There is a large disparity between the number of people who state they support organ donation and the number of people who actually register as organ donors. Research has uncovered different reasons for this: mistrust of medical professionals, misconceptions about “brain death”, incorrect information through TV shows and movies, religion and not to underestimate the uncomfortable feeling or the unwillingness many have to talk about death. And there is the lack of information on how to become an organ donor, how to inform relatives about such a decision, too complicated means to become an organ donor and of course legal questions. For non-natives and expats living in Switzerland, there is the additional language barrier. This post looks exclusively at the situation in Switzerland to enable a better understanding of the situation in our host country and show the ways to become an organ donor here.
According the the swisstransplant website, “all organ donations and transplantations are regulated by the Federal Act on the Transplantation of Organs, Tissues and Cells (in short: Transplantation Act).” These laws include the following main features:
- All donations of human organs and tissue are free of charge.
- The trade with human organs is not permitted.
- The expanded consent solution means that organs, tissues or cells may only be removed from people after their death if they have given their express consent (from www.swisstransplant.org/en/faq).
Organ donation is only possible if the donor’s death has been established beyond any doubt. A person is dead when either brain death (complete and irreversible cessation of brain functions) or irreversible heart failure (donor after circulatory death – DCD) has set in. In addition, consent to organ donation must be provided.
The ultimate objective in regard to human organ donation is fairness and justness, no one may be discriminated. Donor organs are allocated to recipients on the waiting list in accordance with the Transplantation Act and the corresponding ordinances on organ allocation. The primary criteria for allocation are medical urgency, medical benefit and time on the waiting list. In addition, individual criteria apply for each organ. The allocation of human organs is organised by the “Nationale Zuteilungstelle”, in Switzerland swisstransplant. You can read more about the “Swiss Donation Pathway” on the swisstransplant website (this information is not available in English)
The important first step is to understand the “expanded consent” part: this means that “if there is no written consent from the deceased and if their wish is not known, the next of kin must decide as representatives as to the deceased’s presumed intentions regarding an organ donation”.
In Switzerland, explicit written consent is necessary to confirm the wish to become an organ donor. This differs from countries where the “dissent solution” applies, meaning that automatically every person is an organ donor unless they explicitly vetoed. Countries where the dissent solution applies are Austria, Czech Republic, France, Hungary, Italy, Luxembourg, Poland, Portugal, Slovakia, Slovenia, and Spain.
In comparison with other countries, Switzerland has very few organ donors even though many share a positive attitude towards organ donation. For anyone interested in becoming an organ donor and not knowing how to do so, there are different ways to become an organ donor in Switzerland:
- Fill out an organ donor card online on the swisstransplant website. After leaving your personal details, you can select which organs you would like to donate and which organs, tissues or cells you reject to donate. You can also nominate a trusted person, who can make the final decision for you in the case of an emergency. You can print the card and sign it. Then you must carry the card with you at all times, as the information is not saved on the swisstransplant website.
- Order the organ donor card by filling out an order form. You can then fill out the card in the comfort of your home.
- Save the donor card on your smart phone. Beginning in the autumn of 2014, the organ donor card of swissstransplant has been integrated into the emergency call app Echo112. Since November 2015, you need to download the Medical ID app and fill out your information there. The information is saved on your smart phone (but is not saved in the central register) In an emergency, medical staff at hospitals have access to information saved in the app. According to the swisstransplant website, “approximately 40 hospitals in Switzerland that currently use electronic identification (EID) technology: they are equipped with a Bluetooth transmitter in their A&E departments which activates the donor card on your smartphone once you are within radius (i.e. as soon as you enter A&E). You must have Bluetooth enabled on your device to enable hospital staff to access your donor card. Your personal data will be treated as strictly confidential at all times. Your details are saved on your smartphone and can only be accessed without entering the password in A&E.”
For further information, visit the swisstransplant website, where much of the information is also available in English.