By Cristina Richie.
High carbon health care has global environmental effects—population health is damaged by the carbon of health care industries. Many countries have medically underserved residents, and as such, it could be argued that there is an obligation on the part of health care systems to reduce carbon emissions through laws or policy. For instance, Munthe, Fumagalli, and Malmqvist argued in the JME that a sustainability principle “should be added to standard operational principles for public healthcare resource allocation.” Thus, health care policymakers should view lower carbon health care systems as preventive health on a global scale. Sustainable health care systems are not only ethical, they are rational.
In a global world it is short-sighted to see only current residents as stakeholders of health. One Health and other forms of systems thinking recognizes this. Countries do not only export carbon emissions, which affect people in other countries. Countries also welcome those affected by climate health hazards and climate refugees as well as migrants and immigrants that are attracted to education and work internationally. Many of these people come with pre-caused or pre-existing health care concerns related to climate change. Thus, their health care will be more expensive and burdensome than those unaffected. This will put pressure on the health care systems who receive these people and the economic system of the country.
Movement towards lower-carbon health care will lead to more economically robust health care systems, which will also support the flourishing of residents. But, without the option for low-carbon health care in general, absolutely no progress can be made. Thus, fostering international collaborations, policy dialogues, and the formulation of global environmental agreements, such as the United Nations Framework Convention on Climate Change, will be key in addressing environmental issues on a global scale. Sustainability has to be in the pipeline of the medical industry—from fuels sources, to waste disposal practices, to health care delivery.
As the ethical demands for decarbonization coalesce with the mission of health care to keep people well, more needs to be done to meet the moral demands of health care carbon reduction without ignoring global climate justice. The paradox of prevention illuminates the ethical trade-offs of preventive health care in a time of climate crisis. In order to reduce the moral burden on individuals who may need medical treatments (if they wish to live) more attention needs to be paid to the institutional ethical obligation for decarbonization as a matter of global justice. Therefore, a more holistic approach to health care will include not only preventive health care strategies for individuals, but also an evaluation of the way health care carbon affects population health worldwide.
Paper title: Environmental Sustainability and the Paradox of Prevention
Author: Cristina Richie
Affiliations: University of Edinburgh
Competing interests: None decalred