What you need to know about drawing up a patient decree and advance care directive

There are two ways in which you can make arrangements in advance in the event that you are no longer able to make decisions for yourself. You can draw up a patient decree and an advance care directive. Depending on what matters you wish to arrange, you will need to draw up a patient decree or an advance care directive.

The patient decree is the document in which you set out what kind of nursing and medical care you would like to receive and the kind of medical treatment you would like to receive from your doctor.

The advance care directive enables you to decide who should act as your representative. The advance care directive sets out the matters for which this person may act on your behalf. This could involve the following:

• Personal income and assets
• Payment transactions
• Legal representation
• Contractual matters
• Medical treatment
• Everyday assistance

What is a patient decree?
A patient decree sets out your views regarding health and illness. It contains instructions on medical care and specifies the treatments you consent to or refuse should you no longer be able to decide for yourself.

Unlike the advance care directive, you do not have to be of legal age to draw it up. Having the ability to make judgments is enough.

What is an advance care directive?
In an advance care directive, you can appoint a representative to make decisions on your behalf if you are no longer able to make your own decisions. An advance care directive is necessary if you wish to settle matters of a financial or legal nature.

Financial matters include, for example, paying your bills. This part of the advance care directive is called management of assets.

Concluding a residential care home contract, for example, is a legal matter. This part of the advance care directive is called representation in legal matters.

You can also record what kind of nursing and medical care as well as the kind of medical treatment you would like to receive from doctors. You can also refer to your patient decree in the advance care directive. This part of the advance care directive is called personal care.

You can describe the tasks that need to be done. For example, that you plan to sell your car so you can pay the deposit for a residential care home.

What form do the documents have to be in?
Drawing up a patient decree or an advance care directive is difficult. To avoid mistakes, you should seek advice from an expert. Your local branch of the Swiss Cancer League will help you find someone to advise you.

To ensure that an advance care directive is valid, the document must be written completely by hand, and also be signed and dated. You can also type it up and then have it certified by a notary.

To be valid, an advance care directive must be made by a person of sound mind and of legal age (capacity to act).

To be valid, a patient decree must also be in writing, signed and dated. Unlike an advance care directive, you do not have to write it yourself. You may use and sign a template.

Templates for advance care directives and patient decrees can be ordered or downloaded from the internet. You can find the Swiss Cancer League’s patient decree in their online shop. To make a valid patient decree, you must have the capacity to make sound judgments, but you do not have to be of legal age.

Where should I keep the advance care directive and patient decree?
Your patient decree and advance care directive are of no use to you if they cannot be found in the event of an emergency. It is important that people know where the items are stored. You can register the location of your advance care directive at the civil registry office. We recommend doing this.

Give a copy to the person you have named in the document as your representative in the event of an emergency. You should give your patient decree to your GP and other people you trust.

Consider keeping a card with their names and phone numbers on it in your purse or wallet.

Whom can you authorize to be your representative?
You can appoint anyone aged 18 or over to act as your representative. It is advisable to appoint two representatives in the case of a patient decree. It is also best if these people are present while it is being drawn up.

Choose people you trust and who are up to the task. They do not need to sign the document.

In the case of an advance care directive, you can also appoint a company, such as a law firm, to represent you.

How long are a patient decree and advance care directive valid for?
A patient decree and advance care directive apply only if you are incapable of making your own decisions. Once you regain your ability to make decisions, both documents lose their validity.

What happens if I do not draw up a patient decree or advance care directive?
The following applies if you are unable to make your own decisions and have not drawn up a patient decree or advance care directive:

• Your spouse or registered partner may stand in for you if you are unable to perform certain tasks. For example, he/she is authorized to open your post and to settle accounts with the residential care home. However, this only applies if you live together or support each other on a regular basis.
• The law sets out who can represent you in medical matters. They include your spouse or registered partner, people living with you in the same household (e.g. a cohabiting partner), your children, parents, siblings and grandchildren. You need to be in regular contact with them. In urgent cases, doctors are permitted to decide for themselves.