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Focusing attention on physicians’ climate-related duties may risk missing the bigger picture: towards a systems approach to health and climate
  1. Gabby Samuel1,2,
  2. Sarah Briggs2,
  3. Faranak Hardcastle2,3,
  4. Kate Lyle2,
  5. Emily Parker2,
  6. Anneke M Lucassen2
  1. 1Department of Global Health and Social Medicine, King's College London, London, UK
  2. 2Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
  3. 3Nationals Centre for Public Awareness of Science, Australian National University, Canberra, ACT, Australia
  1. Correspondence to Dr Gabby Samuel, Department of Global Health and Social Medicine, Bush House, North East Wing, 40 Aldwych, King's College London, London WC2B 4BG, UK; gabrielle.samuel{at}

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Gils-Schmidt and Salloch recognise that human and climate health are inextricably linked, and that mitigating healthcare-associated climate harms is essential for protecting human health.1 They argue that physicians have a duty to consider how their own practices contribute to climate change, including during their interactions with patients. Acknowledging the potential for conflicts between this duty and the provision of individual patient care, they propose the application of Korsgaard’s neo-Kantian account of practical identities to help navigate such scenarios. In this commentary, we argue that by focusing attention on this physician–patient level, the authors overlook the complexity of climate change, both within the healthcare sector and beyond. We recognise the importance of individual agency in tackling this issue, and we also recognise that the authors do briefly acknowledge the importance of considering these broader complexities; however, we emphasise the need for climate and health discussions/action to be situated in a wider framework of systemic change. Our concern is that overemphasis on patient-level interactions risks normalising the prioritisation of individual-level approaches to addressing climate change, detracting from such a broader approach.

Individual approach versus systems thinking

Physician training emphasises the need for trust, confidentiality and shared decision-making in the doctor–patient relationship. …

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  • Contributors All authors contributed equally to this work.

  • Funding This study was funded by Wellcome (222180/Z/20/Z and 208053/B/17/Z), SB is funded by an NIHR Academic Clinical Lectureship (CL-2022-13-001).

  • Competing interests None declared.

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

  • A ‘carbon footprint’ is an estimate of greenhouse gas emissions associated with a particular product, process or organisation. The greenhouse gases included in a carbon footprint are carbon dioxide (CO2), methane, nitrous oxide and fluorinated gases, which are converted into CO2 equivalents according to their global warming potential. The carbon footprint of metered-dose inhalers is largely attributed to the fluorinated gases released during their use, but it also encompasses greenhouse gas emissions released during their manufacture, distribution and disposal.

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