The Federal Act on the Transplantation of Organs, Tissues and Cells (Transplantation Act) specifies the legal requirements for organ transplantation. With regard to the determination of death, reference is made in the Transplantation Ordinance to the medical ethical guidelines of the SAMS. These guidelines are currently being revised, as new legislation will come into force following the referendum vote in favour of extending the presumed consent system.
The criterion for death given in the Act (French | German) is based on the neurological definition according to which a person is dead if the functions of his or her brain, including the brainstem, have ceased irreversibly or permanently, respectively. For the determination of death, the Transplantation Ordinance (French | German) makes reference to the SAMS guidelines «Determination of death with regard to organ transplantation and preparations for organ removal». The legislation thus makes, not the definition of death, but the procedure whereby death is to be determined, subject to the current state of medical science.
- Determination of Death with Regard to Organ Transplantation and Preparations for Organ Removal (2017) PDF, 2 MB
- Appendix F: Determination of Death with Regard to Organ Transplantation and Preparations for Organ Removal PDF, 511 KB
- Appendix G: Determination of Death with Regard to Organ Transplantation and Preparations for Organ Removal PDF, 532 KB
- Guidance on implementation, available in French PDF, 121 KB
- Guidance on implementation, available in German PDF, 94 KB
Revision of the guidelines
After the Swiss citizens approved the extended presumed consent proposal («erweiterte Widerspruchslösung»), the new legislation is expected to come into force in early 2027. By this date, the SAMS guidelines «Determination of death with regard to organ transplantation and preparations for organ removal» will also be revised. For this purpose, the Central Ethics Committee (CEC) of the SAMS has appointed a subcommittee with a broad interprofessional and interdisciplinary composition. On the one hand, this subcommittee identified the necessary changes with regard to the changeover to presumed consent. On the other hand, it examined which further adjustments to the guidelines should be made in light of practical experience, new medical developments, and in-depth ethical considerations.
Information on the process of drafting and revising guidelines can be found in the document «Formation Process of Guidelines».
Public consultation
In May 2023, the subcommittee began its work. In summer 2024, the draft text was submitted to a consultation process involving experts. The draft guidelines are now readily available for public consultation.
From 16 June to 19 September 2025, all interested institutions, organisations and individuals are invited to review the draft guidelines and provide feedback on the changes. The comments received will be reviewed and taken into account when finalising the definitive version.
Please submit your feedback no later than Friday, 19 September 2025 using the electronic form, to ethics@samw.ch. All necessary documents for the consultation are available in german and french.
Members of the subcommittee
Dr Mathias Nebiker, Aarau, Intensive Care Medicine (Chair)
lic. theol., dipl. biol. Sibylle Ackermann, SAMS, Ethics (ex officio)
PD Dr Vanessa Banz, Bern, Visceral and Transplantation Surgery
Natascha Böhmer, Zürich, Donor Care Management/Intensive Care
Prof. Dr Barbara Brotschi Aufdenblatten, Winterthur, Paediatric Intensive Care
Dr Christian Brunner, Luzern, Intensive Care Medicine
Prof. Miodrag Filipovic, St Gallen, SAMS Executive Board member, Intensive Care Medicine
lic. phil. Sibylle Glauser, Bern, Psychology
Dr Antje Heise, Thun, CEC member, Intensive Care Medicine
Prof. Samia Hurst, Genève, Ethics
Angelika Lehmann, Basel, Intensive Care Nursing
Prof. Paolo Merlani, Lugano, Intensive Care Medicine (until november 2023)
Dr Tanja Michel-Dillier, Sachseln, Representation by Relatives/Surrogate Decision-Making
Dr iur. Veronika Moser, FOPH representative, Law (observer)
Dr Jan Novy, Lausanne, Neurology
Dr phil. nat. Susanne Nyfeler, FOPH representative, Presumed Consent Project Management (observer)
Dr iur. Dario Picecchi, Luzern, Law
Prof. Hervé Quintard, Genève, Intensive Care Medicine/Neurocritical Care
Valentina Rinaldi, Lugano, Intensive Care Nursing (from november 2023)
Dr Marco Rusca, Lausanne, Intensive Care Medicine
Prof. Werner Z’Graggen, Bern, Neurology
Factsheet: Considerations concerning the system of presumed consent and the explicit consent system
To support forming an opinion, the SAMS had published a factsheet in view of the vote in May 2022. It offers ethical, medical and legal principles on transplantation medicine and on the presumed or explicit consent system.