Conscientious objection in healthcare, referral and the military analogy

Steve Clarke

Journal of Medical Ethics

Abstract:  An analogy is sometimes drawn between the proper treatment of conscientious objectors in healthcare and in military contexts. In this paper, I consider an aspect of this analogy that has not, to my knowledge, been considered in debates about conscientious objection in healthcare. In the USA and elsewhere, tribunals have been tasked with the responsibility of recommending particular forms of alternative service for conscientious objectors. Military conscripts who have a conscientious objection to active military service, and whose objections are deemed acceptable, are required either to serve the military in a non-combat role, or assigned some form of community service that does not contribute to the effectiveness of the military. I argue that consideration of the role that military tribunals have played in determining the appropriate form of alternative service for conscripts who are conscientious objectors can help us to understand how conscientious objectors in healthcare ought to be treated. Additionally, I show that it helps us to address the vexed issue of whether or not conscientious objectors who refuse to provide a service requested by a patient should be required to refer that patient to another healthcare professional.

Clarke S.  Conscientious objection in healthcare, referral and the military analogy. J Med Ethics 2016;0:1–4. doi:10.1136/medethics-2016-103777

The Fallacies of Objections to Selective Conscientious Objection

Amir Paz-Fuchs, Michael Sfard

The Fallacies of Objections to Selective Conscientious Objection


This paper critically analyzes the theoretical and pragmatic arguments raised against the refusal of individuals to serve in a specific military campaign that they view as immoral. The Israeli Supreme Court case of Zonshein v Judge-Advocate General will serve as an axis of the discussion, as it combines two related facets: first, the Court’s decision touches upon most of the difficult issues in the field of conscientious objection. And second, the development leading up to the decision was accompanied by an exceptional clash of academics, each side summoning expert opinions in support of its claim.

Courts worldwide have accepted that a categorical distinction exists between universal and selective conscientious objection. The combination of the Zonshein decision and the accompanying academic debate presents the opportunity to reexamine the theoretical and pragmatic reasons that are offered as support for distinguishing the two ‘types’ of conscientious objection. Close scrutiny finds them wanting.

Paz-Fuchs A, Sfard M. The Fallacies of Objections to Selective Conscientious Objection. Israel Law Review, Special Issue: Refusals to Serve – Political Dissent in the Israel Defense Forces. 2002 Fall; 36(3);111 – 143. DOI: