CPR decisions and their consequences involve considerable stress for all concerned. To support healthcare professionals, the SAMS issued medical-ethical guidelines in 2008. These offer guidance for discussions with patients and relatives about resuscitative measures and provide an ethical framework for decision-making in various situations. These guidelines are currently being revised.
The currently applicable SAMS guidelines on «Decisions on cardiopulmonary resuscitation» were first published in 2008. In 2012, they were adapted to reflect the revisions to the Swiss Civil Code which came into force on 1 January 2013, but without any other substantive amendments. Following the adoption of the SAMS guidelines on «Intensive-care interventions» and «Management of dying and death», and in the light of new developments, further revision is now required. The SAMS Central Ethics Committee (CEC) has appointed a subcommittee which began work on the revision of the guidelines in December 2018.
Mandate of the subcommittee
Start of work: December 2018
The guidelines are to be revised in accordance with the latest scientific knowledge. To update the relevant data on the results of cardiopulmonary resuscitation, the SAMS commissioned Cochrane Switzerland to conduct an evidence synthesis. This report provides the basis for the subcommittee’s work. The guidelines will additionally cover new developments such as «NO CPR» stamps, tattoos, etc., and the management of CPR requests which are not appropriate from a medical viewpoint. New advance care planning (ACP) approaches for emergencies are also to be included in the updated guidelines.
The public consultation of the revised draft medical-ethical guidelines «Decisions on cardiopulmonary resuscitation» (available in French and German) ran from 11 December 2020 until 11 March 2021.
The comments submitted by professional societies, organisations and interested individuals are currently being examined and will be taken into account in the final version of the guidelines. These will undergo a multi-stage quality assurance procedure and will finally be approved by the SAMS Senate. The publication of the revised guidelines is planned for the end of June 2021.
Members of the subcommittee
Professor Reto Stocker, Zürich, Intensive Care Medicine (Chair)
Beat Baumgartner, Spiez, Paramedic Care
Luk de Crom, Affoltern am Albis, Nursing/Rehabilitation
PD Dr Karin Diserens, Lausanne, Neurorehabilitation
Dr Gudrun Jäger, St. Gallen, Paediatrics
Professor Tanja Krones, Zürich, Ethics
Angelika Lehmann, BNS, Basel, Intensive Care Nursing
Nicole Rapin Christen, Zürich, Swiss Patient Organisation
Professor Bara Ricou, Genève, Intensive Care Medicine
Dr Fabio Rigamonti, Genève, Cardiology
lic. iur. Michelle Salathé, MAE, Basel
Professor Jürg Steiger, Basel, CEC Chair (until December 2020)
Professor Andreas Stuck, Bern, Geriatrics
Professor Marc Thommen, Zürich, Law
Professor Wolfgang Ummenhofer, Basel, Emergency Medicine