Physicians accompanying forced returns and assessing returnees’ fitness for transport assume an expert function. Physicians have a different role when providing medical care for patients in pre-deportation detention: they determine whether there are any contraindications to a planned forced return, but are not responsible for assessing fitness for transport.
In October 2013, the Central Ethics Committee (CEC) of the SAMS published an opinion on the medical aspects of forced returns, calling for a change to the existing «fit-to-fly» system. This was criticised because of the pressure placed on physicians to assess fitness for transport and the inadequate exchange of information between the medical professionals involved.
Since April 2015, the decision on whether a person in pre-deportation detention is fit to travel is no longer made by the attending (prison) physician, but by the physician accompanying the returnee on the flight. However, the attending (prison) physician determines whether there are any contraindications to a forced return and reports these findings, provided that he/she has been released from the duty of confidentiality. For this purpose, the prison physician refers to the list of medical contraindications to forced return by air (available in French/German; download below). This document lists the most important diagnoses regarded as contraindications for air travel.
A form for reporting contraindications – prepared by the Swiss Medical Association (FMH), the SAMS and the Conference of Swiss Prison Doctors (KSG) – is now available («Medical report in cases of return/enforcement of removal orders»; download below). This takes account of the necessary division of roles between the prison physician and the accompanying physician.
List of contraindications and medical report form
The (prison) physician may only report contraindications with the patient’s consent. If the patient withholds consent, even though contraindications exist, the competent authorities may, on request, release the physician from his/her duty to maintain confidentiality. The procedure is described in detail in Appendix G to the guidelines on «Medical practice in respect of detained persons».
For more information, please visit the State Secretariat for Migration (SEM) website (in German).