Eric Chivian urges doctors to help tackle climate change, but shouldn’t the profession’s energies be spent tackling unsafe hospitals and under resourced healthcare systems?

Dublin psychiatrist Eugene Breen deploys both equine and maritime analogies in his weekend response to Chivian’s essay.  Economies are based on fossil fuels, he argues. Only a disaster will trigger behaviour change.

“Unmet contraceptive needs, overpopulation and the like are the equivalent of the deckchairs on the Titanic as it cruises toward the iceberg, because the real causes of the climate disaster are being ignored, and spurious idealogues are confusing the issue with these false arguments,” he concludes.

Clinical pharmacologist Michael Schacter urges doctors to focus on safeguarding professional standards and refrain from “sixth form ‘activism.’”

Consultant anaesthetist Mario S Sammut was similarly dismayed by Chivian’s essay and argues that climate has changed throughout our planet’s history.

Far better, he says, to ensure our children and grandchildren are “better equipped to cope with anything that nature (and the climate) might throw at them. Anything else would be folly.”

Chivian gets a more sympathetic hearing in responses to Fiona Godlee’s accompanying editor’s choice article.

GP Rachel Cottam says that in the face of the failure of political leadership “clinicians are ideally placed to step into the breach: even where some still prefer to put their heads in the sand, we can argue that taking action will lead to enormous health dividends, both physical and mental, as well as social returns and a reduction in health inequalities.”

Others put it more succinctly. Physician editor George D Lundberg writes: “As Bob Dylan wrote/sang ‘When will they ever learn?’ ”

But Dylan neither wrote nor sang those lyrics, says Sam Lewis. It was written by Pete Seeger in “Where have all the flowers gone?” written by Peter Paul and Mary.

David Payne is digital editor, and readers’ editor