Ethical Issues in the Psychiatric Treatment of the Religious 'Fundamentalist' Patient

Ronald W. Pies, MD; Cynthia Geppert, MD, PhD, MPH, MSBE


March 19, 2013

In This Article
Try and penetrate with our limited means the secrets of nature, and you will find that, behind all the discernible concatenations, there remains something subtle, intangible and inexplicable. Veneration for this force beyond anything that we can comprehend is my religion. To that extent I am, in point of fact, religious.
--Albert Einstein

A Conflicted Young Woman

Ms. A is a single, 18-year-old, evangelical Christian who recently matriculated at a conservative Christian college. Ms. A. has a history of bipolar II disorder, which a psychiatrist in her home state has successfully managed for 3 years. During her previous treatment, the patient's religious beliefs were never an issue.

She is now seeking advice from Dr. M, a psychiatrist who considers himself an agnostic, about whether she should continue taking a mood stabilizer. Ms. A. states, "I have done really well on lithium -- in fact, that's how I made it to college. But now, I'm conflicted. My psychology professor -- who is also an elder of the church I attend in town -- is telling me that I should depend on the Lord, not on medication. He also says I would have been healed by now, if I had put my trust in God and not in a psychiatrist, who, he says, are mostly atheists. My mother said similar things to me when I first started on lithium, and she didn't want her church friends to know that I was seeing a psychiatrist. But I still don't feel comfortable stopping the medication, especially during my first semester of college, because I'm afraid that I will have mood swings again. On the other hand, am I going against God's will by remaining on lithium? What do you think, Dr. M?"


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