Article Text
Abstract
Objective Physical and mental well-being are threatened by climate change. Since hospitals in high-income countries contribute significantly to climate change through their greenhouse gas (GHG) emissions, the medical ethics imperative of ‘do no harm’ imposes a responsibility on hospitals to decarbonise. We investigated hospital stakeholders’ perceptions of hospitals’ GHG emissions sources and the sense of responsibility for reducing GHG emissions in a hospital.
Methods We conducted 29 semistructured qualitative expert interviews at one of Germany’s largest hospitals, Heidelberg University Hospital. Five patients, 12 clinical and 12 administrative employees on different levels were selected using purposive maximum variation sampling. Interviews were transcribed verbatim and analysed using the framework approach.
Results Concerning GHG emissions, hospital stakeholders perceived energy and waste as most relevant emission sources followed by mobility. Climate change mitigation in general was considered as important. However, in their role as patients or employees, hospital stakeholders felt less responsible for climate change mitigation. They saw providing best possible medical care to be the top priority in hospitals and were often concerned that patients’ health could be jeopardised by climate change mitigation measures.
Conclusion Perceptions of most important emission sources did not coincide with those in literature, highlighting the need to inform stakeholders, for instance, about pharmaceuticals as important emission source. A frequently perceived conflict between reducing emissions and providing high-quality medical care could be eased, if reducing emissions would not only be justified as a contribution to mitigation, but also as a contribution to preventing ill health—a basic principle of medical ethics.
- Environment
- Ethics- Medical
Data availability statement
Data are available on reasonable request.
This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
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Data availability statement
Data are available on reasonable request.
Supplementary materials
Supplementary Data
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Footnotes
Correction notice This article has been corrected since it was first published. The open access licence has been updated to CC BY. 17th May 2023.
Contributors CQ, RS and AH were responsible for the study concept and design. CQ conducted the interviews and coded the data. AH had oversight of the coding of the data. The data were interpreted by all authors. CQ wrote the original draft while RS, ID and AH reviewed and edited the draft and the visualisations. All authors critically revised the manuscript for important intellectual content. RS and AH supervised the study. All authors gave final approval of the work to be published. CQ is the guarantor of this publication.
Funding This study was funded by Nationale Klimaschutz Initiative (03KF0150B); Else Kröner-Fresenius-Stiftung; Robert Bosch Stiftung (01000035-002). For the publication fee we acknowledge financial support by Deutsche Forschungsgemeinschaft within the funding programme „Open Access Publikationskosten“ as well as by Heidelberg University.
Disclaimer The Else-Kröner-Fresenius-Stiftung, Nationale Klimaschutz Initiative and Robert Bosch Stiftung had no role in the design, execution, interpretation or writing of this study.
Competing interests AH is member of the German Climate Change and Health Alliance (KLUG e.V.). The other authors declare no competing interests.
Provenance and peer review Not commissioned; externally peer reviewed.
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