In the face of a devastating potentially fatal diagnosis, healthcare professionals and families often turn to palliative medicine for guidance and support. It is not about “giving up”—and in many situations, especially in paediatric medicine—palliative care can and should be provided alongside active treatments. A child with advanced malignant disease, for example, may have chemotherapy aimed at cure, but will also benefit from the holistic and symptom management approach that palliative medicine can provide alongside. Both the aggressive treatment and the palliative management will contribute to healing.

Our planet is in need of palliative care. For years, climate scientists, effectively part of the planet’s “medical” team, have urged us to change the way we live in order to slow, or even reverse, our planet’s rapid spiral towards death. They have shown us the evidence, given us numbers, predicted time scales, and calculated the positive effects of treatment. We have ignored their advice and have continued to do the things that exacerbate the symptoms, that make the planet more unwell, and hasten it’s death. Some have hoped that somehow the “medics” have got it wrong. Others perhaps have taken the approach that if we don’t think or talk about it, then it won’t happen—a common approach to death throughout our society. Whatever our reasons, we have ignored the symptoms and professional advice for so long that the planet is dying. And this will not be a painless death, surrounded by loved ones and with medication to ease the suffering. This will be a slow and painful death, of flooding, of drought, of starvation, of rising temperatures, of forest fires, of increasing pollution, of increased disease, all bringing emotional suffering and pain on a huge global scale.  

It is time for the aggressive, life saving interventions. There is still the hope of cure, and we know what treatments will work. We need big changes, such as a rapid transition away from fossil fuels and investment in renewable energy. We all need to embrace the “treatment” in the knowledge that it can be life-saving. But alongside this we must not ignore the importance and impact of a palliative care approach. In the face of death, every day matters and every person matters. Not just the dying person, but those close to them. We teach our medical students that palliative care is everyone’s responsibility—every single person that comes into contact with the patient has a role to play. It may be just noticing that a water jug needs filling or sitting to listen, but you only have to hear a patient’s story to know the huge impact these apparently small acts of kindness, thoughtfulness, and compassion can have.

Our approach to the planet must be the same. In the face of death, every day matters. Every single person who lives on this planet, who breathes it’s increasingly toxic air, matters. Small acts of kindness, thoughtfulness, and compassion towards our beautiful planet will have an impact. We cannot all roar like Greta Thunberg, but we can all be the person who shows up every day, with the seemingly small acts that matter. We must follow the “medics” advice and stop doing the things that will exacerbate symptoms and contribute further to an early demise. We can all buy less, buy wisely, buy second hand. We must all learn to throw less away, repair, reuse things that others no longer need, and borrow things we don’t need often. We can reduce our use of “disposable” items by switching, for example, to cloth nappies and re-usable menstrual products. We need to change our diet to one that promotes healing, reducing our meat consumption (or even going veggie), and thinking about alternatives to cow’s milk. We need to make life style changes if we want to live. And contrary to what some may think, these will be life style changes that improve our quality of life as well as promoting our survival. 

We can no longer ignore the reality that is facing us. As the planet moves closer to inevitable death, we must hope that the aggressive treatments needed will come, and that these will not come too late. And we must embrace and commit to them, with the hope they bring. But none of us should sit idly by, waiting for the cure. We must all adopt the palliative approach, which will help to nurse our planet back to health. Every act matters. Every person counts. We must all stop feeding the disease and be part of the cure. 

Finella Craig is a consultant in paediatric palliative medicine in London. She travels everywhere on her bike, including to all her patient home visits, and is taking part in Ride for Their Lives London to Glasgow. 

Competing interests: none declared.