By Rammina Yassaie and Lucy Brooks

Our paper “Reassessing ‘Good’ Medical Practice and the Climate Crisis” takes an ethical dive into the roles and responsibilities of the medical profession and the medical regulator, in light of the climate and ecological crisis and its profound implications for health.

The health sector has been called to action given the “human toll of climate change is unequivocal and growing,” with the World Health Organisation prioritising climate change and health within its 2025 – 2028 workstream.

Acting as a world leader, the NHS was the first health system to commit to reach net zero by 2045, with growing numbers of UK-based health organisations joining the UK Health Alliance on Climate Change to “demand and deliver the urgent action that’s needed”.

The landscape was therefore primed for the General Medical Council to play its role in the biggest health crisis of our time. This could have been achieved by recognising the role and ethical responsibilities that doctors have, both in the way they practice medicine, and by using their trusted voices to advocate for the broader societal changes required.

However, when the updated medical standards were announced, they were met with disappointment by many in the medical community at what was described as a “missed opportunity” to present the case for what good medical practice really looks like, in a world on the brink of climate collapse.

Our paper argues that the latest standards in Good Medical Practice 2024 fail to truly respect the ethical principles at the heart of medicine and do a disservice to the powerful role that doctors have in responding to the grave threat of climate devastation, whilst simultaneously neglecting the profound opportunities for health creation.

The GMC is positioned as an ethical compass and with that comes an ethical responsibility for it to steer the profession along the moral and just course of meaningful climate action.

As climate impacts increasingly show themselves, with the injustice of such impacts clear for all to see, there is a growing sense of discontent amongst medics about the failure of the medical regulator to demonstrate ethical climate leadership in this space. This discontent is evidenced by a coordinated protest outside GMC headquarters earlier this year.

History tells us the medical profession has a powerful role in enacting meaningful social change that is deeply beneficial to health. One would assume the medical regulator, who has a legal and ethical responsibility to protect patient health, would recognise its own influential role in this space.  Divesting fully from fossil fuels, for example, would allow the GMC to role model the action that is required and would prevent the moral quandary of doctors’ hard-earned money funding the very crisis they will be left managing the health consequences of.

Since authoring our paper the GMC has also faced criticism for “being on the wrong side of history” by suspending a doctor following their involvement in nonviolent climate protests. They have defended their position by arguing (with no evidence to support the claim) that such a stance was required to protect public trust in the profession. Whilst doctors engaging in such actions have argued they are acting in line with their professional duties to protect patient safety, and there may be a case for arguing doctors have a supererogatory duty to engage in nonviolent direct climate action, the purpose of our paper is to emphasise that doctors can and should be a part of writing a new chapter for health. A chapter that relies on a thriving, regenerative, ecological future, and we call on the regulator to re-examine its own ethical duties along with the duties of the medical profession in light of the calamitous situation humanity now finds itself in.

There is no health on a dead planet and so we make the case that if the GMC (and other powerful health organisations) fail to demonstrate ethical climate leadership in the way that is so urgently required, the next philosophical question for us all to ponder is- who will guard the guards themselves? And how far will those within the medical profession be willing to go to ensure their blowing whistles are heard?

 Paper title: Reassessing ‘Good’ Medical Practice and the Climate Crisis

Author(s): Rammina Yassaie and Lucy Brooks

Affiliations: RY – Sheffield Hallam University, LB – Bradford Teaching Hospitals NHS Foundation Trust

Competing interests: LB- Environmental advisor to Royal College of Anaesthetists

Social media accounts of post author(s): @ramminay @DrLucyBrooks