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Towards an environmentally sensitive healthcare ethics: ten tasks and one model
  1. Kristine Bærøe1,2,
  2. Anand Singh Bhopal3,
  3. TOrbjørn Gundersen4
  1. 1 Institute of Health and Society, University of Oslo Centre for Medical Ethics, Oslo, Norway
  2. 2 University of Bergen Faculty of Medicine and Dentistry, Bergen, Norway
  3. 3 Department of Global Health and Primary Care, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
  4. 4 University College of Norwegian Correctional Service, Lillestrøm, Norway
  1. Correspondence to Professor Kristine Bærøe, Institute of Health and Society, University of Oslo Centre for Medical Ethics, Oslo, Norway; Kristine.Baroe{at}

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In the face of environmental crises such as climate change, pollution and biodiversity loss—which all adversely impact on health—Gils-Schmidt and Salloch explore whether physicians can be justified in taking climate issues into account in clinical care.1 While their approach centres on the ‘climate-sensitive’ decisions, physicians can carry out on the micro-level of clinical decision-making, they encourage further discussions on how climate-related issues can be included across different levels of decision-making in healthcare. We propose a list of tasks and a model to assist with navigating the range of factors and structural elements an environmentally sensitive ethics must address.

Stephen Gardiner’s notion of a perfect moral storm is central to understanding these issues.2 Gardiner describes how a perfect moral storm occurs in the centre of three overlapping conditions for human action and policymaking in the face of climate change. This storm is driven by: (1) a lack of interest among current generations to meet global needs and accommodate the well-being of future generations, (2) a lack of ecological concerns for other parts of nature than humans and (3) weak ethical and political theories and institutions shaping policy decisions on issues with severe implications across borders and generations. Moreover, these conditions are embedded in the existing, complex world of ethically unjustified power imbalances and social injustice.

The growing awareness of healthcare’s climate footprint has amplified and accelerated global, grassroots action to make healthcare more environmentally friendly. This includes incorporating environmental impacts into quality improvement methodologies, building communities of practice to explore how to make …

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  • X @abhopal_1

  • Contributors KB had the idea, developed the model and drafted the first version with input from ASB and TG. KB, ASB and TG all contributed to revising the text.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.