Organ transplantation: archive

SAMS » Ethics » Topics A–Z » Transplantation » Archive

The SAMS has been concerned with transplantation medicine and associated ethical questions for more than 50 years. In 1969, two years after the first heart transplant, it published guidelines on the definition and diagnosis of death. On this page, various relevant publications – now obsolete – are made available for documentation purposes.

Medical advances and the associated ethical questions necessitated numerous revisions and additions to the SAMS guidelines on the determination of death. Until federal legislation on transplantation came into force, the SAMS provided guidance through its guidelines on organ transplantation (in effect from 1981 to 2004), on the transplantation of human fetal tissue, and on xenotransplantation. These documents can be found in our Guidelines archive.



Explanatory notes on the 2017 revision of the guidelines on the determination of death

The guidelines on the determination of death were revised concurrently with the revision of the Transplantation Act. The draft guidelines underwent public consultation between December 2016 and February 2017. In response to feedback from the consultation, the stand-off period for the formal determination of death after permanent cardiac arrest was reduced from 10 to 5 minutes. As this change provoked criticism, the reasons for the decision are explained here:

  1. Switzerland is one of the few countries where cardiac arrest has to be diagnosed, not by absence of pulse on palpation, but by echocardiography (heart ultrasound). This examination demonstrates conclusively that blood flow supplying oxygen to the brain has ceased. If the brain is deprived of oxygen for three minutes, irreversible damage occurs.
  2. In addition, after the stand-off period, brain death has to be formally diagnosed in accordance with the SAMS guidelines. Here, too, the requirement for this procedure marks Switzerland out from most other countries.
  3. The guidelines specify who is authorised to establish the diagnosis of brain death; the requirements are very stringent.


Further information was provided in the SAMS Newsletter of 10 November 2017 (French | German).



Archived SAMS publications

SAMS factsheet: Organ transplantation: opt-out or opt-in system? (2013), available in French | German


SAMS factsheet: Partial revision of the Transplantation Act (2013), available in French | German


There is only one death – Comments by the SAMS on the key points revised in the guidelines «Determination of death with regard to organ transplantation« (2011; available in French | German



lic. theol., dipl. biol. Sibylle Ackermann
Head Department Ethics
Tel. +41 31 306 92 73