Physicians have a duty to climate protection, but beware: we all have!

By Henk Jasper van Gils-Schmidt and Sabine Salloch.

In our article, “Physicians´ duty to climate protection as an expression of their professional identity”, we argue that physicians should undertake action to protect the climate. This question has our interest, as we observe a rising numbers of calls to action to climate protection addressing physicians. Yet, we asked ourselves: Why would physicians have a moral duty that goes beyond the duty we may all share to protect the climate? And to what extend does this duty go beyond a general moral duty? In other words, it was unclear to us on what moral foundation physicians should be singled out for such a call to action.

We therefore started out with researching the reasons for the calls to action and found two central ones. First, physicians are the “advocates for individual and public health” and it shows ever more that climate change impacts human health. Second, the health care system itself is a carbon-emitting industry and thus contributes directly to climate change. But even though these two reasons look powerful on the surface, reflection showed us that it is not clear how a duty to climate protection actually relates to other duties the physician has. For example, part of the common understanding of being a physician is to want to provide the best care possible for one´s patients. Yet, if the “best care” for the individual patient is the prescription of polluting medical products, a conflict arises between what is best for the health of the individual patient and what is best for the public health and health of future generations. So, what should a physician do?

To explore this question, we opted for the neo-Kantian moral theory of Christine M. Korsgaard that puts the concept of practical identity at center stage. (Note: Other moral theories might have led to other conclusions regarding physicians’ duties in the climate crisis.) Working with Korsgaard’s framework, however, was particularly attractive to us as it very well mirrors the personal, existential and emotional dimensions of being a physician. If the WMA Declaration of Geneva indicates that “I SOLEMNLY PLEDGE to dedicate my life to the service of humanity” this can be easily interpreted as a self-commitment not only to the individual patient the doctor is in charge of but to mankind in a wider sense.

How Korsgaard’s framework answers the above question (and more!) can be uncovered in our article. Here, we´d only like to share one surprising conclusion we came to. It seems natural to think that in the daily practice of physicians the duties towards climate protection and advocating health stand in conflict with each other—as the example above illustrates. However, in our analysis we found that the general duty to climate protection and the physician´s duty to advocate for the health of their patients actually can reinforce each other the moment the physician understands climate change as a health issue—something that immediately bears on their identity as a physician.

Note: When it is correct, as we argue, that physicians have a special moral duty to climate protection, this does not free the rest of us of the moral duty to ensure that current and future generations have a planet on which they can live a flourishing life that they find worthwhile.


Paper title: Physicians´duty to climate protection as an expression of their professional identity: A defense from Korsgaard´s neo-Kantian moral framework

Authors: Henk Jasper van Gils-Schmidt1 and Sabine Salloch2

Affiliations: 1) Department of Health Sciences, Hamburg University of Applied Sciences, Hamburg, Germany; 2) 2Institute of Ethics, History and Philosophy of Medicine, Hannover Medical School, Hannover, Germany

Competing interests: None declared

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