Abstract
The responsibilization of patients for their disease and care may imply reduced access to medical care or overly moralize the doctor–patient relationship. This article first examines Luther’s early readings of the penitential Psalms, in which he transposes the nexus between sin and disease into the sphere of faith. His subsequent emphasis on the imputation of salvation further diminishes responsibilization: medical and pastoral care become distinct. This will be contrasted with Calvin’s cathartic, forward-looking understanding of disease and with Melanchthon’s moralist merging of humanism and theology into dietetics. These theological tendencies all represent present-day options.
Highlights
One premise of public healthcare today is the shift towards patients as autonomous, pragmatic self-managers
In this article I look at how Luther, and to an extent Calvin and Melanchthon, distribute the responsibility for disease through their soteriological anthropologies, biblical hermeneutics and integration of other traditions
Thistheology determines the relationship between sin, responsibility/forgiveness and the medicina corporalis
Summary
One premise of public healthcare today is the shift towards patients as autonomous, pragmatic self-managers. This existential relief categorically breaks apart a clearly visible nexus of disease and sin, and medical healing and moral penitence This development can be traced early in Luther’s works, such as his first lectures on the Psalms (Dictata super Psalterium, 1513–18), which are above all hermeneutically significant.[2] With a view to the Psalms as prayers, Luther emphasizes in the preface: ‘To sing with the spirit is to sing with spiritual devotion and emotion. Transitional figure Luther, the second-generation Reformer Jean Calvin saw himself as standing at the beginning of a new era, paving the way for a more rationalist approach to medicine In his commentary on Romans (1540), Calvin drew much less of a sharp distinction between law and gospel.[31] This conditioned a socially transformative understanding of faith reflected in Calvin’s Geneva. In Melanchthon there is ‘a moralizing tendency, leading to a signficant strenghthening of the doctor before the patient, because the latter in principle had to present to the doctor with a bad conscience, as their disease hinted at sins they had committed’.35
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