Swiss Guidelines on Care of the Dying

In November 1976 the Swiss Academy of Medical Sciences issued guidelines on caring for the dying. The guidelines themselves are brief and stress the physician's duty to offer personal support and care as well as medical treatments. As for discontinuing treatment, the physician should abide by the will of the competent patient; in the case of the incompetent or unconscious patient, relatives should be consulted but “the final decision belongs to the physician,” acting on what he presumes is the patient's desire. Reprinted here is a translation of the accompanying Commentary on these guidelines, which repeats and elaborates the original points. The guidelines propose wide discretionary powers for the physician, under the rubric of gestion sans mandat or Geschäftsführung ohne Auftrag , a Swiss legal category providing for urgent interventions on behalf of someone unable to give consent. At the same time, the role of the family or next‐of‐kin is relatively diminished. As the unilateral statement of a medical association, these guidelines have no apparent legal force; but they may well be taken into consideration by Swiss courts deciding difficult cases.