Swedish ethics council criticised for new guidelines on extremely premature babies

A member of Sweden’s National Council on Medical Ethics has condemned new recommendations that prioritise palliative care for babies born before 23 weeks, calling them legally flawed and unprecedented in healthcare. The criticism follows updated guidelines issued after a national investigation into neonatal care practices.

Per Landgren, a council member since 2023 and former Christian Democrat MP, told public broadcaster SVT that the revised advice—recommending palliative care for infants born before week 23 and greater parental influence over treatment decisions—violates three key laws: the UN Convention on the Rights of the Child, the Discrimination Act, and Sweden’s national prioritisation platform for healthcare.

“These are precisely the children we must protect—those with the greatest needs,” Landgren said. He argued that the guidelines contradict the principle that patients with the highest medical needs should receive priority care, adding that presuming palliative care does not alleviate suffering but instead abandons vulnerable patients. “Nowhere else in healthcare do we leave patients to fend for themselves like this.”

The council’s proposal also calls for Sweden’s National Board of Health and Welfare to develop uniform national guidelines, as current practices vary: some hospitals attempt to save babies born as early as week 21, while others do not. Landgren warned that without a “presumption in favour of life,” regional disparities in care could worsen.

Sweden has previously stood out internationally for providing life-sustaining treatment to infants born at 22 weeks—or in rare cases, 21 weeks—below the country’s legal abortion limit of 22 weeks. The guidelines follow an investigative report by SVT’s Uppdrag Granskning titled “The Miracle Children,” which examined outcomes for extremely premature babies.