Freedom of and from religion.

The Canadian Charter of Rights and Freedoms (Part I of the Constitution Act, 1982)1 guarantees the rights and freedoms set out in it subject only to reasonable limits prescribed by law as can be demonstrably justified in a free and democratic society. The Charter details four fundamental freedoms: freedom of conscience and religion; freedom of thought, belief, opinion and expression, including freedom of the press and other media of communication; freedom of peaceful assembly; and freedom of association. Section 15(1)1 of the Charter also indicates that every individual is equal before and under the law and has the right to the equal protection and equal benefit of the law without discrimination and, in particular, without discrimination based on race, national or ethnic origin, colour, religion, sex, age, or mental or physical disability. The application of religion to everyday life has historically not been without its problems and benefits. Societies that contain dominant religions have in some cases promulgated laws specific to that religion that have precluded other religious groups from practising their religion in peace and harmony. To allow for the multitude of religious and spiritual beliefs, many societies—including Canadian society—have separated church and state, which allows for secular government and the ability for citizens to practise their religion of choice freely and openly. In our diverse and multicultural society, any potential emphasis on spirituality and religion may affect the way we practise psychiatry, as well as the way we design and deliver mental health services. Our provincial and territorial regulatory bodies and colleges may be required to rule on issues pertaining to religion and practice. In addition, the training and academia domains at the undergraduate, postgraduate and national level (Royal College of Physicians and Surgeons) will likely be required to deal with issues that reflect culture and religion as it affects training. In accordance with the Canadian Charter of Rights and Freedoms, the Canadian Psychiatric Association (CPA) acknowledges that every Canadian has the fundamental freedom of conscience and religion, and also the freedom of thought, belief, opinion and expression. In a manner consistent with these freedoms, and the Charter, psychiatric care must be provided with the overarching goal of achieving the best possible health for individual patients. However, there is the potential for friction between two of the fundamental freedoms within the Charter, a charter that does recognize the supremacy of God and the rule of law. Unfettered freedom of conscience and religion may, when religion is dominant, negatively impact freedom of thought, belief, opinion and expression when it comes to other ideas, other religious or spiritual beliefs, or even agnostic or atheist perspectives. Canada has been considered a multi-ethnic country, with an expectation of freedom of religion. However, it is possible that religious groups’ belief systems may be sufficiently strong and powerful that they may preclude or affect the ability of mental health professionals from providing person-centred appropriate psychiatric care. Freedom of religion and issues around spirituality in psychiatry are addressed in thoughtful papers elsewhere. Most papers that examine religion and psychiatry argue for the need to address spirituality within the therapeutic relationship.2–5 This may be an important discussion, especially given the extent of religious beliefs in most communities and the relative lack of religious beliefs in psychiatrists compared to other physicians.6 Education and awareness of other views of the world, be they religious or cultural, will make for better informed and sensitive care.7,8 This paper addresses the issue of freedom from religion in our culture where freedom of religion is acknowledged.

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