Advance Care Directive & Living Will in Switzerland 2026

The misconception almost everyone shares

Imagine you spend a few weeks in a coma after a bike accident. Who pays your bills now? Who renews the mortgage that happens to expire this month? Who decides whether the doctors operate?

Most people answer: "My partner, obviously." And that is exactly the misconception. In Switzerland, without an advance care directive (Vorsorgeauftrag), your spouse may only handle everyday matters – paying the rent, opening the mail, managing the account within the usual scope. For anything beyond that, they need approval from the KESB, the child and adult protection authority. And if you live together unmarried, your partner has no legal say at all. None.

The good news: two documents put you back in charge – the advance care directive and the living will (Patientenverfügung). Both cost little to nothing, and both can be done in an afternoon. In this post I'll show you what they cover, where the pitfalls are, and how to set them up step by step.

What happens if you haven't arranged anything

Since 2013, Switzerland's revised adult protection law applies. It draws clear lines depending on who you are and what's at stake:

You're married or in a registered partnership. Your spouse has a statutory right of representation (Art. 374 of the Civil Code) – but only for everyday life: paying bills, handling the mail, ordinary management of income and assets. As soon as something extraordinary comes up – selling the flat, restructuring the portfolio, withdrawing a larger sum – the KESB has to approve every single transaction. Your partner becomes a petitioner at an authority, at a moment that's already hard enough.

You live together unmarried. Then your partner has no statutory right of representation whatsoever. They may neither touch your account nor speak bindingly with doctors. In an emergency, the KESB appoints a deputy – and the authority decides who that is, not the two of you. It could be a family member you haven't spoken to in years, or an outside professional.

You're single. Same situation: without an advance care directive, the KESB determines who acts for you.

And if you're thinking "but I gave my partner a bank power of attorney" – that only helps to a degree. Many banks no longer simply accept an ordinary power of attorney once they learn the account holder is incapacitated, and instead demand confirmation from the KESB or a validated advance care directive. The bank power of attorney is a sensible addition for everyday matters, but not a substitute.

Incapacity is not an old-age topic, by the way. An accident, a stroke, a serious illness – it can happen at 32 just as easily as at 78. Especially if you have children, own property or run your own business, don't put this off.

The advance care directive: you decide who acts for you

With the advance care directive you determine who takes over your affairs if you become incapacitated. The law splits this into three areas, which you can assign to the same person or to different people:

• Personal care: decisions about care, support and living situation – for instance whether a move to a nursing home is needed.
• Asset management: managing accounts, securities, property, bills and taxes.
• Legal representation: concluding or terminating contracts, dealing with authorities, handling mail.

You can appoint any person of trust with legal capacity – your partner, an adult child, a sibling, a close friend. A company such as a fiduciary is also possible, though only for asset management and legal representation. Important: always name a substitute. If your first choice can't or won't act when it matters, the KESB steps in after all.

The formal requirement that trips people up

The advance care directive is only valid in two forms:

1. Handwritten: written entirely by hand, dated and signed. A document typed on a computer and merely signed is invalid – this is the single most common mistake.
2. Publicly notarized: at a notary or, depending on the canton, at the official notariat. Depending on canton and complexity, this typically costs a few hundred francs.

Notarization is worth it if your situation is complex (a business, property, a blended family) or if you want certainty that no one will later question your capacity at the time of writing. For straightforward situations, the handwritten version is perfectly sufficient.

Registering and making it findable

The best directive is useless if nobody finds it. For a small fee, you can have the civil registry office record that an advance care directive exists and where it is kept. The KESB checks this database in an emergency. In addition: tell the person you've appointed and let them know where the original is – in a folder at home, at the notary, or in some cantons deposited directly with the KESB.

What happens when it matters

If you become incapacitated, the KESB reviews the directive once: was it validly drawn up? Is the appointed person suitable? They then receive a certificate and can act – without the authority signing off on every decision. That is precisely the difference from having no directive: one validation instead of constant approvals.

The living will: your medical decisions

The living will covers the medical side: which treatments do you consent to, which do you refuse, if you can no longer express yourself? Typical points are resuscitation, artificial ventilation, artificial feeding and pain therapy. You also designate a medical representative who decides for you on questions your living will doesn't answer.

The formal requirements are much looser than for the advance care directive: in writing, dated and signed by hand is enough. You may fill in a template on the computer and sign it by hand. No notary needed.

Free, medically sound templates are available from the FMH (the Swiss Medical Association), the Swiss Red Cross and Pro Senectute – usually in a short and a detailed version. Set aside an hour for the detailed version and ideally talk through the difficult questions with your family doctor. That conversation also helps your representative: they won't have to guess later what you meant by what you ticked.

Two things are often forgotten: refresh the living will roughly every two years with a new date and signature – doctors give more weight to a recent document. And carry a note in your wallet saying where your living will is kept; most templates come with a card for exactly that.

The two documents compared

In short: the advance care directive protects your assets and day-to-day self-determination, the living will protects your body. You need both – they don't replace each other.

Done in five steps

Step 1: Choose your people and ask them. Who do you want as your representative – and who is the substitute? Ask them directly. Nobody should be surprised by a KESB certificate in an emergency.

Step 2: Fill in the living will. Download a template from the FMH, the Swiss Red Cross or Pro Senectute, fill it in calmly, date it, sign it. Time needed: about an hour.

Step 3: Write the advance care directive. For straightforward situations: by hand, covering personal care, asset management and legal representation, with a main and a substitute person, date, signature. For complex situations: book a notary appointment.

Step 4: Register and inform. Have the storage location recorded at the civil registry office, keep the original safe but accessible (not in a bank safe deposit box nobody can reach in an emergency), and inform your representatives.

Step 5: Review every two to three years. Are the people still right? Has your life changed – marriage, separation, children, buying a home? Re-date and re-sign the living will.

The most common mistakes

• Advance care directive typed on a computer. Invalid. Either entirely by hand or off to the notary.
• No substitute named. If your first choice drops out, the case ends up with the KESB after all.
• Nobody knows the document exists. A directive nobody can find effectively doesn't exist.
• A living will from 2015 in the folder. Formally still valid, but a ten-year-old document raises doubts about whether it still reflects your wishes.
• "We're married, that's enough." It's enough for everyday matters only – not for selling a house, renewing a mortgage or portfolio decisions.
• Relying on habit as an unmarried couple. Without documents, your partner is legally an outsider.

Practical tip: the emergency file

In addition to the two documents, set up a simple emergency file – a physical folder or a clearly named cloud folder your trusted person knows about. It should contain: copies of the advance care directive and living will (with a note where the originals are), a list of your accounts, insurance policies and ongoing contracts, your AHV number, your pension fund certificate, and the contact details of your family doctor, fiduciary and notary. If you have a will, add its storage location to the list. Effort: one evening. Value in an emergency: priceless – your loved ones won't spend weeks hunting for paperwork while everything else is on fire.

Bottom line: two documents, one afternoon

Without an advance care directive and a living will, an authority or the statutory order decides in an emergency – not necessarily the people who know you best. With these two documents, you take that decision back, for somewhere between zero and a few hundred francs.

Concretely, this week: download the living will template from the FMH or the Swiss Red Cross and fill it in. Next week, write your advance care directive by hand. After that, you're covered in an area that more than half of all Swiss residents leave completely open. And while you're at it: a look at our post on writing a will rounds off the planning trilogy.