Organ donation: Swiss citizens should be able to decide
A chronology on the Swiss initiative and the indirect counter-proposal
Edited by "Swiss Standpoint"
• 8 October 2004: The «Federal Act on the Transplantation of Organs, Tissues and Cells» (Transplantation Act) enters into force. Art. 8, para. 1 states that organs, tissues or cells may be removed from a deceased person if he or she consented to removal before death and if death has been established. In the absence of an expression of will by the deceased person, the next of kin may give consent for removal in the sense and in accordance with the presumed will of the deceased = extended consent solution.
• 22 March 2019: The Jeune Chambre Internationale (JCI) from the canton of Vaud submits its federal popular initiative «Promoting organ donation – saving lives» to the Federal Chancellery. The initiative wants a change in the system: if the deceased person did not object to organ donation during his or her lifetime, organ removal is permitted, and the relatives cannot object to removal = narrow objection solution. Anyone who does not wish to donate organs should now have to state this.
• 13 September 2019: The Federal Council submits an indirect counter-proposal to the popular initiative for consultation. It adds to the narrow objection solution that relatives can object to organ removal = extended objection solution.
• 25 November 2020: The Federal Council submits its recommendation on the revised Transplantation Act with the extended objection solution to parliament.
• 21 February 2021: Prof. Christoph Zenger publishes the article below in the NZZ.
• 5 May 2021: The National Council approves the indirect counter-proposal with a large majority.
• 20 September 2021: The Council of States also approves the indirect counter-proposal.
• 7 October 2021: The initiative committee conditionally withdraws the initiative, i.e. the withdrawal only becomes effective when the indirect counter-proposal enters into force.
• 12 October 2021: A committee takes up the referendum on the contradiction solution: «NO to organ donation without explicit consent». The deadline for collecting the necessary 50,000 signatures is 20 January 2022. See https://organspende-nur-mit-zustimmung.ch .
by Christian Gurtner, editor of the magazine «saldo»*
(30 November 2021) Today, organ donors must give their explicit consent. In future, even silence will be considered as a consent. That is what the Federal Council and parliament want. Now a referendum committee has formed: the voters should have the last word.
Today, organs can only be removed from a person if they have given their consent during their lifetime or if their relatives have given their consent. But at the beginning of October, parliament amended the Transplantation Act. In future, doctors are to be allowed to remove organs unless someone has expressly objected by entering their name in a register or their next of kin prohibit the removal.
The change in the law is the result of an initiative by a small lobby. A group of young entrepreneurs from western Switzerland collected signatures for a popular initiative four years ago. The radical demand of the Jeune Chambre Internationale of Montreux VD: consent should no longer be required for organ removal. It should be enough if the deceased did not expressly object in good time beforehand.
The Swisstransplant Foundation has supported the popular initiative from the very beginning. It confirms that it paid the initiative committee 60,000 Swiss francs. The young entrepreneurs used these funds, among other things, for two companies that collected signatures in exchange for money. The initiative was successful. It was submitted in March 2019 with 113,000 signatures.
In the autumn session, the transplant lobby scored a coup in parliament. National Council and Council of States rejected the initiative, but amended the existing Transplantation Act in favour of the initiators («K-Tipp» 16/2021). This prevented a popular vote on the new objection regulation. This is because initiatives have to be voted on by the people – laws, however, only if someone collects 50,000 signatures within three months.
have the last word. (Photo KEYSTONE/Leandre Duggan)
«Lobbyists wanted to prevent a popular vote»
Josef Dittli, member of the Council of States for the Liberal Democrats (FDP) in Uri, told saldo: «the people were tricked». Claudio Kuster of the Foundation for Direct Democracy also criticises the procedure: «the lobbyists didn’t want it proceed to a popular vote». The initiative was withdrawn within a few days of the parliamentary decision.
It remains to be seen whether the lobbyists’ calculation will work. A group of doctors, nursing professionals, lawyers and ethicists has launched a referendum against the new regulation. The deadline for collecting signatures for the referendum is January 2022.
Swisstransplant writes to saldo that it was only contacted by the initiators in 2017, when the initiative text was already available. Swisstransplant was «not involved» in the parliamentary decision against a popular vote.
Pierre-Yves Maillard, then president of the foundation board, said in 2019 in the «Schweizerische Ärztezeitung»: «the public discussion in the context of a popular vote is essential». Today, he tells saldo: the people could also have a say in the indirect counter-proposal of the parliament, if the referendum comes about. Without a referendum, however, it would go faster: «there is pressure of time because people die every year waiting for organs».
| * The magazine saldo is a Swiss consumer magazine published 20 times a year in German. It deals in particular with consumer protection as well as consumer questions on multimedia, travel or health, among other things. It also includes product tests from various areas. |
(Photo www.dialogethik.ch)
«No protection of physical integrity»
by Ruth Baumann-Hölzle, Institute Director at the «Dialog Ethik» Foundation
Ethicist Ruth Baumann-Hölzle is a member of the committee that filed a referendum against the amendment of the Transplantation Act.
saldo: According to the new law, anyone who does not want to donate their organs must document this in a register. What is the problem?
Ruth Baumann-Hölzle: Today the state protects my physical integrity in any case. In the future, I will have to claim this right. If I have a house, it is evident to everyone that it may not be cleared out without my consent. According to the new law, this will no longer apply to the body.
Many people think: when I’m dead, I don’t care what happens to my body. Isn’t that true?
Organ donation affects people while they are still alive. Dying people have to be prepared for organ removal before they die. Because the organs have to be fresh, doctors remove organs as early as five minutes after brain death. I wonder how this is compatible with the right to peace in death.
Doctors are also allowed to remove organs from children – from the age of 4 weeks. Who decides on such a removal?
The parents decide – in a very stressful situation. Those who have no next of kin as adults will no longer have any protection in the future, unless they expressed their opposition to organ removal in the organ donation register during their lifetime.
Source: Magazine «saldo», issue 18/2021, pages 12/13. With the kind permission of the publisher.
(Translation “Swiss Standpoint”)
The signature sheet can be downloaded here: https://organspende-nur-mit-zustimmung.ch/unterschreiben/