Abstract

Conscientious (CO) and religious objections (RO) to controversial medical practices often emerge as early as medical school, influenced by moral, religious and cultural factors. This study explores the attitudes of clinical-year medical students and teachers at a Malaysian medical school toward CO and RO in ethically contentious practices, including abortion, contraception for minors, euthanasia, brain-dead organ donation, gender-diverse care and ritual circumcision. A cross-sectional survey involving 188 students and 21 teachers assessed perspectives on these issues through both quantitative measures and qualitative analysis. Overall, 42% supported the right to object to procedures on moral or religious grounds, while 37% disagreed and 21% were uncertain. Teachers were more likely than students to object to late-term abortion and euthanasia, often citing non-religious or mixed reasons. Religious affiliation significantly predicted objections (p < 0.05), though less so among students (p = 0.06). Qualitative findings revealed tensions between autonomy, professional duty and legal obligations. Generational differences were notable, with students showing greater acceptance of contentious procedures, possibly reflecting shifts in medical education toward patient-centred care. These findings highlight the need for structured ethics training, institutional guidelines and cultural competency education to balance healthcare providers’ moral integrity with patients’ equitable access to care.