Healthcare could be locked into self-destructive cycle

We should be asking if there is a nonmedical alternative to medical treatment to minimise our environmental impacts, says 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.

Climate change causes healthcare problems related to extreme heat, outdoor air quality, flooding, vectorborne infection, respiratory disease, and water and food-related infection. The World Health Organisation reports that climate change currently causes over 150,000 deaths annually with a projected 250,000 additional deaths per year in the next ten to 30 years.

People affected by climate change cause an influx in hospital admissions. Treatments release more carbon, locking healthcare into a selfdestructive cycle whereby medical care causes medical needs. For instance, air pollution is known to induce breathing difficulties. Inhalers are used to minimise the effects of air p ollution, 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 outlined in 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 re-evaluated for efficacy and progress, the NHS has moved from greening hospital buildings, reworking hospital menus to include less meat, and encouraging carbon neutral transportation, to examining the carbon of medical practices like pharmaceutical prescriptions and the environmental impact of single-use plastics. Yet, minimising 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?”. 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.

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 pandemic has ushered in a renewed sense of social solidarity, the importance of personal preventative health measures, and minimising the impact on the NHS. It is precisely these virtues that will facilitate the strength and wisdom needed for sustainable healthcare.

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