“As health and social inequalities widen, and we learn more about the power held over human lives by an ever-diminishing number of individuals and corporations, I predict that more doctors around the world will be drawn inescapably into political campaigning.” – John Launer 

At 7 am on 3 September 2021, Doctors for Extinction Rebellion (XR) gathered at JP Morgan’s Canary Wharf headquarters. The group consisted of more than 50 doctors, nurses, allied health professionals, and students. They had gathered to deliver an urgent public health message—namely, to stop new investments into fossil fuels. Dressed in scrubs, they lay on the pavement under a banner that read “Cause of death: fossil fuel finance,” symbolising the deaths caused by fossil fuel investment. Some sprayed the words “CODE RED” with chalk paint, echoing the recently published IPCC report, which declared a code red for humanity. Their voices could be heard addressing the bank with a letter of concern, which they tried to deliver to its CEO, Jamie Dimon. Before long they were forcibly removed from outside the bank by the Metropolitan Police and private security guards. Six were unable to be carried off as they had superglued their hands to the pavement and planters outside the building. They remained there for three and a half hours, no longer visible to the public as steel barriers were erected around them, hiding the inconvenient truth of their message. Juliette Brown, a consultant psychiatrist, was among them: “I’m involved because my patients are being affected by air pollution and extreme weather. It’s now abundantly clear that if we go on investing in fossil fuels, we’ll see more destruction, disease, despair and death. Governments, banks and corporations have shown themselves unwilling to act on their promises. As a doctor I feel a duty to act on the evidence. So while it’s absurd that we have to risk arrest, we’ll continue to do this until the fossil fuel era is over and we have saved as many lives as we possibly can.”

The evidence is irrefutable; the climate and ecological emergency is the greatest health crisis of our time and is driven by burning fossil fuels. Although they are aware of this, many major banks continue to provide the corporate finance that drives exploitative and extractive fossil fuel projects. JP Morgan is a leading investor in fossil fuel projects among the big banks, having funded $317bn since the Paris Agreement came into force in 2016. As is the case for many companies, its rhetoric on climate change does not match its actions. Despite acknowledging that achieving net zero emissions by 2050 is the benchmark among policymakers, its climate strategy is based on a model that aims for net zero by 2070; a woefully inadequate target. The banking industry are risking the lives of people worldwide for its own profit and need to be held to account. 

Doctors for XR are part of the wider movement of Extinction Rebellion (XR), which uses non-violent direct action to demand urgent action to avert the climate and ecological emergency. The group’s members have three demands: that the UK government tells the truth about the scale of the emergency; that it commits to zero carbon emissions by 2025; and that it agrees to a binding citizens’ assembly to devise policies to tackle the crisis. It is worth dwelling on this third demand—when faced with a complex case in the NHS, we gather a multidisciplinary team of experts to help the patient navigate decisions about their treatment. The same is true for citizens’ assemblies, except here, experts on the climate and ecological emergency enable citizens to vote on recommendations. Assembly members are randomly selected, similar to jury service, to reflect a range of demographics from across the country. This process avoids structural inequality and ensures that the interests of vulnerable communities are considered. It can empower nations to make informed decisions democratically, and enables politicians to enact rapid change.

XR’s focus has recently expanded from raising public awareness to lobbying against the worst corporations and most indefensible government projects. Money Rebellion was launched, seeking to expose the deep causal link between the climate emergency and the economy, and demanding economic systems that safeguard life. XR demands system change; it avoids blaming individuals, acknowledging that we live in a toxic system. It prioritises a regenerative culture. XR is a decentralised, autonomous group that actively break down hierarchies, ensuring equitable participation.

Doctors for XR joined the XR movement in 2019, citing the “duties of a doctor” laid out in the GMC’s Good Medical Practice guidelines as a reason to act: 

“You must take prompt action if you think that patient safety, dignity, or comfort may be compromised.” The same message was stated by the Nursing and Midwifery Council and other regulatory bodies. Medical activism has historically supported social reform—a US physician, Donald Berwick, believes that doctors have a moral obligation to deal with the inherent inequalities in our system: “When the fabric of communities on which health depends is torn, then healers are called to mend it.” This goes for climate justice as well as the intersecting issues of race, gender, and class. 

Working with other groups including Health Declares and PsychDeclares, Doctors for XR lobbied several royal colleges to divest from fossil fuels and to make declarations of a climate and ecological emergency. Doctors for XR successfully campaigned to have an oil and gas conference barred from the Royal College of GPs in London. Other notable actions include organising for health warning labels to be stuck on 20,000 petrol pumps and staging a mock climate inquest at Parliament Square. Doctors for XR have undertaken civil disobedience as a last resort. Dozens of health professionals have been arrested while protesting peacefully. Their actions have received public support from the World Health Organization’s  director general, Tedros Ghebreyesus, and the editor of The Lancet, Richard Horton. 

XR has been protesting for two years, during which the debate around the environment has transformed. XR’s controversial tactics of civil disobedience have proved divisive. Yet the cause was never to win public affection—the group notes that historically, proponents of social change were disliked by wider society—and it has propelled the climate crisis up the agenda. It was after a series of XR protests that the UK Parliament became the first to declare a climate emergency. A recent UN poll found that belief in the climate emergency was highest in the UK and Italy, both at 81%. 

Since the recent demonstration, Doctors for XR have been returning to Canary Wharf in small groups in ongoing protest. 

Amelia Cussans, psychiatry trainee, London @DrAmeliaCussans @PsychDeclares

Ali Rowe, former mental health nurse, Bristol @DoctorsXr

Conflicts of interest: none declared.