by James J. Rusthoven
Relationships between different parties form the core of medical practice. Increasing attention has focused on the possible merits of understanding such relationships as covenantal in nature. Some advocates of a covenant ethic have focused on promise and fidelity as the defining features of this relationship. However, historical and/or metaphysical justification for prescribing a covenantal model varies, with some appealing to the ancient Greek medical tradition while others claim authority in the biblical revelation of covenant initially established by God with humankind.
In contemporary medicine, reliance on rational identification of a common morality without appeal to transcendent authority has become a dominant paradigm of medical ethics. The basis for envisioning a biblical covenant ethic for clinical relationships has a firm foundation in Reformed theology, which has developed the concept of covenant as a central theme. Such an ethic provides a transcendent grounding that is absent from a common morality based on reason alone that dominates much of bioethical thought. The patient-supporter relationship is presented as an integral part of medical practice that can be understood through a biblical covenant ethic as fidelity between a person or community and the vulnerable patient, grounded in the agape love of God for humankind.