Freedom. Protection. Rights. These are the words that most people associate with the First Amendment. other words that should come to mind but rarely do are limitations and boundaries. Where criminal offense meets the First Amendment there is a gray area. In many cases, juries take weeks debating whether the offender should be convicted or if the are protected under the first amendment.
What are the boundaries? At what point does the First Amendment stop being a valid protection? In the case of Commonwealth vs. Twitchell the entire case circled around Americas gray area. Parents were accused of involuntary manslaughter when their two year old son died because they didn't give him medicine. The reason they denied giving him medicine was because they were Christian Scientists. They didn't believe in medicine and thought that through prayer and homemade remedies they could cure the child. This was a difficult case because even though they were following their religion they weren't taking the necessary means to protect they're child who was only an infant. They were convicted and got ten year probation but actually got an appeal and got released. The issue is that the system is like a giant balance. On one side you have the laws. On the other you have the first amendment. The scale at first weighed greater towards law which sent the Twitchells to jail but later there was a shift where the first amendment took greater precedence and they received an appeal and were released. I personally think that they were guilty but I'm not 100%. Their child is dead and that won't change but that doesn't mean they woke up one morning and said "I don't want my child to have medicine so that he will die". They honestly believed that he would get better if they prayed hard enough but that doesn't make up for the fact that they could've prevented his death. That is where the gray area comes in. There is actually no right answer.
I think it is all a matter of offense. If you are endangering a life no matter who you are or what your beliefs you should go to jail. When the effect of your religion damages the life of someone else you are no longer protected under the first amendment. That's the boundary. That's the limit but there will still always be a gray area.