A Hindu woman was scheduled for surgery at a Catholic hospital. Prior to her arrival, a male relative appeared asking to see her room so that he could "cleanse" it. The staff assured him that the room was perfectly clean. He said, "No, a ritual is needed to cleanse the room of evil spirits." He was promptly and forcibly ejected from the hospital.

This incident should shock anyone sympathetic to religious freedom and open to the possibility that religious practices, such as prayer, may be beneficial to health. This family may not have legal recourse against this hospital, which undoubtedly receives some public funding and exercised a certain degree of police authority in the ejection. Even if the hospital were purely a state-funded institution, it is doubtful that the courts would see the Hindu woman's religious practice as a protected right.

We live with two powerful beliefs about religious freedom. First, that the First Amendment protects us against governmental interference with the practice of our religion. Second, that the state should not seek to impose a particular understanding of moral behavior upon its citizens, unless it is clearly harmful to others.

Religious freedom, at times, seems to be more myth than reality. Witness the long struggles of the Jehovah's Witnesses to secure the right to refuse blood transfusions, and the Christian Scientists' legal difficulties in refusing medical treatment in favor of healing through prayer, scripture readings, and faith.

However, the victories these groups have achieved are not really about religious freedom, but about individual autonomy. These rights do not extend to minors, nor those deemed incompetent. Indeed, following the demands of faith against the dictates of medical science may itself raise questions about one's competence.

In addition, the recent U.S. Supreme Court decision, City of Boerne v. Flores, shows the fragile nature of religious liberty. In the 6-3 decision, the Court struck down a 1993 act, known as the Religious Freedom Restoration Act, that had prohibited the government from "substantially burdening" a believer's religious practices. This law, primarily intended to protect minority religions, has been supported by mainstream groups. Despite its political popularity, the Court's majority recognized that the 1993 act was an attempt to overturn the Court's own interpretation of the First Amendment.

Many laws embody conventional medical understandings of health care and public health. Insofar as those laws are generally applicable to all citizens, they do not protect "alternative approaches" to health and health care from state interference.

Congress enacted the Religious Freedom Restoration Act in response to a 1990 Supreme Court decision that many religious groups criticized. In Employment Div. v. Smith, the Supreme Court held that the Constitution did not privilege religious activities against routine restrictions even when these activities benefited public health. In this case, the court ruled that a state's prohibition against the use of peyote, a mild hallucinogen, was valid even against its religious and sacramental use by practitioners of a Native American religion.

The Court upheld this law even though evidence suggested that peyote did not create significant health problems. Viewed holistically, this community's spiritual life — including peyote — contributed to the public health. Nonetheless, the Court ruled that the use of peyote violated its determination of appropriate moral behavior (abstinence from certain proscribed drugs).

Without an understanding of religious freedom which truly respects and honors spirituality and spiritual practices, the law will remain a potential or actual adversary of spiritually based alternative medicine. While the government may legitimately protect its citizens against quackery and abusive practices that may seek to hide behind the label of religion, the government must allow for a different and broader understanding of human health and human life.

In order to afford spiritually based medicine true religious freedom, Congress and the Court may need to recognize that spiritual health (and mental health) may, as in the cases of the Jehovah's Witnesses and Christian Scientists, violate standards drawn strictly from an understanding of the body as a biological machine that is to be "fixed" by conventional medicine when it malfunctions.

Admittedly, the religions of the majority are not immediately at risk. As the Hindu woman's story shows, it's the minority religions that seem most vulnerable. Yet it is within these traditions that alternative therapies seem most prevalent. Moreover, the failure to respect the rituals of Hindus or Native Americans today may banish from the bedside the rituals of Christians, Jews and Muslims tomorrow. Given our constitutional understanding of the right of equal treatment under law and the prohibition against favoring one religion over others, the Court might feel justified in disregarding the rights of all religions, not just a few.

David Sinacore-Guinn is a researcher at the Park Ridge Center.