The possibility of organ donation after assisted suicide raises complex ethical questions. The Central Ethics Committee of the SAMS has examined the challenges arising and also commissioned an assessment of the legal aspects. The central questions concern protection of the autonomy of all parties, the role of hospitals and health professionals, and possible effects on public confidence in medicine.
Hospitals occasionally receive enquiries regarding the possibility of organ donation following assisted suicide. Even though this question concerns only a small group of people – and organ donation after assisted suicide is not currently carried out at any transplantation centres – the Central Ethics Committee (CEC) of the SAMS considers it appropriate to reflect on the associated ethical and legal questions. Both assisted suicide and organ donation are established practices in Switzerland, each of which has been the subject of detailed discussion from the perspective of professional and medical ethics. For both areas, the SAMS has already published medical-ethical guidelines; see Deceased organ donation and Assisted suicide. However, if these two sensitive practices are combined, new and additional questions arise.
Questions of medical and professional ethics
In 2025, the CEC published a position statement examining the medical and professional ethical challenges arising in connection with organ donation after assisted suicide. The most important points relate to the protection of autonomy. On the one hand, the autonomy of the decision on organ donation would be assured to a greater extent than in other cases of deceased organ donation. On the other hand, the decision on assisted suicide could be influenced by a desire to save lives through organ donation. It is a requirement of medical and professional ethics to ensure that the framework for the decision-making process is such that no problematic incentives arise.
Also to be taken into account is the autonomy of medical personnel. The combination of assisted suicide with organ donation in no way alters the professional ethical principle that assisting suicide is not a medical act forming an integral part of the professional role. The CEC takes the view that these and other challenges require further discussion, and its position statement represents a contribution to this debate. The topic was discussed by CEC President Paul Hoff in an interview with the newspaper «Tages‑Anzeiger» (20 October 2025). Download the interview in French or in German.
Legal opinion examining compatibility with current law
Since organ donation after assisted suicide would have to be carried out at a transplantation or organ retrieval centre – and thus in a hospital – it needs to be determined whether this practice would be compatible with federal legislation and cantonal laws. A legal opinion was commissioned by the SAMS, to consider two questions in particular:
- Is assisted suicide in Swiss hospitals compatible with current law?
- What legal requirements are applicable for organ donation after assisted suicide?
The legal opinion also examines the roles, rights and duties of hospital staff and other actors concerned. In addition, it considers the question of whether the legally specified unnatural death procedure can be practicably implemented in compliance with current law if an organ donation is planned. Not least, the legal opinion explores the crucial question of whether medically assisted suicide with subsequent organ donation involves «selfish motives», which is prohibited under criminal law.
Development and findings of the legal opinion
The opinion is based on a literature review and a detailed analysis of the legal situation in Switzerland (federal and cantonal levels) and in selected countries (Benelux states, Canada and Spain), as well as internal hospital directives. The clinical perspective was taken into account via qualitative interviews conducted at four university hospitals, involving three to four experts from the disciplines of intensive care, transplantation medicine and ethics in each case.
The authors of the opinion note that, since no clear legal requirements concerning organ donation after assisted suicide are applicable either at the federal level nor in all cantons, legal uncertainties and differences remain. The opinion concludes that organ donation after assisted suicide is fundamentally compatible with current federal legislation – albeit subject to narrow provisos, including the following:
- appropriate measures to preserve the autonomy of a person having capacity who requests suicide;
- prohibition of the promotion by hospitals of organ donation after assisted suicide;
- clear separation between staff participating in assisted suicide and those involved in the organ donation process; and
- exclusion of benefits, i.e. the costs of assisted suicide would have to be borne by the person requesting suicide or by third parties not concerned with the organ donation.
Conclusions
The actual legal permissibility of organ donation after assisted suicide at a given hospital depends on the provisions of cantonal law and/or internal hospital directives. Insofar as regulations exist at all, different approaches are adopted by different cantons and hospitals: in some cases, assisted suicide is generally prohibited, while in others it is permitted and regulated – for example, assisted suicide may only be tolerated at a hospital if the person requesting suicide cannot reasonably be transferred home. In certain cantons and hospitals, staff are permitted to participate in assisted suicide as long as certain principles are complied with, while in others this is prohibited. As a general principle, based on freedom of conscience, staff cannot be obliged to participate in organ donation after assisted suicide.
It should also be noted that, while a person with capacity can decide, based on individual freedom, to end their own life, there is no entitlement to state assistance with suicide and no right to the possibility of organ donation after assisted suicide.
Recommendations of the CEC
With the publication of the CEC position statement (2025) and the legal opinion commissioned by the SAMS, the key points from an ethical and legal perspective have been presented, albeit without any claim to completeness. The CEC and the SAMS recommend that, before making any decisions on the introduction of organ donation after assisted suicide, hospitals should at least wait until it has been determined whether – and if so how – the legally and ethically required points could actually be complied with in practice.
Reflection on professional ethics
Even if appropriate arrangements for practical implementation were to be successfully made, challenges would remain. It should be borne in mind, for example, that the implementation of organ donation after assisted suicide would involve a medicalisation, amounting to a paradigm shift for assisted suicide in Switzerland. This would inevitably affect how health professionals perceive themselves in terms of professional ethics. So far, there has been little reflection on this matter by the professional groups concerned, but it would be indispensable.
Societal factors
The possibility of organ donation after assisted suicide could alter society’s perception of the work of physicians and nursing staff in hospitals and impair public confidence in the institution. It is difficult to predict whether and how society’s assessment of transplantation medicine would change overall. Even when it is not combined with assisted suicide, organ donation is a highly sensitive area. Societal debates on this topic are heavily shaped by personal attitudes. The current, basically positive view taken by a large proportion of the population – and by the considerable proportion explicitly consenting to organ donation – must not be rashly jeopardised.
Wider considerations of this kind need to be taken into account in the forthcoming detailed reflection process. In the coming years, the CEC will monitor how this question is discussed in professional circles and among the public and will continue to contribute its ethical reflections to the debate.