taken into account as well. Furthermore, chapter 6 on psychosocial evaluations based on the latest research findings (in particular the multi-centre study «Psychosocial evaluation in potential living kidney donors in Switzerland») will be revised.