PSYCHOSIS AND RELIGION

The patient was a 30-year-old, single man from India who was raised as a Muslim. He had been hospitalized three times in the past year; this admission was occasioned when he assaulted a passerby. At the time, the patient was under the influence of a psychotic delusion that he was a secret agent whose cover had been betrayed by his therapist.

Upon his admission, the patient refused medication on the ground that he was a Christian Scientist. The surprised resident learned that the patient had, while psychotic on his last admission, encountered a Christian Science practitioner who was visiting the ward and decided to join the Christian Science Church. Consultation with the practitioner raised the question of the extent to which the patient's choice of Christian Science should be seen as a free choice, especially since the practitioner did not view the patient as a true Christian Scientist. On the other hand, the patient, although delusional, was able to cite chapter and verse of Christian Science literature in support of his drug refusal. The dilemma facing the resident was whether this patient's religious choice was suspect because of his concurrent delusional state, and thus whether his drug refusal based on this choice was competent.

Questions

1. (1) The First Amendment gives us a right to freedom of religion. Would this right be violated if this patient were forced to take medication?

2. […]