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Harmonising green informed consent with autonomous clinical decision-making: a reply to Resnik and Pugh
  1. Eva Sayone Cohen1,2,3,4,
  2. Dionne Sofia Kringos2,3,4,
  3. Wouter Johan Karel Hehenkamp1,3,
  4. Cristina Richie5
  1. 1 Department of Obstetrics and Gynaecology, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
  2. 2 Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
  3. 3 Centre for Sustainable Healthcare, Amsterdam UMC, Amsterdam, the Netherlands
  4. 4 Amsterdam Public Health, Quality of Care, Amsterdam UMC, Amsterdam, the Netherlands
  5. 5 Department of Philosophy, The University of Edinburgh, Edinburgh, UK
  1. Correspondence to Eva Sayone Cohen, Department of Obstetrics and Gynaecology, Amsterdam UMC, location VUmc, Amsterdam, the Netherlands; e.s.cohen{at}


Resnik and Pugh recently explored the ethical implications of routinely integrating environmental concerns into clinical decision-making. While we share their concern for the holistic well-being of patients, our response offers a different clinical and bioethical stance on green informed consent and patient autonomy. Contrary to the authors’ lack of data to support their concerns about provider and patient willingness to engage in climate-related conversations, we provide evidence supporting their sustainability engagement and stress the importance of a proactive, anticipatory approach in healthcare to align with evolving societal values. If climate change is perceived as a politicised issue, though it is not inherently so, healthcare providers are professionally trained to address sensitive subjects and have a duty to inform patients about potential health risks. Recognising the environmental crisis as a health crisis underscores the direct connection between environmental hazards and patients’ well-being. Our perspective advocates for integrating individual considerations, societal responsibilities and systemic changes to promote environmentally sustainable healthcare.

  • Decision Making
  • Environment
  • Ethics- Medical
  • Informed Consent
  • Personal Autonomy

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  • Contributors ESC and DSK: conceptualisation, writing (original draft preparation), writing (reviewing and editing). WJKH and CR: conceptualisation, writing (original draft preparation), writing (reviewing and editing), supervision.

  • 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.

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