Advance directives in Switzerland: understand everything and create your own online
Introduction
An accident. An operation gone wrong. A disease that progresses too quickly. In these moments, you may no longer be able to say what you want — neither to your doctors nor to your loved ones.
Advance directives are the document that speaks for you.
Recognized and binding on medical teams under Swiss law, they allow you to indicate in advance which treatments you accept or refuse, and to designate the person who will defend your interests if you can no longer do so yourself.
This guide explains everything you need to know — and allows you to create your template based on the official FMH (Swiss Medical Association) form directly online, without downloading a PDF.
Advance directives — also called “end-of-life arrangements” — are a written document in which you express your wishes regarding the medical treatments you consent to or do not consent to, in the event that you become incapable of making decisions.
Incapacity to make decisions means that you are no longer able to express or understand decisions that affect you. This can occur suddenly—following an accident, cardiac arrest, or serious injury—or gradually, as part of a progressive illness or advanced dementia.
This document allows you to:
Indicate which treatments you want or refuse in different medical situations
Appoint a healthcare proxy — a trusted person who will discuss matters with doctors and make decisions on your behalf.
Express your values and your attitude towards life, so that your loved ones and caregivers understand what matters to you.
State your position on organ donation
In Swiss law, validly established advance directives are binding on doctors.
What is the practical purpose of advance directives?
They respect your wishes when you can no longer express them. Without this document, the medical team decides — in an emergency, without knowing your wishes.
They bring relief to your loved ones of an overwhelming responsibility. Having to choose between resuscitation or palliative care for someone you love, without knowing what they would have wanted, is one of the most difficult situations imaginable.
They guide the doctors with clear and legally valid instructions, even if your usual doctor is not available.
They designate your therapeutic representative — the person who will represent your voice to the healthcare team, consult your medical file and participate in decisions.
Is it mandatory in Switzerland?
No. Advance directives are not mandatory. However, they are strongly recommended — by the FMH (Swiss Medical Association) and the HUG (Geneva University Hospitals) — because they are the only legal way to guarantee that your wishes will be respected if you are no longer able to express them.
Without advance directives, doctors will apply the default legal rules of representation: your spouse or registered partner, then your descendants, then your parents. This may not be the person you would trust most to make this type of decision.
Who can establish advance directives?
Every person capable of discernment, regardless of age. You don't need to be in poor health to write them — on the contrary, writing them in good health allows you to think calmly, without pressure.
Two conditions are required:
To be capable of discernment at the time of drafting and signing
Not having drafted the document under duress
What the official FMH model contains
The reference form in French-speaking Switzerland is that of the FMH (Swiss Medical Association)Legal Testa automatically generates this template from your answers. Here's what it contains:
Section 1 — Your personal data and your therapeutic representative
The first section identifies who you are and who will represent you.
Your data: Name, surname, date of birth, address.
Your therapeutic representative — This is the most important designation in the document. This person:
You are authorized to assert your wishes to the healthcare team.
Must be informed of your health condition
It is integrated as soon as possible into all medical decision-making
Can access your entire medical file if necessary
How to choose your therapeutic representative? It doesn't have to be your spouse or eldest child. It's someone who knows you well, who will be able to make difficult decisions in a moment of extreme stress, and who will respect your wishes even if they differ from their own. Discuss this with them before appointing them—and inform them of your directives.
You also indicate your attending physician, to whom you can give a copy of the document.
Section 2 — Your attitude towards life
This section is often underestimated, but it is essential. It allows your loved ones and doctors to get to know you as an individual, beyond the boxes to be ticked.
You can think about it and answer questions such as:
Why are you writing these guidelines?
What matters to you about your health?
What brings you joy in life?
What is causing you concern or fear?
What do you think about when you imagine being seriously ill?
These answers help doctors interpret your choices in situations the form might not have explicitly addressed. A purely technical document without this section can be difficult to apply in ambiguous cases.
Section 3 — The three medical situations and your treatment choices
This is the core of the document. The FMH distinguishes three situations you may encounter, and for each you choose between two therapeutic objectives: the life support (Intergovernmental Panel on Climate Change) and the alleviation of suffering.
Situation 1 — Emergency: sudden incapacity for judgment
This is a sudden loss of your ability to express yourself, in a situation where recovery is normally possible: serious injury in an accident, cardiac arrest, loss of consciousness.
You have three options:
Option A — Life support with full resuscitation You wish to be resuscitated and admitted to the intensive care unit. Everything is being done to keep you alive.
Option B — Life support without resuscitation You wish to be admitted to intensive care, but without cardiopulmonary resuscitation if your heart stops.
Option C — Relief of suffering You do not want resuscitation or intensive care. The goal is your comfort, not keeping you alive at all costs.
You are unable to make decisions for several days or weeks, but recovery is still possible: coma following an accident, prolonged state of unconsciousness.
The same three options apply, but within a different timeframe. Your response may differ from situation 1—some people want to try everything in the immediate emergency, but fewer interventions if the incapacity is prolonged.
Situation 3 — Permanent disability
You will most likely never be able to express yourself again: after-effects of a severe brain injury without the possibility of social interaction, advanced dementia.
This is often the most difficult situation to anticipate, and the most important to clarify. Without guidelines, doctors and families can find themselves in a situation of great uncertainty for years.
Can we respond differently for the three situations? Yes — and that often best reflects the reality of people's wishes. Someone might want complete resuscitation in an emergency situation (where recovery is possible), but choose pain relief in the event of permanent disability.
Section 4 — Treatment of pain and other distressing symptoms
Regardless of the chosen therapeutic objective, you specify your wishes regarding the management of pain, respiratory distress, anxiety or nausea.
Option A — Effective pain treatment You want optimal symptom relief, even if this treatment alters your state of consciousness or potentially reduces your remaining lifespan.
Option B — Priority to mental agility You prefer to remain lucid and communicate with your loved ones, even if it means enduring certain symptoms.
There is no right or wrong answer — this section reflects what matters most to you in these moments.
Section 5 — Organ Donation
You indicate your position on organ donation after your death:
Yes, all the organs: You authorize the removal of all your organs, tissues and cells
Yes, except: you can exclude certain specific organs
No : you do not wish to donate your organs
Since July 1, 2023, Switzerland has adopted presumed consent. If you have not expressed a refusal, you are considered a default donor. Your advance directives are precisely where you can formalize a refusal if that is your wish.
Create your advance directives template with Legal Testa
This is where Legal Testa makes the difference compared to the classic FMH PDF that you download and fill out yourself.
Our generator guides you through each section of the official form, explaining in clear language what each choice entails. At the end, your document is automatically generated in FMH format — ready to be printed, dated, and signed by hand.
What our tool does for you:
Personal data — We pre-fill what we already know from your profile
Therapeutic representative — You enter their details; we integrate them in the correct format
Attitude towards life — A guided space to express your values in free text
The three medical situations — Clear choices with an explanation of each option before answering
Pain and symptoms — Two options explained simply
Organ donation — With a reminder of the presumed consent rule in effect since 2023
Document generation — The completed FMH form, ready to print and sign
This guide allows you to create your own template based on the official FMH (Swiss Medical Association) form directly online. You can then print and save it.
Preservation is as important as writing. Guidelines that cannot be found at the critical moment are useless guidelines.
Storage options:
At your primary care physician's office (recommended first — the doctor is the first to look for this document)
At your healthcare representative's office
In the Legal Testa digital vault
At the Swiss Red Cross drop-off center (paid service, available 24/24)
In your electronic patient record (EPR), if you have one.
The wallet card: The FMH provides a small card to cut out and keep in your wallet, indicating the existence of your directives and their location. In an emergency, this is often the first place people check.
Update : The FMH recommends reviewing your advance directives every two yearsto add a new date and signature. Your values and health situation may change — your document must remain a reflection of your current wishes.
Frequently asked questions about advance directives in Switzerland
Are advance directives legally binding in Switzerland? Yes. Since the new Civil Code came into effect in 2013, advance directives are legally binding for physicians, provided they are validly established (indicating capacity for discernment, and are dated and signed by hand) and that the person is in a situation covered by the document. Any violation may be subject to legal penalties.
Do you need to have your advance directives authenticated by a notary? No. In Switzerland, no authentication by a public official is required. The formal requirements are: capacity for discernment at the time of drafting, clearly stated identity, and a dated and handwritten signature. That's all.
Can a doctor refuse to follow my advance directives? In very limited cases. If the doctor has serious reasons to believe that the directives no longer reflect your current wishes, or if there is a clear conflict of interest with the healthcare proxy, they may refer the matter to the adult protection authority. Otherwise, they are obligated to respect them.
Can I modify or revoke my directives at any time? Yes, provided you are still capable of making your own decisions. You can modify, supplement, or revoke them entirely. If you verbally express a wish contrary to your written directives during treatment, your words spoken at the time prevail—even if they contradict what you wrote.
What is the difference between advance directives and a power of attorney for incapacity? These are two complementary but separate documents. Advance directives concern your medical care. A power of attorney for incapacity designates the person who will manage your personal and financial affairs if you become incapable of making decisions—paying your bills, managing your housing, and making estate decisions. It is recommended that both documents be completed together.
→ Learn more about the mandate for incapacity
What happens if I don't have a designated therapeutic representative? The law provides a default order of representation: spouse or registered partner, then descendants, then parents, then siblings. If you wish to have someone else represent you—a close friend, an unmarried partner—you must explicitly designate them in your advance directives or in a power of attorney for incapacity.
Are my instructions written abroad valid in Switzerland? In principle, yes, if they were drawn up in accordance with the law of the country where they were written. However, to avoid any uncertainty, it is recommended to have a document drawn up under Swiss law if you reside in Switzerland.
At what age should you write your advance directives? There is no minimum or optimal age. As soon as you are capable of making sound judgments—in practice, from adulthood—you can establish them. Most experts recommend not waiting for a serious illness to start thinking about it: drafting your advance directives when you are healthy and calm offers the best guarantee of quality and thoughtful consideration.
Advance directives and inheritance: the often-forgotten link
Advance directives are part of a larger set of documents that everyone should have prepared. As part of comprehensive planning, they complement:
Le Types of will — who organizes the transfer of your assets after your death
Le mandate due to incapacity — who designates your legal representative for personal and financial matters should you become incapacitated
Legal Testa generates the official FMH advance directive template. This service does not replace the advice of a doctor or specialist for complex medical situations. It is recommended that you share your directives with your treating physician.
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