Advance Care Directive & Living Will

The advance care directive (Art. 360 ff. Swiss Civil Code) is a document with which you authorize one or more people to act for you in the event of incapacity. It can cover three areas:

Personal care: - Decisions about living arrangements (home care, nursing home, etc.) - Organizing care and support - Managing personal correspondence - Social contacts and daily life

Asset management: - Managing bank accounts and securities - Paying bills and ongoing costs - Managing real estate - Tax returns and dealings with authorities

Representation in legal matters: - Entering into contracts (rental agreements, insurance, etc.) - Representation before authorities and offices - Conducting legal proceedings before courts

You can appoint different people for each area (e.g. your spouse for personal care, an adult child for asset management).

The living will (Art. 370 ff. Swiss Civil Code) specifically governs medical treatment. You can specify:

Treatment preferences: - Which medical measures do you want? - Which treatments do you refuse? - Pain management and palliative care - Artificial nutrition and ventilation

End-of-life decisions: - Resuscitation: yes or no? - Life-prolonging measures in a hopeless prognosis - Intensive care treatment - Organ donation

Healthcare proxy: You can name a person who makes medical decisions for you in cases of doubt. This person interprets your living will and decides in unforeseen situations.

Important: the living will is binding on doctors and nursing staff. They must respect your wishes, even if they would act differently themselves.

Both documents have formal requirements that must be strictly observed:

Advance care directive: 1. Entirely handwritten, dated, and signed (like a will) OR 2. Publicly notarized (before a notary)

Recommendation: for complex situations (larger assets, real estate, businesses), notarization is preferable. It offers more legal certainty.

Living will: - In writing (can also be typed on a computer) - Dated and signed - No notarization required

Important for both documents: - Review regularly (every 2-3 years) - In case of changes: create a new document, destroy the old one - Keep it in a findable location - Inform trusted people where the documents are kept - Deposit a copy with your family doctor (for the living will)

Choosing the right person is crucial. The following considerations help:

Basic requirements: - Of legal age and capable of judgment - Willing to take on the task (be sure to ask beforehand!) - Trustworthy and reliable - Accessible and available

For personal care: - A person who knows you well and shares your values - Often: spouse, adult children, close friends - Emotional closeness is important

For asset management: - A person with financial and administrative skills - Can also be a trustee or lawyer - Integrity and diligence are crucial

For medical decisions: - A person who knows your end-of-life wishes - Willing to make difficult decisions as well - Emotionally stable enough for crisis situations

Substitute agents: Always name substitute agents in case your first choice is unavailable (death, illness, prevention). Without a substitute, the KESB steps in again.

To ensure the advance care directive and living will are found when needed, the following steps make sense:

Depositing the advance care directive: - With a notary (if notarized) - With the civil registry office (on request) - With the appointed agent - In a safe deposit box (with information given to trusted people)

Registering with the civil registry office: You can have the civil registry office record THAT you have created an advance care directive and WHERE it is located. If incapacity occurs, the KESB will inquire there.

Note on the insurance card: The living will can be noted on the insurance card. In an emergency, doctors can check whether a living will exists.

Additional recommendations: - Copies to all appointed agents - A copy with your family doctor - A note card in your wallet ("I have a living will, it's kept at...") - A digital copy (e.g. in a family cloud folder)