Swiss medical weekly最新文献

{"title":"The role of advance directives in preventing compulsory placement and coercive measures in Switzerland: a need to review present practice.","authors":"Nikola Biller-Andorno, Sophie Gloeckler","doi":"10.57187/s.4616","DOIUrl":"10.57187/s.4616","url":null,"abstract":"<p><p>In Switzerland, where individual self-determination and self-responsibility are strong values, coercive measures are still very present in the care of individuals with mental health conditions. In 2022, over 18,000 cases of compulsory care placements were recorded - one of the highest rates in Europe [1]. The Swiss Academy of Medical Sciences (SAMS) is reviewing its guidelines on coercion to better support practice. The present viewpoint aims to contribute to such efforts by focusing on the role of advance directives in preventing unwanted compulsory placement and coercive measures. Advance directives support individuals to document treatment preferences in anticipation of future incapacity. There is, though, differentiation between psychiatric and non-psychiatric cases: while treatment refusals for somatic conditions are typically considered binding, the preferences expressed in psychiatric advance directives can be overridden following compulsory placement. This creates a double standard that undermines self-determination for individuals with mental health conditions. The present article advocates for uniform legal standards that would grant psychiatric advance directives equal binding force. It explores the validity of common arguments against doing so, suggesting that objections often rely on inconsistent or ethically flawed reasoning. The piece lays out arguments in support of modifying policy on psychiatric advance directives, suggesting that comparably binding directives might enhance patient autonomy, reduce the harm of coercive interventions, promote goal-concordant care, strengthen oversight, and address discriminatory policy. As the Swiss Academy of Medical Sciences revisits guidelines on coercive practices, it is a good moment to consider the potential value of binding psychiatric advance directives as tools to uphold patient autonomy and contribute to broader efforts to reduce the harm of coercive practices.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"4616"},"PeriodicalIF":1.9,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145865646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the COVID-19 pandemic on routine childhood immunisation coverage and timeliness in Switzerland: a retrospective analysis using data from the Swiss National Vaccination Coverage Survey, 2019-2023.","authors":"Vasiliki Baroutsou, Monica N Wymann, Jan S Fehr, Phung Lang","doi":"10.57187/s.4525","DOIUrl":"10.57187/s.4525","url":null,"abstract":"<p><strong>Background: </strong>The coronavirus disease 2019 (COVID-19) pandemic has disrupted healthcare systems worldwide, leading to concerns about reduced access to routine childhood immunisations. However, comprehensive data on how the pandemic specifically impacted paediatric vaccination coverage in Switzerland remain limited across the country. The present study provides an analysis of the timeliness and coverage of routine childhood immunisations in Switzerland before and during the COVID-19 pandemic, offering insights into potential fluctuations in coverage.</p><p><strong>Aims: </strong>To assess the impact of the COVID-19 pandemic on routine childhood immunisation in Switzerland by comparing vaccination coverage and timeliness for children under 35 months of age before and during the pandemic. Additionally, the study seeks to identify factors associated with the likelihood of children receiving vaccinations, considering demographic and geographic variables.</p><p><strong>Methods: </strong>We used 2019-2023 data from the Swiss National Vaccination Coverage Survey (SNVCS), a cross-sectional survey that collected immunisation information of children under 35 months of age from a nationally representative sample of households. Children who were eligible for a vaccine from March 2020 to March 2021 were considered as the COVID-affected group and those eligible for a vaccine before this date were included in the pre-COVID-19 cohort. Coverage of the following vaccine doses was considered: diphtheria at one, two and three doses (Di1, Di2, Di3); pneumococcus at one, two and three doses (PCV1, PCV2, PCV3); and measles first and second dose (MCV1, MCV2). Vaccine timeliness was defined as receiving a dose on time with a tolerance period of 30 days. We used logistic regression models to identify and understand the factors that might influence vaccination rates.</p><p><strong>Results: </strong>For the diphtheria vaccines (Di1, Di2, Di3), while coverage remained high, there was a slight decrease observed in timely vaccination rates for some doses, with reductions of around 1% to 3% compared to pre-COVID-19 levels. The impact on PCV1, PCV2 and PCV3 showed similar trends, with slight reductions in coverage during the pandemic, but these differences were not statistically significant. For measles-containing vaccines (MCV1 and MCV2), coverage during the pandemic was higher compared to pre-COVID-19 rates. Geographic and demographic factors, such as an urban setting, nationality and linguistic region, significantly influence childhood vaccination rates in Switzerland.</p><p><strong>Conclusion: </strong>While minor declines in vaccine timeliness were observed (diphtheria vaccine, pneumococcal conjugate vaccine), the overall likelihood of vaccination was not significantly affected by the COVID-19 pandemic. However, changes in vaccination recommendations introduced in 2019 may have influenced these trends.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"4525"},"PeriodicalIF":1.9,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145865636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modelling the health and cost implications of expanded access to HIV, HCV and sexually transmitted infection testing in Switzerland.","authors":"Harsh Vivek Harkare, Marina Antillón, Axel J Schmidt, Fabrizio Tediosi","doi":"10.57187/s.4581","DOIUrl":"10.57187/s.4581","url":null,"abstract":"<p><p>BACKGROUND: This study was conducted as part of the Swiss National Programme to Stop HIV, Hepatitis B Virus, Hepatitis C Virus and Sexually Transmitted Infections (NAPS), which aims to reduce the spread of sexually transmitted infections in Switzerland. The goal was to identify the most effective and cost-efficient screening strategies to lower the incidence of human immunodeficiency virus (HIV), hepatitis C virus (HCV), syphilis, Neisseria gonorrhoeae and Chlamydia trachomatis by improving access to screening.</p><p><strong>Methods: </strong>A Markov model was developed to assess the impact of various screening strategies among key populations over two years, including men who have sex with men (MSM), female sex workers (FSW) and people who inject drugs (PWID). The model further stratifies individuals based on partner number (MSM) and injection-equipment sharing (PWID). Comprehensive cost estimates for screening and treatment were derived from insurance data, literature and expert opinions. The effectiveness of screening interventions was evaluated by measuring reductions in disease incidence and cost savings, comparing the costs of screening to those of acute and chronic care for prevented infections.</p><p><strong>Results: </strong>Increased screening frequency among key populations led to a reduction in incidence for all five infections studied. The largest effect was seen in people who inject drugs who share injecting equipment, where HCV incidence fell by up to 76% with four annual screens. However, only screening for HIV, HCV and syphilis proved to be cost-saving. Screening for Chlamydia trachomatis and Neisseria gonorrhoeae consistently incurred net costs due to the high screening costs and relatively low treatment costs.</p><p><strong>Conclusion: </strong>Targeted expansion of screening among key populations can reduce the incidence of HIV, HCV and syphilis in Switzerland, with regular screening offering potential cost savings to insurers under specific coverage and treatment scenarios.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"4581"},"PeriodicalIF":1.9,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145865645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum to: Evolution of adult respiratory syncytial virus detection: impact of testing strategy changes and pandemic-related measures at a Swiss regional hospital, 2016-2023.","authors":"","doi":"10.57187/s.5218","DOIUrl":"10.57187/s.5218","url":null,"abstract":"","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"5218"},"PeriodicalIF":1.9,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145865555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality assessment of Andrographis paniculata products reveals significant labelling inaccuracies and contaminations.","authors":"Angélique Bourqui, Hugo Morin, Robin Huber, Chantal Csajka, Clara Podmore, Jean-Luc Wolfender, Emerson Queiroz Ferreira, Pierre-Yves Rodondi","doi":"10.57187/s.4728","DOIUrl":"10.57187/s.4728","url":null,"abstract":"<p><strong>Background: </strong>Andrographis paniculata products have gained in popularity for the management of respiratory infections since the COVID-19 pandemic. None of these products holds marketing authorisation and all are sold as herbal food supplements. Current herbal food supplement regulations generally do not impose quality assessments prior to commercialisation, such that the quality of herbal food supplements available to consumers is largely unknown.</p><p><strong>Study aim: </strong>To assess the quality, purity and labelling accuracy of A. paniculata-containing products, focusing on andrographolide content (the pharmaceutically active component) and the presence of contaminants and residues.</p><p><strong>Methods: </strong>Forty A. paniculata-containing products were purchased from 13 countries: 13 from pharmacies and 27 from online retailers readily accessible to consumers in Switzerland. Samples were analysed using ultra-high-performance liquid chromatography-ultraviolet (UHPLC-UV) and ultra-high-performance liquid chromatography-mass spectrometry (UHPLC-MS) based on the European Pharmacopoeia method. Contaminants and residues were assessed using inductively coupled plasma mass spectrometry and gas chromatography-mass spectrometry, respectively.</p><p><strong>Results: </strong>All samples except one contained A. paniculata. The measured daily dose of andrographolide was compared to the labelled dose. Andrographolide content ranged from 29% to 174% of the labelled dose, with only 2 products accurately labelled, while 20 were underdosed and 1 overdosed. Two products contained quercetin, which interfered with UHPLC-UV analysis. Additionally, three online-purchased products contained toxic contaminants, including a heavy metal (mercury) or pesticides (strychnine, butralin).</p><p><strong>Conclusion: </strong>This study reveals widespread mislabelling and underdosing in A. paniculata-containing food supplements marketed internationally, along with the presence of impurities that pose risks to consumers in products bought online. Regulatory authorities must implement stringent quality controls to ensure consumer safety and product transparency.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"4728"},"PeriodicalIF":1.9,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145763917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does health insurance status influence surgical complications? An analysis of abdominal, thoracic and vascular interventions in a Swiss tertiary referral centre.","authors":"Maximilian Bley, Stefan Gutknecht, Laurin Burla, Christoph Zindel, Markus Weber, Simon Wrann","doi":"10.57187/s.4179","DOIUrl":"10.57187/s.4179","url":null,"abstract":"<p><strong>Study aims: </strong>In Switzerland, basic health insurance is compulsory. Supplementary or private health insurance may be arranged, providing advantages such as hospital comfort and a free choice of doctors. Since there is limited data on whether insurance status influences the outcome of surgery, this study aimed to investigate the influence of supplementary insurance status on the overall complication occurrence in a group of abdominal, thoracic and vascular surgeries.</p><p><strong>Methods: </strong>This study is based on surgical patient data prospectively collected between September 2016 and March 2018 from one participating Swiss tertiary referral hospital of the StOP?-trial (NCT02428179), which investigated the effect of structured intraoperative briefings on patient outcomes. First, additional data, including insurance status, demographic and surgical parameters within 30 days was collected. Second, due to endogeneity concerns in the sample driven by selective access to a supplementary insurance, propensity-score matching (PSM) was used to balance samples for the treatment variable (insurance status) by demographic parameters and surgical complexity. The primary outcome was the estimated treatment effect of a supplementary insurance on the occurrence of surgical complications, categorised by the Clavien-Dindo classification (CDC). Finally, multiple logistic regression was used to detect further conditional associations of demographic and surgical variables with the occurrence of complications.</p><p><strong>Results: </strong>Of all 3173 procedures, 64.3% were elective, 48.2% had a higher surgical complexity (excluding appendectomies, cholecystectomies, hernia surgery and lymph node excision) and 18.6% of all patients had supplementary insurance. The occurrence of complications, including surgical site infection and postoperative complications, was 30.4%. After matching 591 patients with basic insurance to 591 patients with a supplementary insurance, no significant association between insurance status and complications could be found (crude odds ratio [OR] [95% CI]: 0.97 [0.77-1.23]). In contrast to insurance status, multiple logistic regression identified that variables such as surgical complexity (adjusted OR [95% CI]: 1.80 [1.27-2.56]), contamination (adjusted OR [95% CI]: 1.90 [1.41-2.56]) and duration of surgery (adjusted OR [95% CI]: 1.008 [1.006-1.009]) were associated with the occurrence of complications.</p><p><strong>Conclusion: </strong>Despite the different cost-liable insurance levels, there were no significant differences and, therefore, no disadvantages for basic insured patients regarding the complication rate in this Swiss cohort undergoing abdominal, thoracic or vascular surgery.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"4179"},"PeriodicalIF":1.9,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145865522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is it still useful to publish case reports?","authors":"Gérard Waeber, Stefano Bassetti, Stefan Weiler","doi":"10.57187/s.5203","DOIUrl":"10.57187/s.5203","url":null,"abstract":"<p><p>Although the medical literature is flooded with case descriptions, it is difficult to dismiss the significant impact that a clinical observation limited to one or two patients can have. Case reports can also play a critical role in other areas such as drug safety by serving as early warning signals for adverse drug reactions. Unlike the aggregated data and statistical abstractions of clinical trials or meta-analyses, case reports reflect the real-world context of medical practice, where decisions are made patient by patient. This alignment with everyday clinical experience makes case reports particularly relatable and valuable to practicing clinicians, offering insights that resonate far beyond the confines of population-based evidence. The \"Swiss Medical Weekly\" wishes to participate in the dissemination of high-quality case reports. A new section entitled \"Clinical reasoning\" will provide a dedicated platform for well-structured case reports while upholding the journal's high and very strict editorial standard and its Diamond Open Access model.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"5203"},"PeriodicalIF":1.9,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145715795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genotype-phenotype correlations in <i>NTHL1</i>-associated tumour syndrome: case report and literature review.","authors":"Agata Bukowska, Henrik Horváth, Karl Heinimann","doi":"10.57187/s.4554","DOIUrl":"10.57187/s.4554","url":null,"abstract":"<p><p>NTHL1-associated tumour syndrome, formerly known as NTHL1-associated polyposis, is a rare autosomal recessive tumour predisposition in which biallelic carriers of pathogenic NTHL1 variants develop multiple, predominantly adenomatous, polyps and have an increased risk of colorectal cancer and extracolonic tumour manifestations. The Nth like DNA glycosylase 1 (NTHL1) gene encodes for an enzyme involved in the base excision repair pathway which plays an important role in the maintenance of genomic integrity in the cell. Upon identification of our first Swiss biallelic NTHL1 carrier, we performed a literature survey on mono- and biallelic NTHL1 carriers, followed by genotype-phenotype correlations in order to delineate the clinical manifestations and review current screening recommendations. A comprehensive literature search was conducted to identify all individuals with NTHL1 variants reported since the initial discovery in 2015 to 2022, followed by a genotype-phenotype analysis on a total of 216 individuals, 59 being biallelic and 157 monoallelic NTHL1 carriers. 81.4% of biallelic NTHL1 carriers presented with colon polyps, the majority (69%) exhibiting between 5 and 99 polyps. Interestingly, though not statistically significant, 19% (6/31; p = 0.0766) of carriers homozygous for the recurrent p.Gln90Ter variant displayed a classical (>100 polyps) polyposis phenotype compared to none of the compound heterozygous patients (n = 20); additionally, compound heterozygotes were diagnosed with breast cancer twice as often as homozygous women (75% vs 38.9%, p = 0.0717). Among biallelic carriers, colorectal carcinomas were reported in 50.8% (n = 30; median age at diagnosis: 49 years) and extracolonic malignancies in 55.9% (n = 33), with breast (53.3%), skin (27.1%), endometrial (16.7%) and bladder cancer (8.5%) being the most frequent. Among monoallelic NTHL1 carriers, 15.3% (n = 24) presented with colon polyps and 17.8% (n = 28; median age at diagnosis: 55 years) with colon carcinomas. Timely surveillance measures are essential for early colorectal and breast cancer detection, treatment and prognosis. Prospectively gathered data are needed to further establish and refine clinical guidelines for individuals with NTHL1-associated tumour syndrome.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"4554"},"PeriodicalIF":1.9,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145763361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serial cerebral magnetic resonance imaging before and after birth in patients with complex congenital heart disease - a prospective, multicentre observational study.","authors":"Walter Knirsch, Alexandra De Silvestro, Celine Steger, Verena Rathke, Roland Weber, Michael Von Rhein, Juliane Schneider, Damian Hutter, Bettina Reich, Ulrike Held, Annette Hackenberg, Ruth Tuura O'Gorman, Raimund Kottke, Andras Jakab","doi":"10.57187/s.4466","DOIUrl":"10.57187/s.4466","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Study aims: &lt;/strong&gt;Our objective was to establish a multicentre foetal-to-neonatal magnetic resonance (MR) neuroimaging programme for neonates undergoing surgery for complex congenital heart disease (CHD). We assessed structural and volumetric MRI findings at different timepoints in various types of CHD and evaluated neurodevelopmental outcomes at one year of age. Additionally, we analysed the feasibility, challenges and limitations of implementing this MR neuroimaging programme.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this prospective, multicentre observational study, we examined brain development and growth in infants with complex CHD requiring neonatal cardiac surgery. Brain MRI was performed at multiple timepoints: at the 32nd week of gestation, after birth (both before and after stage I surgery), and before stage II surgery in single-ventricle CHD. We analysed and compared cardiac diagnoses, treatment approaches, structural and volumetric brain MRI findings and neurodevelopmental outcomes at one year of age (assessed using the Bayley III scale) with those of healthy controls.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Between April 2020 and September 2023, 81 patients and 15 healthy controls underwent at least one MRI. Cardiac diagnoses were biventricular CHD (66.7%), single-ventricle CHD (25.9%) and borderline left ventricle CHD (7.4%). New structural cerebral lesions were found before stage I or after stage I including white matter injury in 3.8% and 8.7%, respectively, ischaemic cerebral lesions in 11.5 and 11.6%, intraventricular haemorrhages in 7.7% and 7.2%, and subdural haemorrhages in 33.6% and 26.1%. Total brain volume at 32.6 (interquartile range [IQR]: 31.3-33.3) gestational weeks was 228.9 ml (213.1-241.2) in biventricular CHD, 194.4 ml (165.3-223.6) in single-ventricle CHD and 196.4 ml (186.4-235.2) in normal healthy controls. After birth, at 6 days (3-16) of life total brain volume was 337.1 ml (310.3-350.2) in biventricular CHD, 331.6 ml (305.9-350.7) in single-ventricle CHD and 406.8 ml (389.9-438.7) in normal healthy controls. After stage I, at 26.5 days (18.3-40.8) total brain volume was 367.7 ml (341.8-385.5) in biventricular CHD, 353.6 ml (338.2-375.7) in single-ventricle CHD and 514.1 ml (482.9-554.6) at 116 days (94.5-118.5) in patients with single-ventricle CHD. At 12.1 months of age, neurodevelopmental performance determined by the Bayley III scale (mean ± SD [standard deviation]) was lower for patients with single-ventricle CHD (cognitive composite score [CCS]: 92.9 ± 13.1; language composite score [LCS]: 88.5 ± 12.0; motor composite score [MCS]: 85.6 ± 14.5) than in patients with biventricular CHD (CCS: 101.2 ± 11.1; LCS: 95.7 ± 13.1; MCS: 87.6 ± 18.0) or in healthy controls (CCS: 113.3 ± 5.6; LCS: 102.3 ± 7.9; MCS: 100.7 ± 8.2). Feasibility for performing cerebral MRI was limited due to maternal/patient safety reasons and further logistical infrastructural reasons.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Structural cerebr","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"4466"},"PeriodicalIF":1.9,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145763844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In dubio pro REA: criminal liability risks in resuscitation.","authors":"Marc Thommen","doi":"10.57187/s.5033","DOIUrl":"10.57187/s.5033","url":null,"abstract":"<p><p>Can lifesaving be punishable? Performing resuscitation in an emergency places individuals under great pressure. Empirical studies indicate that potential helpers often hesitate to intervene for fear of legal consequences. However, this concern is unfounded. The article examines four scenarios: death despite resuscitation, harmful or unwanted resuscitation, and omission of aid. The conclusion is unequivocal: in case of doubt, initiating resuscitation (\"in dubio pro REA\") is legally safe. Only in cases where it is clearly established that resuscitation is not desired does the exception apply, meaning that no assistance should be rendered (\"no means no\"). This article analyses criminal liability risks in resuscitation based on Swiss law. Nevertheless, the findings are broadly transferable to other jurisdictions, as the relevant offences are universally codified.</p>","PeriodicalId":22111,"journal":{"name":"Swiss medical weekly","volume":"155 ","pages":"5033"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145715851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}