Healthcare could be locked into self-destructive cycle - Cristina Richie

In 2017, the National Health Service’s Health and Social Care sectors had a carbon output (CO2) of 27.1 million tons. Carbon emissions are accelerated by human activity and contribute to climate change.

Cristina Richie, PhD is a Member of the Scottish Council on Human Bioethics and a Fellow at the Institute for Advanced Studies in the Humanities, University of Edinburgh, and a Lecturer the Philosophy and Ethics of Technology department at Delft University of Technology (Netherland).

People affected by climate change cause an influx in hospital admissions and require medical care. These treatments release more carbon, locking healthcare into a self-destructive cycle whereby medical care causes medical needs. For instance, air pollution is known to induce breathing difficulties. Inhalers are used to minimize the effects of air pollution, but inhaler use generates a significant amount of CO2, which exacerbates pollution. In response, the United Kingdom Climate Change Act of 2008 led to legally binding carbon reduction measures in healthcare. These are outline in the NHS Scotland’s Climate Change Plan, with additional support from the Scottish Public Health Network and Scottish Managed Sustainable Health Network (SMASH), which addresses climate change health hazards.

As the climate plan is reevaluated for efficacy and progress, the NHS has moved from greening hospital buildings, reworking hospital menus to include less meat, and encouraging carbon neutral transportation—like walking and biking—to examining the carbon of medical practices like pharmaceutical prescriptions and the environmental impact of single-use plastics. These are important initiatives. Yet, minimizing the environmental impacts of healthcare is not only the responsibility of the NHS, but also the patients who it serves and the doctors who provide care.

One of the best ways for patients to participate in healthcare carbon reduction is simply to ask “is there a non-medical alternative?” at the next visit to the doctor. While there may not be an alternative that is as effective, in some cases, there is. And, moreover, the alternative may have fewer side-effects. Such is the case with diet and exercise to combat Type II diabetes instead of bariatric surgery.

Doctors who participate in Extinction Rebellion often make headlines for their activism, sometimes calling it a “moral duty” to highlight the connections between climate change and health. Protesting is one tool that doctors have to make healthcare more sustainable, in addition to keeping up to date on low-carbon alternatives and adhering to NHS carbon reduction guidelines.

Climate change health hazards, availability of healthcare services, and NHS capacity will be among the most urgent medical challenges for Scotland in the coming decades. Choices will need to be made as to which healthcare services should be retained and which should be cut to meet future carbon guidelines. Yet the COVID pandemic has ushered in a renewed sense of social solidary, the importance of personal preventative health measures, and minimizing the impact on the NHS. It is precisely these virtues that will facilitate the strength and wisdom needed for sustainable healthcare in the post-pandemic world.

Cristina Richie, PhD is a Member of the Scottish Council on Human Bioethics and a Fellow at the Institute for Advanced Studies in the Humanities, University of Edinburgh, and a Lecturer the Philosophy and Ethics of Technology department at Delft University of Technology (Netherland).

On November 25 Dr Richie will be giving a virtual talk on “Economic Policies for Medical Reproduction that Support the United Nations Sustainable Development Goals,” at the Edinburgh Speaker Series Seminar, 1pm, University of Edinburgh – visit iash.ed.ac.uk for details.