@article {Wardrope791, author = {Alistair Wardrope}, title = {Health justice in the Anthropocene: medical ethics and the Land Ethic}, volume = {46}, number = {12}, pages = {791--796}, year = {2020}, doi = {10.1136/medethics-2020-106855}, publisher = {Institute of Medical Ethics}, abstract = {Industrialisation, urbanisation and economic development have produced unprecedented (if unevenly distributed) improvements in human health. They have also produced unprecedented exploitation of Earth{\textquoteright}s life support systems, moving the planet into a new geological epoch, the Anthropocene{\textemdash}one defined by human influence on natural systems. The health sector has been complicit in this influence. Bioethics, too, must acknowledge its role{\textemdash}the environmental threats that will shape human health in this century represent a {\textquoteleft}perfect moral storm{\textquoteright} challenging the ethical theories of the last. The US conservationist Aldo Leopold saw this gathering storm more clearly than many, and in his Land Ethic describes the beginnings of a route to safe passage. Its starting point is a reinterpretation of the ethical relationship between humanity and the {\textquoteleft}land community{\textquoteright}, the ecosystems we live within and depend upon; moving us from {\textquoteleft}conqueror{\textquoteright} to {\textquoteleft}plain member and citizen{\textquoteright} of that community. The justice of the Land Ethic questions many presuppositions implicit to discussions of the topic in biomedical ethics. By valuing the community in itself{\textemdash}in a way irreducible to the welfare of its members{\textemdash}it steps away from the individualism axiomatic in contemporary bioethics. Viewing ourselves as citizens of the land community also extends the moral horizons of healthcare from a solely human focus. Taking into account the {\textquoteleft}stability{\textquoteright} of the community requires intergenerational justice. The resulting vision of justice in healthcare{\textemdash}one that takes climate and environmental justice seriously{\textemdash}could offer health workers an ethic fit for the future.}, issn = {0306-6800}, URL = {https://jme.bmj.com/content/46/12/791}, eprint = {https://jme.bmj.com/content/46/12/791.full.pdf}, journal = {Journal of Medical Ethics} }