Sunday, October 15, 2006

SOUND OFF: A DUTY TO SERVE

Mary Hanna's medical education cost $184,000, which was paid for by the U.S. Army. Hanna had committed herself, once she became a doctor, to giving the Army four years of active duty and four years of reserve duty. Now that she's finished her residency, however, Hanna has notified the Army that she wants reclassification as a conscientious objector based on religious beliefs that she has recently embraced.

The case is now winding its way through the courts, but there are ethical questions that don't depend on the legalities: Hanna's lawyer says that she's willing to repay the money, but even so is she morally bound to carry out the commitment she made to the Army? Or does a new religious obligation trump an old contractual agreement?What do you think?

Send your thoughts to rightthing@nytimes.com or post them here by clicking on "Comments" below. You can choose the anonymous posting option, but please consider including your name, your hometown and the name of the newspaper in which you read this column in the text of your response. Readers' comments may appear in an upcoming column.

Jeffrey L. Seglin, author of "The Right Thing: Conscience, Profit and Personal Responsibility in Today's Business" (Smith Kerr, 2006), is an associate professor at Emerson College in Boston, where he teaches writing and ethics. He is also the administrator of www.jeffreyseglin.com, a Web log focused on ethical issues.

Do you have ethical questions that you need answered? Send them to rightthing@nytimes.com or to "The Right Thing," New York Times Syndicate, 609 Greenwich St., 6th floor, New York, N.Y. 10014-3610.

29 comments:

Anonymous said...

I will be 82 years old in two months and am always surprised at someone having a problem doing the 'right thing' . Of course Mary Hanna should, in addition to repaying the medical education cost, stick to her commitment (which she made BEFORE she got religion) to give the Army four years of active duty and four years of reserve duty. Ethically, morally, you name it. She absolutely MUST carry out the commitment she made to the Army. And she MUST be made to do it! (Please keep us posted ).

Madelon F. Russ
Charlotte, NC
The Charlotte Observer

Anonymous said...

Isn't it amazing how many people "find God" when religion suddenly serves their interests? A doctor's job is to help sick and injured people regardless of how they get sick or injured. Soldiers are even more likely to have injuries, if they serve on a war front, than most people, so I'm having a hard time figuring out what religion would hold that she can't ethically give them medical attention. She should not only repay the debt, she should honor her commitment. If she has become a "peace activist," she should be aware that all her behavior does is make the path of war easier for those who oppose us.

Anonymous said...

Ms. Hanna appears to have a change of heart. She must, however, do the right thing. It is an honor to serve one’s country and she has a duty to love her God and in the Second Commandment, to love her neighbor. She has a moral responsibility to serve her country and also meet her contractual obligations for debt or time in service.

I suspect the military process goes something like this. She signs up, attends school, and toward the end of the educational process, the military begins a process to identify where this person will serve. If, for some reason, she is not able to report for duty, that “slot” is now
vacant and it will take x-number of years to train a replacement. If she does report for duty, then she serves her obligated time. Failure to do so likely results in a courts-martial.

I think she can do both. She can be a conscientious objector and serve the military as a medical professional. I think most people object to war yet in the American Military, loyalty to team, unit and country is very strongly emphasized. She can honorably serve her time and at the same time, use her medical skills to save others and in so doing, serve
her God and the core religious belief to love her neighbor.

Having said this, I spent 12 years in the Navy. I enlisted in 1968 to
avoid being drafted by the Army as I did not see the Vietnam war as a
winnable war or a war that was critical to the protection of the United States. I did not want to go to war. I spent my first two years in the Navy training small boat crews for Vietnam. I loved what I was doing as I had always been messing around in boats on San Francisco Bay. I was sent to Officer Candidate School after that and became an Ensign assigned to a carrier group where I made my first tour in Vietnam waters. My next tour was in country, at a repair base. From there, after
a tour in London, England, I returned to a ship in San Diego. During a deployment to the Western Pacific, we participated in the evacuation of the American Embassy. Three tours to Vietnam. I didn’t want to go but I had a responsibility to go. Today, after 20 years working in industry
and nearly ten for state government, I am pursuing becoming an ordained minister.

I admired the doctors in the Navy that I had the pleasure to work with. I never once felt the medical care I received was anything less than first class. The medical corpsmen that reported to me when I was in country were truly professional and skilled in their work. On the carriers I served on and the shore stations where I worked, I was blessed with excellent medical care. In that year at my base in-country, we did not loose a single sailor and all survived.

I can understand clearly a spiritual awakening calling one to serve God. This has happened to me. But equally important is how we live the values that our culture has established and work hard to be ethically correct
while avoiding situational ethics where we change from what was once not okay to something that now is okay. This is an issue that has yet to be addressed.

Peace be with you.

Jack J. Stollery

Anonymous said...

Here are my thoughts on today's column (on the assumption that Mary Hanna is totally honest):

If Hanna truly "found her path" as a conscientious objector after her medical education was paid for by the Army, I think the Army should accept her lawyer's offer to repay the money (with interest) for her education. Requiring her to meet her contractual (and moral)obligation to the Army could backfire. If indeed she is true to her newfound faith, she might try to bring others into "the fold" during her tour of duty. Another possibility is that she could be so distressed by her internal conflicts that she could not function effectively. The Army could end up discharging her (at some expense) for proselytizing or for incompetence. Why take the chance if the Government can get its money back?

Phil Clutts
Harrisburg, NC

Anonymous said...

In previous conflicts, conscientious objectors (read Quakers) were placed in non-combat roles (corpsmen, logistics, etc). I would be surprised if the Army couldn't find a way to use Ms. Hanna's training without insisting that she be put in a combat position - say as a doctor on an evac flight to Germany. Then she wouldn't even need to carry a gun. Seems to me Ms. Hanna could learn something about commitment from serving her country.

Anonymous said...

I don't believe this is a matter of the "new religious obligation trump[ing] an old contractual agreement". Ms. Hanna made an initial honest (our assumption) commitment but her mind changed over her 4-year medical education period. So it's a matter of "settling up".

Ms. Hanna has indicated a willingness to repay the money, which is appropriate since she is breaking the commitment she made. This is an ethically correct response. The Army should accept her offer, and work out a repayment plan with her.

P.S. In the future, the Army might want to include a clause in such agreements that will make more clear what will happen if (even for religious reasons) the recruited future medical doctor fails to honor her part of the active duty service commitment in the agreement.

Jan Bohren
Adjunct Professor
Mercy College
(Dobbs Ferry, NY)

Anonymous said...

My name is Linda Kelly, Charlotte NC & I read the column in the Charlotte Observer. This is about the Mary Hanna who wants to be reclassified as a conscientious objector. I personally don't think she should, since there are plenty of ways she can serve her active & reserve duties. She doesn't have to be deployed into a war zone & it seems to me she should want to help the people injured by something she does not believe in. It's not just a matter of her repaying the money, the agreement depended on her committing to future work.

Anonymous said...

Regarding your question on Mary Hanna and her medical career with the US Army, I think that Mary has a contractual obligation to remain in the Army and serve her eight years as promised. However, I’m sure there are many fine hospitals in the US or overseas that serve our military personnel that would keep her out of a war zone and allow her to follow her religious beliefs. Or could she fulfill her obligation in a hospital helping military families?

Barbara Langdorf
Irvine, California
Orange County Register

Anonymous said...

Hanna and her country would be well served if she both paid the money back with interest and also served the US government in some branch other than military for four years.

Steve Leveen.

Anonymous said...

If her new religion conflicts with the ability to serve in combat, fine. There are plenty of other Army functions in which she can serve, that do not involve combat. She has the moral and legal obligation to serve her committed time.
Teresa Williams-Shearer
Escondido, CA
Orange County Register

Anonymous said...

From: E. L. "Red" Wolfe of Melbourne,FL I read the story in the Orange County Register online, before retiring we lived in Lake Forest, CA.

My comment to Dr. Mary Hanna is that a contract is a contract. Your Army contract gave you a free education based on your completing the agreed upon contract, buying out is not, nor should not be an option. I would have loved your contract with the Army, mine was a draft notice with two years active duty and five years of reserve, starting pay at $ 72 per month and no buy outs. So suck it up and do the honorable thing and do your duty as per your contract, regardless of second thoughts.

Anonymous said...

Dear Mr. Seglin,

While it seems that Mary Hanna has conveniently acquired her new religious beliefs just as it was time for her to keep her end of an important agreement, I will give her the benefit of my doubt and allow that she is sincere.

BUT, she studied medicine to fulfill a desire to treat people, to repair them, make them well, improve their lives, whatever specialty she has chosen. It is certain that she will be doing just that while she fulfills her commitment to our men and women (and possibly their families) in the Army. Treating people. Our people.

She can do this while holding her beliefs. As a civilian physician, she would conscientiously object to smoking, drug addiction, over eating and gang activity but she would not refuse to treat patients whose ailments or injuries resulted from these causes. It would be morally wrong.

She has a moral obligation to keep her promise. We (yes, the Amy's money comes from all of us) paid for her education and training and now we need her resulting abilities. She will earn an income and she will gain experience to carry into future private practice.


Mary Burson
Laguna Niguel, CA
The Orange County Register

Anonymous said...

Under the circumstances (and given the number of similar cases that developed during the last Gulf War) one is left under the uneasy supposition that the conscientious objection the lady has is to the possibility of getting her tuckus shot off.

Understandable, but hardly admirable.

However, granting her honesty, the question remains as to what she is actually objecting. Historically (at least until recently) conscientious objectors objected to committing acts of violence. We have to assume that, as a highly trained healer, her duties would not involve battle or violence. Does she have a religious objection to treating those injured in war? Interesting religion, if so.

Still, all of this is a side issue. Rex Stout once remarked that what the tongue has promised, the body must submit to. Granted that she has offered to reimburse the money, it is quite probable that what the services want are medically trained people, not reimbursement of cash. If the medically trained people are permitted to bail because they don't want to face danger, what about the thousands of others?

Is the whole volunteer Army permitted to scarf the benefits of agreeing to face danger only to declare a conscientious objection once the danger appears? I think not; I even find it morally reprehensible. Remember, these are volunteers; there was no coercion to get them to sign up in the first place and their position is as one who has signed up and reaped the benefits of a contract only to say he has changed his mind when the bill comes due.

As another related observation, I am given to understand that certain Muslim proponents have decreed that their religion does not require that treaties or compacts with infidels be complied with. Makes them rather difficult to deal with for outsiders--come to think of it, a society that does not enforce its social compacts at least internally comes to be totally dysfunctional, does it not?

Under the circumstances, I think the option of strict enforcement or other forms of settlement ought to be left with the other party to the contract. If the services desperately need medically trained staff, it would be inequitable to let them get stung in this fashion. If they do not, I should think they would be happy to allow a disaffected person to escape the contract, particularly if she would make up the advanced costs with a suitable rate of interest. However, I think that this choice should be their option rather than given to the person who has chosen to duck her responsibilities under the deal.

Dave Marohl
Sun Prairie, Wisconsin

Anonymous said...

The current topic that Mr. Jeffrey Seglin has presented us with, is one that is disturbing, with regard to military service.College and university students signing up for military service, in exchange for the U.S. government paying their way through medical school / dental school. With a world class education costing $ 184,000 in exchange for serving 4 years active duty and four years of reserve duty. The example in this case is Hanna, a female who has just finished her residency.

Now after years of government paid schooling, she has embraced a new religion, and has asked to be reclassified as a conscientious objector , in order not to serve out her obligation. My position is that she should be granted this reclassification. President Bush should sign a Executive Order, preventing her or others in the future from becoming licensed to practice medicine, anywhere in the United States, or its' territories.

Collection proceedings should begin immediately by the federal government, because she has defaulted on her loan, by breaking the provisions of her contract, with the U.S. Army (military service trained as a physician). In addition, since the U.S. Army is out two physicians, one that would have fulfilled their contractual obligation, and Hanna who will not meet the terms of her contract.She should be sued for depriving the federal government, of a trained physician, to the tune of another $ 180,000, for a total of $ 360,000. Good luck with your new religion Hanna.

Todd Brklacich
Murray, UT

Anonymous said...

Let me preface this by saying I was born in an Army Hospital and all of my children were born in Air Force or Army hospitals, so I've had first hand knowledge of military doctors. Even though the doctors are in the army, their first commitment is to do no harm just as a civilian doctor's is. They are not expected to fight, just cure. If Mary Hanna truly has conscientious objections she should serve her country and God by healing men and women who really need it. Not all doctors are off to war.

Gwen Wooldridge
Huntington Beach, CA
"The Orange County Register"

Anonymous said...

Mary Hanna has the absolute duty to keep her end of the bargain and serve her country as she promised to do. The Army has "bought" her services. Repaying the debt doesn't quite get it either as the Army could have used the money given her to help someone else thru med school who would have served without whining.

Further, being a conscientious objector (which I doubt) fits nicely with serving as an Army doctor. She would have the opportunity to treat not only her fellow soldiers, but also the wounded enemy and wounded civilians, a very, very conscientious thing to do.

Serving in the Army, even if for only one tour, will give this immature doctor not only a priceless post graduate course in medicine and human suffering, but a great boost toward becoming a decent human being.

Jean Crawford
Charlotte, NC
Reading the Charlotte Observer

(I am an ex Army nurse, having received a salary from the Army for 2 years of college toward my BSN for which I owed, and served 3 years active duty, followed by 5 years of Reserve many years later. )

Anonymous said...

Dear Mr. Seglin:
I read with interest your column which ran Oct. 15 in the Charlotte Observer.

I am a physician, in Internal Medicine, and can tell you the practice of taking advantage of religious beliefs is nothing new. Perhaps the most common abuse is Jewish students who, all of a sudden, become observant of the Sabbath when they are subject to Friday PM and Saturday daytime on-call service. Occasionally, this will apply to Seventh Day Adventists, although Christian churches pretty much assume the admonition doesn't apply to medical practice in a hospital.
It is fairly common for students in such programs, on completing medical school, but before internship and residency, to petition to pay off an obligation in lieu of government service. This is because a resident earns a salary (though certainly not as much as the work is worth). Pretty rare to go through an entire residency before religious convictions kick in.

Most primary care physicians seem to come from state medical schools, where tuitions are lower. They don't incur as many costs, have lower loan amounts to pay back so don't have to make as much to pay back loans - we can "afford" to make less initially. I may be cynical, but I bet Dr. Hanna pursued a residency in one of the more lucrative specialties. If so, she can probably afford to quickly pay off $184,000 through earnings in the private sector. The government makes their agreements in the expectation that they are going to get physicians at a lower pay rate than what the private sector provides, an investment, if you will. The government in this situation is not functioning as a bank; it has other loan programs for that.

I think the fairest path would be to compel Dr. Hanna to complete a non-combatant obligation in the Army or in the US Public Health Service, or, alternatively, to go into private practice but be compelled to pay the government back, not $184,000, but the difference between her private sector earnings and what the Army would pay her for those eight years, which I guarantee would be a lot more than $184,000. She gets to follow her religious ideals and the government gets to recoup its investment, not just its costs.

cordially,
Luis D.Velasco, M.D.

Anonymous said...

Mary Hanna should follow through on her original promise to give the army four years of active duty and four years of reserve duty. The army gave her what she wanted and she must in turn honor the contract she promised the army. After her commitment to the army, she can pursue whatever direction she chooses. Mary MUST know that the army didn't support her education so she could pay them back. The original agreement was that they pay her medical education costs in exchange for service to the army. Mary's new religion is her personal belief. She may keep it close to her heart, but it is no excuse to relieve her from her previous commitment. (Advice to Mary: "Mary, the sooner you start the years of service, the sooner you will be able to choose your place of service. Hopefully, you will learn more about life and real people working as a doctor with the army. Good luck to you and the army."

Patricia Bennett
Orange, California
The Orange County Register

Anonymous said...

This isn't complicated. Mary Hanna made a legal commitment and she needs to honor it by serving her time.

Wendy Hagmaier
Fullerton, CA

Anonymous said...

Mary Hanna made a commitment, She should stick to her word. It would be gracious of the U.S. Army to accept full financial payment including other costs beyond the loan in leiu of fulfillment of her time commitment. This decision should be the option of the US. Army, and not that of Mary Hanna.

Bill Wotring
Fullerton, California

Anonymous said...

Last I checked, physicians in the military are non-combatants.

This opportunist's attempt to cheat our government should be punished.

- an Army physician

Anonymous said...

Mary Hanna should complete her obligation to the Army. She will still be able to practice medicine and save lives while in the Army. She won't be carrying a gun, so she will not be participating in the violence of war.

Also, I'm suspicious of her recent conversion to being a conscientious
objector. She signed an agreement. She should live up to her to her
word.

Billy in San Bernardino, CA

Anonymous said...

Dear Mr. Seglin:

Yes, this woman has not only a legal, but a moral, obligation to serve her contracted duty. Just paying the money back is not sufficient. The government offers these scholarships, not as a lending institution, but because they need doctors. $164,000 is mighty cheap for a doctor's education, to begin with, and she was taking up a spot which could have been used by a bona fide army MD candidate. Her decision sounds too much like a jailhouse conversion.

I think the time and the cost are two separate problems. There are many places in the military where conscientious objectors can fulfill their obligations. If she can demonstrate that her new-found religion is genuine, she could be assigned to a non-combatant role. I am reminded of the wonderful example of a young man (Desmond Doss) from this area who was a genuine conscientious objector during WWII. He was cited for his bravery and for saving the lives of many of his army comrades. This young woman can be a conscientious objector even if she were to be sent into the worst war zones. She needs to put in her four-and-four as she agreed to when enlisting.

Sincerely, Mary L. Dodge
Lynchburg, VA

Anonymous said...

Is it just me, or am I suspicious, that her religious conversion happened when i t came time to serve? After all, she ain't St. Paul. Surely she had some inklings.

In the old days, c.o.s served in some capacity in the medical services of the armed forces. Is this not still an option? I think her offer to repay the money is just a feeble attempt to salve her conscience. Money cannot buy ethics. It seems that nowadays people are trying every avenue to get out of their commitments.

So, she should serve, and perhaps in the future be a little clearer on the words responsibility, honoring commitments and standing by what one has said. To let all these people get off the hook chips at the cornerstone of civilization, honor and commitment. Soon nothing will mean anything. I served my four years during the Viet Nam era; there were times it was scary and I did not want to be there, but I had made a commitment. How could I face people if I came home early under dubious circumstances????.

Jerry Wright
San Juan Capistrano, Cal

Anonymous said...

In the years of training Mary Hanna could very well have had a change in her attitude toward serving in the army. There are other ways to fulfill her obligation besides direct military service. She could be assigned to a veteran’s hospital, provide medical services to native American communities or any other community without adequate medical care. She could very well do even more good for more people than serving in the army.

I don’t know if this would be acceptable to her- although conscientious objectors have done similar things in the past- or if the army considers this an option. If either or both do not think this an acceptable alternative then both of them need to reconsider their positions.

Merrilee Gardner
Irvine, CA

Anonymous said...

Dear Mr. Seglin,

The "sound off" portion of your column (lead off item - school Christmas party raises red flags) sets forth the following facts:

Mary Hanna's medical education was paid for the U.S. Army, meaning taxpayers like you and me. Ms. Hanna has finished her residency and suddenly wants to renege on her obligation of four years of active duty and four years of reserve duty because of religious beliefs that, it seems, she has embraced near the end or after finishing her residency. Sure puts a new spin on the definition and conduct of a conscientious objector. [see comments below]
You asked if Ms. Hanna is morally bound to carry out her commitment she made to the Army? Hell, yes! She is a member of the medical profession, and I have a problem trying to figure out why she feels her recent religious obligation would prevent from healing the wounded. She is not being asked to shoulder an M-16 and go out on a combat mission. For that matter, she may not even be deployed to a combat zone!!!

I note that Quakers (I am not one), whose members have claimed conscientious objector status from way back (I am 71 years old), have served in the armed forces in noncombatant roles, such as "medics," the equivalent of an Emergency Medical Technician or paramedic. So what's the problem for Ms. Hanna?

However, I am a pragmatist and figure that we (taxpayers and the U.S Army) may be better off in collecting the $184,000 plus interest and letting Ms. Hanna off the hook. After all, if she were compelled to serve, would you want this resentful self-righteous person providing medical care to our soldiers in general, and in particular, if that involved a member of your family or a friend?

Thank you for letting me sound off.

Ileana Liel
Riverside, CA

P.S. I read your column in the Orange County Register (hard copy when I can get it, otherwise on line)

MSC, Wisconsin said...

Mary Hannah made a legal contract; she agreed for a service in exchange for a service. Following all elements of law; the contract is valid and should be adhered to. While agreeing to contracts, whether it be a simple auto purchase, loan contract or other type of agreement, one needs to realize that while time passes, things may change. While under the terms of a contract, you may lose your job, your spouse, your home, etc, but you are still obligated to keep your agreement/contract.

While Ms. Hanna may have found a religion she believes prevents her from serving her country, she needs to realize the bottom line is her agreement with the country to "give" in exchange for a "get". A doctor's responsibility is to save lives; "to do no harm". I can't think of a better place to help her fellow mankind than to treat those that have allowed her to have this benefit in the first place.

She is not on the front line, she is helping to save her fellow women/men who ARE on the front lines. Perhaps she does not WISH to complete her obligation, but she MUST...she did not make an agreement stipulating to "changes that may occur in her beliefs". If she has a strong religious belief and practice; she can share this spirit while saving and helping lives.

Ms. Hannah, while I applaud your decision to find "religion", do the right thing and, as they say, "suck it up; deal with it". Life isn't always fair; but it is life.

I'd trade with you any day...as would many others.

It is an insult to offer to pay the "the money back". I agree with Mr. Russ, she MUST be made to fulfill her contract.

Richard Anderson said...

One word pops in my mind when I read about Hanna: PATHETIC. Rather than pay back the money, I believe that she should be called to active duty as an E4 and pack her bags for Baghdad. I feel sorry for any soldier who has to serve under her command in the future.

dcramer1 said...

I find her timing a little suspect. I don’t think as an Army doc she would be out shooting people. She would be stuck in an Army hospital fixing the wounded on both sides of the conflict. She might want to rethink being a doctor. If her beliefs get in the way of her medical service for the military how will it affect her civilian practice? Is she going to refuse to assist police officers, government employees or other groups that are connected to government security because in some crazy way it might support violence. What about criminals, are they out of luck too? Is she going to need some special version of the Hippocratic oath since she will only treat patients that are near perfect or completely disconnected from any organizations that might have ties to violence?

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