1. Although the U.S. Constitution guarantees the separation of church and state, this case seems to have far more to do with ethical issues than legal ones. What is the difference, and where do they overlap in this case?
2. How far should the navy (or any public organization) go in making religious accommodations? Are the accommodations that were offered to the doctor reasonable?
3. Would the issues be different if the case occurred in the civilian public sector? 4. A local newspaper reports, “He said people who criticize him for using his faith as
a reason not to prescribe birth control contend he should not use his position to stake out a political stand. . . . His commanding officer, he said, ‘is using this as a platform for his bias on contraception’”. Does his view of his superior’s alleged bias justify Dr. Messe’s taking a counter position? Why?
5. Regulations and standard operating procedures are not neutral but implicitly bear ethical values and call on selected duties and principles. One of the central issues in this case is referral, obligatory under navy guidelines. Is there a difference in terms of values, duties, or principles between prescribing contraceptives and referring patients to other staff? Is complicity an issue, given that the patient requests the service?
6. Should personal religious beliefs play a role in a public manager’s decision making and service delivery? Why? Is the doctor’s behavior here any different, from an ethical perspective, from the chief justice’s defiance of a court order, as related in Chapter Three?
7. You are the new director of clinical services and Dr. Messe’s superior. How would you handle this, and why?