Objectives: The commissions for risk assessment of offenders dangerous to the public were established in 1995 in Switzerland. The main goal was to reduce recidivism of offenders released into the community by means of identifying high-risk offenders and recommending measures for offender management. This study investigates long-term recidivism data of this high-risk cohort of offenders.Methods: Baseline data included risk assessment of one of the commissions, the type of index offense, and psychiatric disorders according to ICD-10 for the total cohort of offenders examined by the commissions between 1995 and 2009. Criminal records were drawn in 2019 for all offenders from the Swiss Federal Office of Justice.Results: From a total of 147 offenders 35 recidivated within a median time at risk of 9.1 years (31.8%), of which 10 (9.1%) recommitted a severe offense. Within the treatment status, sentences (imprisonment and preventive detention) were compared to court-ordered measures (in- or outpatient court ordered treatment, civil court mandated treatment, vocational training facility). There were no significant differences comparing treatment status, different diagnostic groups, type of index offense and other risk factors. Except of age at release (or relapse), which predicted recidivism with younger subjects showing higher recidivism rates (p = 0.014).Conclusion: Our study showed that over a long-term time at risk this high-risk cohort showed a similar recidivism rate as many other studies with different cohorts. With appropriate management recidivism rates in high-risk offenders can be lowered allowing them being consecutively reintegrated into society. The finding that younger subjects have higher recidivism rate was reproduced in this population.

With about 65,000 deaths per year in Switzerland, about 1,000 assisted suicides of Swiss citizens are carried out with the help of assisted dying organizations per year. Assisted suicide, which is carried out without selfish motives on the side of the helping person, only remains unpunished if there is a free will decision by the person willing to die who has the capacity of judgement and to act independently. While this is usually accepted as an option for somatically terminally ill patients in society at large, this procedure is controversial for psychiatrically ill patients. In Switzerland the topic of assisted dying is highly debated between medical professionals. In 2018, the Swiss Academy of Medical Sciences (SAMS) put revised guidelines into force, which are in discrepancy to the current rules of the Swiss Medical Association (FMH). This article gives an overview of the past and current development of the Code of Professional Conduct and medical-ethical guidelines as well as current Swiss criminal and medical law on this topic. Practical implications for the assessment of assessing persons with mental illness in this circumstances are discussed. It is to be concluded, that persons with a mental illness seem to face extra obstacles in relation with somatically ill persons as the assessment of the prerequisites comprises additional requirements. Among other issues there is an urgent need for the elaboration of contents to be assessed and standards of procedures. The procedures and guidelines to be elaborated should be scientifically accompanied in order to gain a more reliable basis for decision-making. Multidisciplinary assessments would help to avoid biases and blind spots of a mono-disciplinary assessments. In addition, even in the case of mentally ill people, their right to self-determined suicide should not be restricted by excessive hurdles in the assessment process. Lastly, reliable funding should be secured, as it is otherwise to be expected that the complex assessment of prerequisites through multi-professional-teams or just one assessor cannot be sustained. The exercise of fundamental rights must be possible for all persons to the same extent, regardless of their financial resources.

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L'abus sexuel d' enfants fait partie des délits les plus graves et ayant le plus de conséquences pour les victimes. Des méta-analyses suggèrent qu' environ 13,4% à 19,7% des filles et environ 5,7% à 8,8% des garçons sont victimes d'abus sexuels dans le monde [1, 2]. Selon une enquête menée auprès d' écoliers et écolières suisses (N=7000), 22% des filles et 8% des garçons ont déclaré avoir déjà été victimes d'agression sexuelle avec contact physique (autrement dit, avoir être touchés ou embrassés de manière non consentie dans une intention sexuelle) [3]. 40% des filles et 20% des garçons ont également décrit des agressions sans contact physique (exhibitionnisme, harcèlement via les médias électroniques).Ces taux de victimisation élevés ne se reflètent guère dans la statistique policière de la criminalité. Ainsi, au cours des dix dernières années, entre environ 1 100 et 1 300 cas d'abus sexuels sur des enfants ont été signalés chaque année en Suisse. [4]. La statistique policière 2020 donne pour la première fois des chiffres sur les cyber-délits sexuels (pornographie interdite, pédopiégeage, live streaming d'actes d'abus); en 2020, 2 612 cyber-délits sexuels ont été enregistrés et 283 victimes ont été identi-© Alexander Melnikov / Dreamstime Prévenir les abus sur enfants Prévention Facile d'accès, anonyme et en partie gratuite: l'association «Kein Täter werden Suisse» aide les personnes qui sont attirées sexuellement par des enfants. Une année après l'introduction de cette offre de prévention, le bilan est positif.