Is the resolution of the objection delayed? | 26. August 2024
Four out of five donor hearts for children have recently been imported from abroad. This is one of the reasons why the mortality rate of children who depend on a donor heart has fallen to 15 percent, said Franz Immer, director of Swisstransplant.
Franz Immer, Director of Swisstransplant, poses at the Swisstransplant office in Bern. Fotos: Keystone
When Immer started at Swisstransplant around 16 years ago, the mortality rate of children who needed a donor heart was still at 80 percent. This was stated by the director of the national foundation for organ donation and transplantation in an interview with the “Tages-Anzeiger” on Saturday.
Between 350 and 400 organs are listed each year on the platform of the European allocation organization Foedus, Immer said. The most common are hearts, followed by lungs and livers. The organization was founded because it is often not possible to find a recipient in one’s own country, especially for children.
Transport of maximum four hours
Switzerland imported 45 organs and exported 26 organs last year, said Immer. The aim is to balance exports and imports. The transport of an organ costs around 20,000 francs, depending on the distance. “For a heart, transport should not take more than four hours,” said Immer.
Swisstransplant uses such cool boxes to transport donated organs for transplantation.
To put the figure into perspective: According to Immer, a heart transplant costs around 150,000 francs, a kidney transplant a good 60,000 francs. Dialysis, on the other hand, costs 100,000 francs per year. “With 300 transplants, the savings potential amounts to half a billion francs per year,” Immer calculated.
All-time high for organ donations in Switzerland
Last year, more organs were donated in Switzerland than ever before. A total of 675 people on the waiting list received an urgently needed organ in 2023. In 2022, the Swiss electorate approved the so-called extended opt-out solution (the J platform reported). It is expected to come into force in 2026. After that, all people who did not refuse to do so during their lifetime will be considered organ donors. A person’s relatives can still prevent organ removal.
General agreement with the Transplantation Regulation
The Federal Council’s regulation on the implementation of the so-called opt-out solution for transplants has been met with general approval by parties and organizations. However, there was criticism during the consultation process because the opt-out process was too complicated and there was a possible delay due to the link to the e-ID.
The Swiss electorate approved the so-called extended opt-out solution in 2022. This means that all people who did not refuse to do so during their lifetime are now considered organ donors. A person’s relatives can still prevent organ removal.
According to the Swiss Academy of Medical Sciences (SAMS), the procedures for determining willingness to donate in the Federal Council’s ordinance are too complicated and there are various ambiguities.
In addition, the obligation of hospitals to inquire about known and reachable next of kin is formulated too comprehensively. This would lead to too much work for hospitals.
Data protection and information
The SVP, for its part, insists that the register in which people who do not wish to donate their organs must register must “have the highest standards of data protection.” The party also demands that, in addition to the e-ID, identification in the register must also be possible using a passport or a physical ID.
However, the party believes that the key to implementation is the obligation to provide information by authorities and experts. The population must be actively informed about their right to object and be able to receive help with registration. If the will is unclear, the surviving relatives must also be given precise information.
The SP is also concerned about informing the population: it demands that the Federal Council be explicitly obliged in the regulation to carry out an information campaign so that most people are motivated to hold on to their will.
Transitional solution required before E-ID
The director of Swisstransplant, Franz Immer, feared in the SRF program “Heute Morgen” on Wednesday that linking the declaration of objection to the e-ID could lead to a delay in the implementation of the will of the people. This would be difficult from the perspective of the patients affected.
In its response to the consultation, which ended on Wednesday, the SP is therefore calling for an interim solution until an e-ID is introduced. This would allow people to register in the organ and tissue donation register beforehand.
The FDP is even clearer on this point: it is incomprehensible that linking the register to a future e-ID would create further hurdles. It is therefore also calling for alternative identification features to be used until the e-ID is available.
The Evangelical Reformed Church of Switzerland (EKS) also fears that problems with the introduction of the e-ID could also lead to “immediate negative effects” on organ distribution.
The EKS considers it unacceptable that the regulation allows preparatory measures for organ removal to begin before a possible objection has been finally resolved. This contradicts the principle of doing no harm and doing good to the dying or deceased person.