Sweden has it all – except freedom of conscience

A court has ruled that abortion rights leave no room for a midwife to be exempted.


Carolyn Moynihan*

Because of its welfare state and gender equity policies Sweden has become a beacon of progressiveness in everything that affects women. But there is one kind of woman the Scandinavian state seems to have no time for: a health professional who objects to abortion.

Two years ago Ellinor Grimmark completed a midwifery internship at Hoglandssjukhuset women’s clinic in southern Sweden, but because she told the management that she had a conscientious objection to performing abortions, she was denied further employment there.

A voicemail message from the head of the maternity ward informed her that she was “no longer welcome to work with them”, and she was challenged about “whether a person with such views actually can become a midwife.” Her student funding was also cancelled.

Mrs Grimmark was subsequently turned down for employment at another clinic, where she was told that a “person who refuses to perform abortions does not belong at a women’s clinic”.

Finally she was offered a job at the Varnamo Hospital women’s clinic. But by then she had filed a civil rights complaint against the Hoglandssjukhuset clinic with the local Equality Ombudsman, and when the media got wind of it Varnamo withdrew its offer.

These days Mrs Grimmark practices her profession in Norway, where her conscience rights are respected, but her case is by no means closed.

The Ombudsman’s ruling held that she was not being discriminated against for her pro-life views but for not being available to fulfil the job description, thus threatening the “availability of abortion care” and the “protection of health” of patients requiring an abortion in Sweden.

Represented by the organisation Scandinavian Human Rights Lawyers, she then took her case against the county where the Hoglandssjukhuset clinic is located to the Jonkoping District Court, at the same time seeking compensation for damages and discrimination – a total of 140,000 Swedish kronas (around $20,000 USD).

Last week that court acknowledged that Mrs Grimmark’s rights had been infringed, but it still ruled against her, saying that maternity centres have the right to define job descriptions and a “duty to ensure that women have effective access to abortion.” The court also ruled that she is liable to pay for the other party’s legal costs, which will amount to more than USD $109,000.

The US-based Alliance Defending Freedom, which filed an amicus brief on behalf of Mrs Grimmark, regards this order as calculated to scare others who might follow her example. Her wages as a midwife are unlikely to measure up to such punishing costs. Her husband has launched an appeal for funds on Facebook.

Strong grounds for appeal

There are, however, solid grounds for an appeal, as her senior counsel, Ruth Nordstrom, has indicated. She said it was disappointing that the lower court had “decided not to examine the right of freedom of conscience according to international law and the European Convention on human rights, at all.”

The fact is that freedom of conscience is a fundamental human right protected by the 1950 European Convention on Human Rights and Fundamental Freedoms (ECHR), signed by Sweden in 1993. Article 9 (2) states:

“Freedom to manifest one’s religion or beliefs shall be subject only to such limitations as are prescribed by law and, in a democratic society, are necessary with regard to the general public safety or the protection of public order, health or morals or for the protection of other rights and freedoms.”

Is Sweden’s democracy and public health so fragile that it cannot stand the odd health worker being exempted from the grisly business of killing unborn babies?

It’s true that the country seems to have a pressing need for abortion – one in every two women who get pregnant during their lifetime has a termination. This gives Sweden the highest rate in Scandinavia and one of the highest rates in the world – especially among teenagers, who are schooled in birth control rather than abstinence.

Perhaps it is Sweden’s famously liberal sexual culture that makes it so defensive of abortion rights. Writing in National Review in May, Jacob Rudolfsson of the Swedish Evangelical Alliance noted:

* The Swedish Association of Health Professionals has offered no support for Ellinor Grimmark, since it is committed to abortion.

* “Only one hospital has offered her ‘assistance’, and it was for a counsellor to help her ‘overcome her aversion to abortion’ …”

* One local health administrator has declared that he “would gladly stand in the front with a baseball bat to prevent” conscientious objectors working in his hospital.

* Mona Sahlin, the national coordinator against violent extremism, has declared that “one who refuses to participate in abortions is an extreme religious practitioner,” one who is simply “on a different level from the Islamic State”.

Did you get that? A pro-life Swede is just a few notches down from jihadi terrorists, on the same scale.

And yet, says Rudolfsson, when the current Abortion Act was drafted in 1974, assurances were given that medical workers would, for ethical or religious reasons, be able to opt out of participating in abortions. “Forty years later, the consensus has changed.”

‘Consensus’ may carry the day, but whose consensus?

But this freedom-stifling “consensus” actually puts Sweden out of step with a 2010 resolution of the Parliamentary Assembly of the Council of Europe that states:

“No person, hospital or institution shall be coerced, held liable or discriminated against in any manner because of a refusal to perform, accommodate, assist or submit to an abortion, the performance of a human miscarriage, or euthanasia or any act which would cause the death of a human fetus or embryo, for any reason.”

Clear enough, surely, but Sweden has wriggled around resolution 1763 by arguing that it is “soft law” and that it interferes with its own laws guaranteeing abortion within certain limits. At the same time it argues that a midwife’s participation in abortion is required by the (older) ECHR provision that “the interests and rights of individuals seeking legal medical services are respected, protected and fulfilled.”

Legal battles have also been waged in Scotland, Poland, Croatia and Norway, but according to ADF, even last week’s Swedish court acknowledged that the majority of European states allow for rights of conscience for doctors and nurses.

And according to Swedish legal scholar Reinhold Fahlbeck, the stronger the European consensus, the less wriggle room there is for Sweden — or other holdout states.

That consensus just got stronger with a ruling from Poland’s highest court, the Constitutional Tribunal, last month recognising the rights of all medical staff to not perform abortions, based on their conscience. It further ruled that neither would they be required to refer women seeking abortions to physicians who would perform them.

ADF notes that the Polish ruling “significantly raises the stakes in Ellinor’s case, as a victory could define conscience rights for all European medical workers.”

It would also allow some fresh air to blow through the stifling conformity of Sweden’s sexual culture which depends so heavily – and thoughtlessly, it seems – on extinguishing human life. Even for women’s equality, this is too high a price.

This article is published by Carolyn Moynihan and MercatorNet.com under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact Mercatornet for permission and fees. Some articles on this site are published under different terms.

Lack of Conscientious Objection Clause for Medical Staff in Sweden

Decision of the European Committee of Social Rights

News Release

European Federation of Catholic Family Associations  (FAFCE)

Contrary to Resolution 1763 adopted by the Parliamentary Assembly of the Council of Europe (PACE) on 10 October 2011, Medical Staff in Sweden have no legal right to conscientious objection in case of ethically sensitive issues which occur particularly at the beginning and the end of life. The European Federation of Catholic Family Associations (FAFCE) which has a participatory status with the Council of Europe submitted a collective complaint against Sweden in 2013 based on the above grounds and the right to health, together with the Swedish organisations Provita and Christian Medical Doctors and Students (KLM). The decision of the European Committee of Social Rights was made public today.

One of the issues addressed in the Collective Complaint against Sweden was freedom of conscience for medical staff. In its response to the Complaint the Swedish Government argued that freedom of conscience should be discussed in the work place and that if the issue can’t be resolved in a satisfactory manner for the employee, it can be brought before Court, based on article 9 of the European Convention on Human Rights which is incorporated into the Swedish law and on the grounds of the anti-discrimination law for the individual. The right to freedom of conscience is enshrined in article 18 of the Universal Declaration of Human Rights and in article 9 of the European Convention on Human Rights.

In its response the Government also notes that contacts have been established with the concerned employers and workers union: none of these could provide examples of situations where freedom of conscience had been problematic. Thus the Government considers that the problem is purely theoretical.

”It is of course very noteworthy that the Government stated that denied freedom of conscience only is a theoretical problem in its response to the European Social Rights Committee. In a recent complaint to the United Nations Swedish by European Centre for Law and Justice, medical staff – four midwifes, three general practioners and two pediatricians – testify of how the negative attitude towards freedom of conscience has limited them and their colleagues in their professional practice”, says Mrs Nordström, CEO or Provita and President of Scandianvian Human Rights Lawyers, and the legal representative of a Swedish midwife, Ellinor Grimmark, in an ongoing courtcase about freedom of conscience in Sweden. Mrs Grimmark lost her job and was refused employment due to her refusal to perform abortions as part of her tasks as a midwife at several Swedish hospitals. – “This is a concrete case that proves that freedom of conscience for medical staff is all but a theoretical problem in Sweden”, says Ruth Nordström.

In its decision the European Committee of Social Rights states that it has previously, in a Collective Complaint against Italy, considered whether freedom of conscience in accordance with article 11 of the European Social Rights Charter affects women’s access to abortion in Italy (International Planned Parenthood Federation vs. Italy (Complaint 87/2012)).

The Committee establishes that article 11 is not applicable in this case, where the situation is the opposite, i.e. where women’s access to abortion is not affected. Since article 11 is not applicable the Committee does not take a position regarding the issue of discrimination according to article E in the European Social Rights Charter.” says Ruth Nordström.

The Swedish Federation of Medical Doctors (Läkarförbundet) and the Swedish Federation of Medical Staff (Vårdförbundet) together with the Swedish Planned Parenthood Federation (RFSU) recently claimed that ”conscience clauses threaten free abortion”. In other words the official representative bodies of medical staff in Sweden consider access to abortion as superior to freedom of conscience. FAFCE’s President Antoine Renard remarks that “this statement is a stark contrast to the position recently expressed in another Council of Europe Member State, namely France where The National Council of the Order of Medical Doctors publically opposes the suppression of the conscience clause related to abortion and “recalls that it is a fundamental provision foreseen by the medical deontological statute-book and by the public health law.”

Furthermore, the Committee considers that it cannot be proven that the number of abortions in Sweden is considerably high or that these abortions are a result of insufficient access to preventive measures.

FAFCE’s Secretary General Maria Hildingsson underlines that ”Sweden has among the highest abortion rates in Europe, year after year, statistics show this trend very clearly.” She considers that “it is regrettable that the European Committee of Social Rights does not take a clear stance in favour of stronger legal protection regarding the ethical issues addressed in the Complaint.

Regarding sex selective abortions in Sweden, another issue reported in the Complaint and the treatment of infants surviving late term abortions the Committee states in its decision ”that FAFCE’s complaints relate to an issue which is very sensitive for many of the State Parties to the Charter, i.e. the question of when human life begins, which depends on the wide diversity of values and traditions in the different states.”. The Committee pursues by saying that “States Parties enjoy a wide margin of appreciation in deciding when life begins and it is therefore for each State Party to determine, within this margin of appreciation, the extent to which a foetus has a right to health.”

“The issue of infants surviving late term abortion has caught considerable attention across Europe during the recent months, namely in connection with a petition signed by over 200 000 citizens which will be debated in the Legal Affairs and Human Rights Committee of the PACE next week” underlines FAFCE’s President Antoine Renard.

“It is astonishing that the Committee argues that Member States should decide when life begins. It is an undisputed biological fact that life begins at conception. What the committee is likely to mean is when the unborn life should be protected and granted human dignity. This wording can hardly be due to ignorance, but rather it is a rhetorical approach that’s both tendentious and cynically” says Tomas Seidal, Vice President of KLM.

”The issue of abortion has been, is and will remain controversial for us who work in medical care, since it is a unique intervention with the consequence of putting an end to a human life. We also consider that the issue becomes particularly complicated when the unborn child is the object of medical care in other circumstances, and as such a patient with the right to life and health care. If it collides with a strongly established conviction and belief against extinguishing a life at its beginning, there must be room for conscientious freedom” says Tomas Seidal.


Maria Hildingsson, Secretary General, European Federation of Catholic Family Associations  (FAFCE)
+32 4 70 20 39 18

Ruth Nordström, President, Provita 
+46 70 725 1917

Tomas Seidal, Vice-President, Christian Medical Doctors and Students (KLM)

Founded in 1997 the European Federation of Catholic Family Associations (FAFCE) holds a participatory status with the Council of Europe, is a member of the EU Fundamental Rights Agency Platform, and represents family associations from 15 European countries.

Doctors, midwives revolt over mandatory abortions

Legal center files complaint with U.N. over requirement to participate

World Net Daily

Bob Unruh

A formal complaint has been submitted to the United Nations against Sweden over its practice of requiring physicians and others to perform abortions.

While there was an uproar in the United States and a successful court challenge to President Obama’s plans to require people to pay into a fund for abortions, in Sweden officials have carried the mandate much further, according to the complaint submitted by the European Center for Law and Justice.

Director Gregor Puppinck wrote to Heiner Bielefeldt, special rapporteur on freedom of religion or belief, at the office of the high commission on human rights at the U.N.

The victims are represented by several named midwives, doctors and pediatricians, he explained. . . [Full text]

Swedish midwife denied employment for being pro-life

ADF files brief with Swedish court after three different clinics won’t consider woman because of her beliefs

News Release

Alliance Defending Freedom

JÖNKÖPING, Sweden – Alliance Defending Freedom has filed a friend-of-the-court brief with the district court of Jönköping County Council in Sweden on behalf of a midwife whom three different medical clinics denied employment because she will not assist with abortions.

“No one deserves to be denied a job simply because she is pro-life,” said ADF Senior Legal Counsel Roger Kiska. “International laws to which Sweden is obligated recognize freedom of conscience and make clear that being pro-abortion cannot be a requirement for employment, nor can medical facilities force nurses and midwives with a conscience objection to assist with practices that can lead to an abortion.”

In November 2013, Höglandssjukhuset women’s clinic rescinded a job offer as a midwife from Ellinor Grimmark after she explained that she could not perform abortions because of her Christian faith. The head of the maternity ward left her a telephone message saying that “she was no longer welcome to work with them” and questioned “whether a person with such views actually can become a midwife.” A few months later, Grimmark tried to obtain employment with Ryhovs women’s clinic, which told her that a person who refuses to perform abortions does not belong at a women’s clinic.

In January, Värnamo Hospital’s women’s clinic offered Grimmark a job but then withdrew employment because of the complaint she filed against Höglandssjukhuset in April. The group Scandinavian Human Rights Lawyers represents Grimmark in court.

The ADF brief in Grimmark v. Landstinget i Jönköpings Län explains that the Parliamentary Assembly of the Council of Europe has affirmed that “no person, hospital or institution shall be coerced, held liable or discriminated against in any manner because of a refusal to perform, accommodate, assist or submit to an abortion, the performance of a human miscarriage, or euthanasia or any act which could cause the death of a human foetus or embryo, for any reason.”

As the brief also explains, “The Grand Chamber of the European Court of Human Rights has itself explicitly affirmed rights of conscience for sincerely held religious and moral beliefs as falling within the gambit of Article 9 of the Convention.”

“Willingness to commit an abortion cannot be a litmus test for employment,” added ADF Legal Counsel Paul Coleman. “Medical centers need to respect the desire and conviction of a midwife or nurse to protect life – a desire that very likely led her to pursue the profession in the first place.”

  • Pronunciation guide: Kiska (KISH’-kuh)
Alliance Defending Freedom is an alliance-building, non-profit legal organization that advocates for the right of people to freely live out their faith.
# # # | Ref. 44753

Swedish midwives must provide abortions even if they object


Caution: machine assisted translation

Ellinor Grimmark denied job – was not discriminated against

It was not discriminatory of Jönköping County Council to deny Ellinor Grimmark the job of midwife when she refused to perform abortions. Thus says the Equality Ombudsman in dismissing the case.

The midwife Ellinor Grimmark felt discriminated against because of her faith, but after investigation the Discrimination Ombudsman (DO) felt that not to be the case.

“It was quite expected, I did not think the Swedish Equality Ombudsman would dare bring it up,”  Ellinor Grimmark told Smålandsnytt.

According to the DO, the County Council of Jönköping did not deny Ellinor Grimmark employment because of her beliefs in themselves, but because she was not prepared to carry out a task which is part of midwifery.

Although this had serious consequences for Ellinor Grimmark, this was proportionate to the aim of guaranteeing the rights and freedoms of others, thought the DO.

Today,  Ellinor Grimmark is working as a nurse in California, but will soon start working as a midwife in Norway, where it is possible for a midwife to refrain from participating in abortions.

But I intend to pursue this further.  We are just a short way down this  road,” she says.

However, the DO’s decision cannot be appealed, and the case is closed. [Original Swedish text]

Conscientious objection to “patriarchal norms”

 Hymen restoration and ‘virginity certificates’ in Sweden


 Michael Cook*

Informed consent and conscientious objection are easy to fulminate about, but tricky to discuss with consistency. Take, for instance, the delicate topic of requests for hymen restorations and virginity certificates. Worldwide, an estimated 5,000 women were victims of honour killings in 2000. If a young woman from a culture which sanctions honour killing approaches a doctor, what should he or she do?

Refusal is not a popular or even, in some jurisdictions, a legal option for doctors who are asked to refer for an abortion or to prescribe contraception. But a request which reinforces “patriarchal norms” is different.
Full Text


Zero tolerance against patriarchal norms? A cross-sectional study of Swedish physicians’ attitudes towards young females requesting virginity certificates or hymen restoration

J Med Ethics doi:10.1136/medethics-2013-101675

N.Juth, N. Lynöe


Many countries, Sweden among them, lack professional guidelines and established procedures for responding to young females requesting virginity certificates or hymen restoration due to honour-related threats. The purpose of the present survey study was to further examine the attitudes of the Swedish healthcare professionals concerned towards young females requesting virginity certificates or hymen restorations. The study indicates that a small majority of Swedish general practitioners and gynaecologists would accommodate these patients, at least given certain circumstances. But a large minority of physicians would under no circumstances help the young females, regardless of speciality, years of practice within medicine, gender, or experience of the phenomenon. Their responses are similar to other areas where it has been claimed that society should adopt a zero tolerance policy against certain phenomena, for instance drug policy, where it has also been argued that society should never act in ways that express support for the practice in question. However, this argument is questionable. A more pragmatic approach would also allow for follow-ups and evaluation of virginity certificates and hymen restorations, as is demonstrated by the Dutch policy. Hence, there are some obvious advantages to this pragmatic approach compared to the restrictive one espoused by a large minority of Swedish physicians and Swedish policy-makers in this area.
Full Text

Swedish nurse takes a stand on conscience rights

 If soldiers can object to using weapons, why can’t health professionals refuse to assist at abortions?


Mariola O’Brien

In 2011, the European Council adopted a resolution that protects healthcare workers’ right to freedom of conscience regarding abortion and euthanasia. Sweden has signed this agreement. But reality paints a different picture. Out of the 47 member states in the European Council, Finland and Sweden are the only two which do not uphold freedom of conscience in practice.

Ellinor Grimmark, 37, is the first midwife in Sweden to report a hospital to the Discrimination Ombudsman (DO) concerning abortion. She claims to have been discriminated against on the basis of her religious beliefs and moral convictions. Newly-graduated, she was fired from her position last summer because she refused to assist abortions. Even though there is a shortage of midwives at the moment, and even though she is willing to take on double shifts, she has been denied a job ever since. One employer had first agreed to hire her in spite of the “complication”, but withdrew the offer when her story began to spread in media.
Full Text


Sweden discriminates against conscientious objection

News Release

Federation of Catholic Family Associations in Europe

Sweden lacks respect both for the fundamental freedom of conscience laid down by the European Convention on Human Rights and for the democratic proceedings of the Parliamentary Assembly of the Council of Europe. On 7 March the FAFCE filed a collective complaint against Sweden on the grounds of lack of respect for articles 11 (right to protection of health) and E (Non-Discrimination) of the European Social Charter.

On 7 October 2010 the Parliamentary Assembly of the Council of Europe adopted resolution (1763(2010)) The right to conscientious objection in lawful medical care, a text that invites member States to develop comprehensive and clear regulations that define and regulate conscientious objection with regard to health and medical services.

The Swedish Parliament voted its own initiative resolution against this text in May 2011, despite the fact that the resolution was adopted according to the democratic process that regulates all decisions taken at the Council of Europe. By not respecting this fundamental right for any citizen across Europe, Sweden actually breaches the very principles that are the foundation of the Council of Europe: Human Rights, Rule of Law and Democracy:

“The Report of Christine McCafferty, “Women’s access to lawful medical care: the problem of unregulated use of conscientious objection”, that preceded the Resolution 1763, caused a debate in Sweden about freedom of conscience for health care workers. The Swedish standing Committee has remained negative to the content of Resolution 1763 and the Swedish delegation has been directed by the Swedish Government to take action to accomplish a “change” of this resolution.

On 11 May, 2011, the Swedish Parliament debated the report, Resolution 1763 and its recommendations after a report from the Foreign Affairs Committee. The prospect that medical professionals and health care workers might exercise freedom of conscience initiated a debate. The Foreign Affairs Committee Report recommended that the Parliament should advise the Government to be “critical of the content of Resolution 1763” and consider “that the delegation should work to bring about a change in the nature of this resolution.” [1]The Left Party added a “reservation” suggesting that the Parliament ask for the abrogation of Resolution 1763. The Sweden Democrats, in contrast, expressed support for the Resolution in a separate reservation. The Swedish Parliament accepted the recommendation of the Foreign Affairs Committee. Sweden thus formally set itself against freedom of conscience for health care workers and against the goals of Article 11 of the European Social Charter.” (FAFCE’s collective complaint).

The Federation of Catholic Family Associations in Europe, FAFCE, a member of the INGO Conference of the Council of Europe and deeply attached to the values promoted by the latter has paid close attention since to the implementation of the resolution.

FAFCE’s President Antoine Renard stresses that “The right to conscientious objection is a safeguard for all of us, it provides a possibility for medical staff to enlighten their work by their conscience in relation to each one of their patients. The importance of conscience in the medical field grows every day as technology moves forward and medical staff is faced with ever more complicated decisions to make. Practising medicine is a human and moral activity, not just a technical one, as Hippocrates pointed this out centuries before our time.”

Considering that freedom of conscience is a fundamental right laid down by the European Convention on Human Rights and by the Charter of Fundamental Rights of the EU, and that its restriction is contrary to both these legal instruments and to the jurisprudence of the European Court of Human Rights, the FAFCE has been very concerned with Sweden’s lack of respect for the principles set forth by the resolution, which have still not been implemented there.

Mr Renard explains that this is why the FAFCE has filed a collective complaint against Sweden: “We hope that our collective complaint against Sweden will raise international awareness of this lack of respect for the democratic procedure and for the fundamental right to freedom of conscience, there is no reason that Swedish medical staff should be deprived of a right laid down by several European human rights instruments”.

Contact Maria Hildingsson: +32 4 70 20 39 18 or info@fafce.org