Is there no alternative? Conscientious objection by medical students

Abstract

Recent survey data gathered from British medical students reveal widespread acceptance of conscientious objection in medicine, despite the existence of strict policies in the UK that discourage conscientious refusals by students to aspects of their medical training. This disconnect demonstrates a pressing need to thoughtfully examine policies that allow conscience objections by medical students; as it so happens, the USA is one country that has examples of such policies. After presenting some background on promulgated US conscience protections and reflecting on their significance for conscience objections by medical students, this paper observes that the dominant approach (following the American Medical Association's conscience clause) is to allow exempted students to instead be evaluated on the basis of alternative curricular activities to learn the associated underlying content. This paper then introduces and discusses an example in which male Muslim students who believe it is wrong to touch members of the opposite sex object to performing physical examinations on female subjects in their medical training. This sort of case, it is argued, causes difficulty for a conscience clause that resolves the dilemma by granting reasonable exemptions in the form of participation in alternative curricular activities: there are cases where one must perform the 'objectionable' activity itself in order to learn the necessary content and underlying principles.

Reasonability and Conscientious Objection in Medicine: A Reply to Marsh and an Elaboration of the Reason‐Giving Requirement

“…I will understand discrimination as different treatment based upon an arbitrary or irrelevant characteristic . Imagine a case in which male medical students of the Muslim faith conscientiously refuse to learn how to perform physical examinations on members of the opposite gender . Or imagine such physicians who were granted such an exemption then refusing to care for women on this basis.…”

“…17 Imagine a case in which male medical students of the Muslim faith conscientiously refuse to learn how to perform physical examinations on members of the opposite gender. 18 Or imagine such physicians who were granted such an exemption then refusing to care for women on this basis. Even though we can identify the tenets of belief system that support this putative conscientious objection, 19 it is imperative that we must be able to evaluate the reasonability of granting a conscientious objection on this basis.…”

Conscientious object in nursing: Regulations and practice in two European countries

“…44 This indicates that conscientious objection remains a live debate for practitioners and students, particularly as the author held a view that conscientious objection is often discouraged among medical students. 45 Research among physicians in the United States has revealed that many approve of conscientious objection. 46,47,48 However, it is essential to consider that attitudes towards conscientious objection may be both country and profession specific, depending on cultural norms and professional regulation.…”

Ethical Diversity and the Role of Conscience in Clinical Medicine

“…This reasoning suggests that honest exploration of the issues would help healthcare workers develop realistic approaches to deal with conscientious objections [56]. Although well-intentioned, the current culture of medicine does not necessarily always foster or condone open discussion [120].…”