Abstract
Biomedical ethics has been dominated by principles-based ethics (PBE). PBE focuses on the process of moral problem-solving by rational consensus but suffers from minimal ethical content and inattentiveness to relational aspects that constitute the core of medical care. Grounded in a Reformational philosophical view of the created order, the Normative Reflective Practitioner (NRP) model acknowledges constitutive (structural and aspectual) as well as regulative (directional) dimensions of medical practice. Medical practice is qualified by the ethical principle of care for relational activities in medicine, which are most meaningfully expressed within a biblical covenantal ethical framework (CEF). CEF helps to transform the disparity in knowledge and power between caregiver and patient toward a covenantal disposition of caring for the vulnerable and needy. This model acknowledges creationally ordered individuality structures of medical practice, provides dynamic and normative direction to changes in the expression of those structures, and maintains focus on patient needs in light of techno-formative advances.
Both the NRP model and the CEF help to reinterpret the principle of beneficence within medicine as the ethical core aspect of all medical encounters, providing overarching moral force for maintaining relational cohesion in patient care.
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- 1.
References to the Greek deities or the Judeo-Christian God are often omitted and references to perceived morally negative behaviors are retained in codal form.
- 2.
Also known as the “Teachings of the Twelve Apostles”, the Didache (Greek for “teaching”) speaks of the fetus as the molded image of God.
- 3.
These aspects include numerical, spatial, kinetic, physical, biotic, psychic, logical, historical, lingual, social, economic, aesthetic, juridical, ethical, and pistical (or faith) aspects.
- 4.
Seerveld introduces the idea of a techno-formative control or a techno-formative aspect in his attempt to clarify Dooyeweerd ”s articulation of the normative opening process. For the former, what Dooyeweerd calls the historical or cultural modal aspect might be better captured as the techno-formative aspect or activity of community expression over time. I use the term here to connote human activity involving the opening of medical knowledge that leads to adjustments in human activity for the sake of improved human care and healing.
- 5.
See also Mt. 9:13 and 22:37–40.
- 6.
This article contains the early beginnings of ideas whose further development can be found in Rusthoven, J. (2014). Covenantal Biomedical Ethics for Contemporary Medicine: An Alternative to Principles-Based Ethics. Eugene, OR: Wipf and Stock Publishers.
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Rusthoven, J.J. (2018). Covenantal Ethics for Health Care. In: Buijs, G., Mosher, A. (eds) The Future of Creation Order. New Approaches to the Scientific Study of Religion , vol 5. Springer, Cham. https://doi.org/10.1007/978-3-319-92147-1_12
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