Conscientious Objection in Medical Students

Nearly half of medical students believe it is the right of doctors conscientiously to object to any procedure, and this is especially the case among Muslim medical students, according to research by Sophie Strickland published on 18 July in the ‘online first’ version of the Journal of Medical Ethics.

Strickland contacted 1,437 medical students at St George’s University of London, King’s College London, Cardiff University and the University of Leeds, sending them on 5 May 2008 an email link to an anonymous online questionnaire hosted by the Survey Monkey website. 733 responses (51% of the target population) had been received by the time the survey closed on 24 June 2008.

29% of the medical students stated that they had no religion and 12% were atheists. 17% were Protestant Christians, 11% Roman Catholics, 9% Muslims, and 21% of other religious persuasions. Almost two-thirds of respondents were women, which may account for the relatively religious nature of the sample.

Asked in general whether doctors should be allowed to object to any procedure on moral, cultural or religious grounds, 45% agreed, 41% disagreed, and 14% were unsure. The proportion in agreement fell to 36% among the irreligious and atheists but soared to 76% for Muslims. It was somewhat higher among Protestants (51%) than Catholics (46%).

Faced with a follow-on question enquiring whether they would object to performing eleven specific medical procedures, 15% objected to all of them, ranging from 6% for atheists to 30% for Muslims. Of those raising objections, 20% cited religious reasons, 44% non-religious reasons, and 36% a combination of both. Muslim students were most likely to report religious only objections (28%).

Muslims were particularly exercised about most abortion-related procedures, especially abortion for congenital abnormalities after 24 weeks and abortion for failed contraception before 24 weeks. However, there was also a significant amount of Muslim concern about intimate examination of a person of the opposite sex and reservations about the treatment of patients intoxicated with alcohol or recreational drugs.

Although General Medical Council guidelines provide for some accommodation of conscientious objection among doctors, it is clear from this study that the views of many Muslim medical students, and of some others, could well be in potential conflict with those guidelines once they qualify and begin to practise medicine in the community. Since fieldwork was completed three years ago, some of these tensions are presumably already being evidenced on the ground.   

For the abstract of Strickland’s article on ‘Conscientious Objection in Medical Students: A Questionnaire Survey’, and options to purchase the full text, go to:

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