Advance Care Planning

When engaging in advance care planning (ACP), individuals reflect on their personal values, wishes, expectations and ideas regarding treatment and care in the event of an illness, accident or the need for medical attention. This involves recording one's wishes for third parties in case decision-making capacity is lost. Planning one’s care in advance strengthens self-determination and reassurance regardless of age or health status.

 

ACP is voluntary, but should be accessible and understandable for all who are interested in the topic. The Swiss Federal Council formulated a need for action in a postulate report 18.3384 (available in German or French). Healthcare professionals often cannot find or access advance care directives, or cannot use them because the respective statements are not meaningful in an emergency situation. Furthermore, the end-of-life is often approached as an acute event, whereas around 70% of deaths in Switzerland are foreseeable and can be prepared for.

 

To strengthen the awareness, accessibility, and quality of ACP, the Federal Council established a national working group on «Advance Care Planning» in 2021 led by the FOPH, the Section Healthcare Developement, and the SAMS. The working group is tasked with steering the implementation of ACP measures on a strategic and thematic level throughout the entire process, and setting key priorities. It consists of experts from the fields of medicine, nursing, palliative care, social work, law, and ethics. Also represented are national professional associations, organisations of healthcare providers as well as patient and stakeholder organisations that offer consultation on the subject.

 

The implementation concept (version May 2021) is available in German or French

 

 

The SAMS and the FOPH have developed a logo for the national project. It is intended to create visibility to ensure that ACP is not only dealt with in theory, but is also anchored in people's minds.

Since 2021, the broad-based working group led by the FOPH and SAMS has analysed the need for action. A model with concrete recommendations was open for public consultation from 17 May until 15 July 2022. Taking into account the 170 comments received, the working group published the «Roadmap for the implementation of advance care planning (ACP) in Switzerland» in March 2023. The roadmap outlines 12 recommendations that should help to expand and anchor the use of ACP further in everyday (medical) practice. The document is available in four languages:

 

Podcast «spectra» de l’OFSP, conversation avec Valérie Clerc, Secrétaire générale de l’ASSM, juin 2023 (in French)

 

The recommendations listed in the roadmap are to be implemented in a phased manner. The working group awards mandates for the implementation of various subprojects, which it accompanies and advises. The following subprojects are currently underway:

• ACP in retirement or nursing homes
• Emergency medical order for life-sustaining treatment (to follow in autumn 2024)

Subprojects on raising awareness and defining minimum standards for advance directives are currently in planning stage. The SAMS will report on the project’s progress through its usual communication channels (bulletin, website and newsletter).

• Subscribe to the SAMS newsletter
• Visit the FOPH website in German or French 

 

 

The Annual Report 2023 provides an overview of the activities and projects of the working group. It also contains an outlook on future plans and strategies. The document is available in German and French.

 

Professor Miodrag Filipovic, SGI-SSMI, Intensive Care Medicine, President

Franziska Adam, Spitex Switzerland, Outpatient Care

Stefan Berger, H+

Dr Gabriela Bieri-Brüning, SFGG, Geriatrics/Inpatient Long-term Care

Piero Catani, SAGES, Social Work

Professor Christine Clavien, Delegate Network Romandie, Ethics

Dominique Elmer, LangzeitSchweiz

Professor Monica Escher, palliative.ch

Nathalie Gerber, SRK Switzerland, Counselling and Stakeholder Organization

Dr Salome von Greyerz, MAE, NDS MiG, FOPH

Renate Gurtner Vontobel, MPH, palliative ch

PD Dr Ulrich Hemmeter, SGAP, Geriatric Psychiatry and Psychotherapy

Emeritus Professor Paul Hoff, Central Ethics Committee, SAMS, Ethics/Psychiatry

Isabelle Karzig-Roduner, RN, MAE, MScN, ACP-Swiss, Advance Care Planning

Professor Dagmar Keller, SSERM, Emergency Medicine

Dr Philippe Luchsinger, mfe, Family Medicine

lic. rer. soc. Silvia Marti Lavanchy, CDS

Paola Massarotto, MNS, SGI-SSMI, Intensive Care Nursing

Professor Beat Reichlin, Conference for the Protection of Children and Adults KOKES

Dr Reka Schweighoffer, CURAVIVA, Long-Term Care/Residential Homes

Dr Jana Siroka, FMH, Internal Medicine and Intensive Care Medicine

Melea Scheuner, Pro Senectute Switzerland, social counselling

lic. iur. Judith Wyder, Federal Office of Justice, Law

 

lic. theol., dipl. biol. Sibylle Ackermann, SAMS (ex officio)

Dr Manya Hendriks, SAMS (ex officio)

lic. phil. I Flurina Näf, FOPH (ex officio)

Dr Milenko Rakic, FOPH (ex officio)

lic. phil. I Lea von Wartburg, FOPH (ex officio)

 

 

ACP in retirement or nursing homes