Psychiatry and religion/spirituality (R/S) share an interest in
human flourishing, a concern with beliefs and values, and an
appreciation for community. Yet historical tensions between science
and religion continue to impede dialogue, leaving clinicians
uncertain about how to approach ethical questions arising between
them. When are religious practices such as scrupulosity disordered?
What distinguishes healthy from unhealthy religion? How should a
therapist approach a patient's existential, moral or spiritual
distress? What should clinicians do with patients' R/S convictions
about faith healing, same-sex relationships, or obligations to
others? Discussions of psychiatric ethics have traditionally
emphasized widely accepted principles, generally admired virtues,
and cultural competence. Relatively little attention has been
devoted to the ways that R/S inform the values of patients and
their clinicians, shape preferred virtues, and interact with
culture. Ethical Considerations at the Intersection of Psychiatry
and Religion aims to give mental health professionals a conceptual
framework for understanding the role of R/S in ethical
decision-making and serve as practical guidance for approaching
challenging cases. Part I addresses general considerations,
including the basis of therapeutic values in a pluralistic context,
the nature of theological and psychiatric ethics, spiritual issues
arising in diagnosis and treatment, unhealthy and harmful uses of
religion, and practical implications of personal spirituality. Part
II examines how these considerations apply in specific contexts:
inpatient and outpatient, consultation-liaison, child and
adolescent, geriatric, disability, forensic, community,
international, addiction and disaster and emergency psychiatry, as
well as in the work of religious professionals, ethics committees,
psychiatric education, and research. Thick descriptions of case
examples analyzed using the framework of Jonson and Winslow show
the clinical relevance of understanding the contributions of
religion and spirituality to patient preferences, quality of life,
decision making, and effective treatment.
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