J Med Ethics 38:602-604 doi:10.1136/medethics-2011-100190
  • Papers
    • Law, ethics and medicine

Is there no alternative? Conscientious objection by medical students

  1. Robert F Card
  1. Correspondence to Dr Robert F Card, Department of Philosophy, SUNY; Center for Ethics, Humanities and Palliative Care, University of Rochester Medical Center; 212 Campus Center, SUNY-Oswego, Oswego, NY 13126, USA; robert.card{at}
  1. Contributors Provenance statement: RFC conceived the basic philosophical argument and structure of this paper. RFC is Associate Professor of Philosophy at the State University of New York and conceived the idea for this paper while Fellow in Clinical Ethics and Visiting Associate Professor of Medicine at the University of Rochester Medical Center. The sources used to construct this paper are the bioethical, medical, philosophical and other sources listed in this paper, in addition to personal experience gained while Fellow in Clinical Ethics at URMC. RFC was solely responsible for drafting and revising this manuscript. RFC is the guarantor for the article. No copyright clearances are required for this paper.

  • Received 19 August 2011
  • Revised 10 November 2011
  • Accepted 28 March 2012
  • Published Online First 3 May 2012


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.


  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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