By Gabrielle Samuel and Cristina Richie.
Developed countries’ health care systems comprise a significant proportion of their national carbon emissions (e.g., 6% in Great Britain) that, in turn, contribute to global emissions. These carbon emissions are compounded by other health issues such as climate change health hazards; social issues like war and environmental migration; and other environmental impacts such as natural resource use (mining, water, wood etc), cumulating waste (plastics, digital waste etc), and decreasing biodiversity.
Within biomedical ethics, ethical frameworks exist (albeit in scarcity) to guide clinicians and hospital managers to consider such environmental impacts in their decision-making and practices. While a shared understanding of best practice for patient and population health has not yet fully formed, the conversation has started in public health and biomedical ethics.
Research drives the development, dissemination, and use of medicine and medical technologies. While biomedical ethics has traditionally focused on the last part of research—its implementation—research ethics drives the former (development) and therefore research ethics and biomedical ethics are inextricably intertwined.
When considering what an ethics framework that specifically accounts for research’s environmental impact would look like, we were keen to draw on those frameworks that were already well-established. This is because the ethical conduct of research is highly regulated, and it made sense to modify an already shared understanding of practice rather than invent the wheel. Our framework therefore includes five perhaps already recognisable principles: social value, scientific quality, respect for persons, communities and environment, justice and favourable risk-benefit ratio – though these principles have been expanded to include environmental considerations.
The framework can, of course, be viewed as yet another bureaucratic (albeit important) aspect of research that now needs to be considered when developing a project. But we mean it to be much more this, by re-imagining how health research is practiced. Like One Health initiatives and other bio-medical-health projects, if research ethics broadens their understanding of health to something more holistic—to health research as equally focusing on the social determinants of health rather than high-tech solutions for preventable health conditions—and appreciate that the consideration of environmental impacts (and other ethical issues such as social justice) need to be at the heart of any research design, this framework can help us move away from the current goal driven research that focuses on narrowly constructed conceptions of health, towards something in which environmental (and social) issues are placed at the heart of any health research practice.
Author: Gabrielle Samuel and Cristina Richie
Affiliations: King’s College London, UK; Delft University of Technology, NL
Competing interests: None
Social media accounts of post authors: @gabriellesamue1