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The participation of doctors2 in coercive measures exercised by the police, in particular during the deportation of illegal aliens from Switzerland, has given rise to serious public concern. With a view to responding to the expectations of the different circles involved, the Swiss Academy of Medical Sciences (SAMW) has drawn up guidelines for doctors who might be asked for their active cooperation in this sensitive domain, in which the boundaries of ethical behaviour may easily be overstepped. More generally, specific aspects of the medical treatment of persons in police custody or held in a prison establishment have also been examined. The fact that there exist in Switzerland various codes of criminal procedures and cantonal regimes for the execution of sentences does not facilitate the establishment of such guidelines. If the detained person suffers from a mental disorder, the complexity of the laws on guardianship – currently under revision at the federal level – further complicates the situation. Concerning the last point it must also be noted that unfortunately there is a severe lack in penal institutions3, appropriate – in the sense of the Swiss Penal Code (SPC) – for the accommodation of such persons, as well as a lack of suitably trained medical (and socio-therapeutic) personnel. Against this complex background, the SAMW now submits guidelines which, while being largely inspired by international recommendations for the provision of care to detainees, make no claims to have dealt with the subject in an exhaustive way. In particular, the general question of means of restraint in the psychiatric domain or of emergency measures in somatic medicine, are not treated. However, the SAMW has already set up a new subcommittee to draft guidelines concerning persons deprived of their liberty for the purpose of receiving assistance on purely medical grounds (in the sense of art. 397a and ss., Swiss Civil Code). The SAMW is fully aware that part of these guidelines on the exercise of medicine in respect of detained persons is concerned with tasks incumbent on the administrative and executive authorities, as well as on the legislators of our country. Where this is the case, they can only be applied conditionally and mainly serve the purpose to make known the views of the medical profession on this subject. 136 Medical-ethical guidelines

The exercise of medical activities in respect of detained persons