Prayer and Public Policy

FREE exercise of religion, although written into the United States Constitution, is sometimes limited by public policy in its application. This result, evidenced in several recent child-care cases, raises concerns about the reach of the First Amendment.

The courts have endorsed, virtually without limitation, the freedom to believe even that which society holds to be extremist religious views.

They have taken exception at times, however, to the practice of religion when it appears to challenge government policy or is in conflict with other rights.

The latter decisions alarm many constitutionalists, who believe that the free exercise of religion will be further impeded by a judicial philosophy that doesn't give religious freedom precedence over other freedoms.

A US Supreme Court finding in an American Indian case involving the use of peyote in a religious ceremony specifically raised this issue in Oregon Employment Division v. Smith. The high court could have reached the same conclusion - upholding the right of the state to dismiss two drug-rehabilitation workers - without tampering with free exercise.

Also troubling is the reasoning of the Supreme Court in the so-called right-to-die case, Cruzan v. Missouri Department of Health. Here the justices refused to allow a family to force the state to remove life-support systems from a comatose patient, their adult daughter, without ``clear and convincing'' evidence of the patient's wishes.

Although this ruling permits states to set up their own guidelines in this situation, it raises other issues regarding care and parental rights.

Importantly, the justices found a ``liberty interest'' in Cruzan as they had in other recent cases - specifically in this instance citing liberty in terms of the right to refuse medication. But they quickly narrowed it.

Chief Justice William Rehnquist said this right to refuse medical treatment was not absolute but could be modified in the face of countervailing government interests.

In Cruzan, the Supreme Court held that Missouri had an interest in protecting life and guarding incompetent patients against those - including family - who claim to speak for them.

The issue was pinpointed last week in a Massachusetts verdict in which David and Ginger Twitchell were convicted of involuntary manslaughter in connection with the death of their 21/2-year-old son Robyn. The child, who died of a bowel obstruction, was treated by prayer rather than conventional medicine.

The defense had argued that the parents were lifelong Christian Scientists who had in the past successfully used prayer to heal themselves and their other children.

Trial court judge Sandra Hamlin instructed the jury that spiritual healing was not proper physical care for a seriously ill child. Also, the jurist explained that parental withholding of medicine in these circumstances amounted to ``wanton and reckless conduct'' that a reasonable and prudent person would see as harmful.

Defense lawyer Rikki Klieman said that the parents were unaware of the severity of the illness. Ms. Klieman pointed out after the jury verdict that the law does not call for medical care and that many states, including Massachusetts, permit by statute spiritual treatment in lieu of medical treatment for those who rely on prayer for healing.

The Twitchell verdict is being appealed to a higher court.

Regardless of the final outcome, the issue of prayer and public policy will continue to be debated in government and private arenas.

Among the questions raised:

Is reliance exclusively on prayer ``reckless'' conduct - particularly for an infant or a minor child?

Is it unreasonable for a family to forgo medical treatment for a child?

May the free exercise of religion be upstaged by broad government interest or specific policy?

It seems inconsistent that a nation that advocates prayer and encourages religious pluralism would hold reliance on God in extreme circumstances as wanton or reckless.

And to those who have been healed by prayer - and the numbers are considerable - the suggestion that radical reliance on prayer is unreasonable is itself an unreasonable premise.

Finally, a government built on the quest for religious freedom and that acknowledges a standard of liberty including denominational choice must also accommodate within the scope of its public policy the right to practice what one preaches.