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From Contract to Covenant in Advance Care Planning

Published online by Cambridge University Press:  01 January 2021

Joseph J. Fins
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Type
Commentary
Information
Journal of Law, Medicine & Ethics , Volume 27 , Issue 1 , Spring 1999 , pp. 46 - 51
Copyright
Copyright © American Society of Law, Medicine and Ethics 1999

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References

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By proxy, I mean a surrogate specifically designated by the patient for health care decisions while the patient had decision-making capacity. In some jurisdictions, this individual may be known as a durable power of attorney for health care or as a health care agent.Google Scholar
Introducing the notion of covenant into a discussion concerning the relationships that emerge through the use of advance directives is not without some weighty precedents in other areas of medicine. See Landis, D.A., “Physician Distinguish Thyself: Conflict and Covenant in a Physician's Moral Development,” Perspectives in Biology & Medicine, 36 (1993): 628–41; Crawshaw, R. et al., “Patient-Physician Covenant,” JAMA, 273 (1995): 1553; and Cassel, C.K., “The Patient-Physician Covenant: An Affirmation of Asklepios,” Annals of Internal Medicine, 124 (1996): 604–06.Google Scholar
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A more recent commentator has suggested how a marriage contract can become covenantal when sanctified by a shared faith: “Without religion, the institution of marriage—the foundation of family life—is no longer the product of vows made solemnly before God; it is just another contract, less binding, even than a mortgage obligation.” Beran, M.K., The Last Patrician: Bobby Kennedy and the End of American Aristocracy (New York: St. Martin's Press, 1998): at 182.Google Scholar
Having observed that some contractual relationships can evolve into covenantal, it should also be noted that some covenants do not have their origins in contracts.Google Scholar
I am indebted to Nancy Dubler for this phrase.Google Scholar
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A covenantal approach can assist a proxy because it can help him “serve and draw upon the deeper reserves of the other.” See May, supra note 12, at 121.Google Scholar
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