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A matter of priority: equitable access to COVID-19 vaccines

Viewpoint
Holzer F, Luna F, Manriquez T, Biller-Andorno N
Swiss Med Wkly. 2021;151:w20488

We need to publicly debate what we mean by “equitable access” to COVID-19 vaccines, whether the prioritisation of individuals should take place at a global level or be decided by countries, and what allocation criteria and mechanisms should look like.

Research projects in human genetics in Switzerland: analysis of research protocols submitted to cantonal ethics committees in 2018

Original article
Driessen S, Gervasoni P
Swiss Med Wkly. 2021;151:w20403

This analysis provides a full national overview of genetic research dossiers pertaining to clinical and nonclinical trials, and to further-use research projects submitted for approval to ethics committees in Switzerland in 2018 .

COVID-19 pandemic: triage for intensive-care treatment under resource scarcity (revised version 3.1, 17 December 2020)

Special article
Swiss Academy of Medical Sciences
Swiss Med Wkly. 2021;151:w20458

Going first: the ethics of vaccine self-experimentation in coronavirus times

Viewpoint
Manríquez Roa T, Biller-Andorno N
Swiss Med Wkly. 2020;150:w20415

The potential role of self-experimentation in the search for a vaccine is in urgent need of further clarification.

COVID-19 pandemic: triage for intensive-care treatment under resource scarcity (3rd, updated version)

Special article
Swiss Academy of Medical Sciences
Swiss Med Wkly. 2020;150:w20401

Given the development of the pandemic in October, the guidelines issued by the Swiss Academy of Medical Sciences (SAMS) and the Swiss Society of Intensive Care Medicine (SSICM) needed to be revised and updated in the light of the experience accumulated since March. There has been no change in the guiding principle that uniform criteria for intensive-care unit (ICU) admission and continued occupancy should be applied throughout Switzerland. The present guidelines provide the necessary basis.    

Strong second COVID-19 wave calls for a second look at ICU triage guidelines

Viewpoint
Suter P, Pargger H
Swiss Med Wkly. 2020;150:w20407

The revised Swiss guidelines bring not only a useful framework for delicate discussions and decisions at the bedside, but hopefully also progress in public awareness of some limits of the best health systems in the world, appearing much faster in a time of scarcity of resources. Based on what we learned from the crisis of this year, several aspects of our and other health systems could benefit from a revision or an update, in line with a recognised truism.

Communication challenges in end-of-life decisions

Review article: Biomedical intelligence
Becker C, Beck K, Vincent A, Hunziker S
Swiss Med Wkly. 2020;150:w20351

With the progress in healthcare over recent decades and a growing life expectancy, discussions and decisions regarding end-of-life issues have become increasingly important. Especially in intensive care and emergency medicine there is a growing need of decision making for optimised end-of-life care. Prolonging life and preventing death is considered to be the highest principle of healthcare professionals; however, in some cases alleviation of suffering is a more appropriate goal. This article discusses communication challenges in end-of-life decision making and outlines strategies from an area of growing interest and research.

Uncertainties about the need for ethics approval in Switzerland: a mixed-methods study

Original article
Gloy V, McLennan S, Rinderknecht M, Ley B, Meier B, Driessen S, Gervasoni P, Hirschel B, Benkert P, Gilles I, von Elm E, Briel M
Swiss Med Wkly. 2020;150:w20318

Jurisdictional inquiries are an important means for researchers to clarify whether their project requires ethical oversight. However, this mixed-methods study has identified some difficulties in the interpretation of legal terms, which often reflect persistent structural issues that many other countries also face. More detailed guidance may be helpful to reduce the researchers’ uncertainties and ethics committees’ workloads in relation to jurisdictional inquiries.

Shared decision making: patients have a right to be informed about possible treatment options and their risks and benefits

Viewpoint
Rosca A, Krones T, Biller-Andorno N
Swiss Med Wkly. 2020;150:w20268

Shared decision making is a key concept in the process of working towards high-quality, patient-centred care for all patient populations. It is relevant not only for current care decisions, but also for advance care planning, and it is needed particularly during times of crisis such as we are seeing currently with COVID-19.

Social, cultural and experiential patterning of attitudes and behaviour towards assisted suicide in Switzerland: evidence from a national population-based study

Original article
Vilpert S, Bolliger E, Borrat-Besson C, Borasio GD, Maurer J
Swiss Med Wkly. 2020;150:w20275

Switzerland has the longest history of the legal practice of non-physician assisted suicide of any country. Assisted suicide is not very tightly regulated in Switzerland, and almost all assisted suicides are supported by a right-to-die organisation.

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