RT Journal Article SR Electronic T1 Health justice in the Anthropocene: medical ethics and the Land Ethic JF Journal of Medical Ethics JO J Med Ethics FD BMJ Publishing Group Ltd and Institute of Medical Ethics SP 791 OP 796 DO 10.1136/medethics-2020-106855 VO 46 IS 12 A1 Alistair Wardrope YR 2020 UL http://jme.bmj.com/content/46/12/791.abstract AB Industrialisation, urbanisation and economic development have produced unprecedented (if unevenly distributed) improvements in human health. They have also produced unprecedented exploitation of Earth’s life support systems, moving the planet into a new geological epoch, the Anthropocene—one defined by human influence on natural systems. The health sector has been complicit in this influence. Bioethics, too, must acknowledge its role—the environmental threats that will shape human health in this century represent a ‘perfect moral storm’ 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 ‘land community’, the ecosystems we live within and depend upon; moving us from ‘conqueror’ to ‘plain member and citizen’ 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—in a way irreducible to the welfare of its members—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 ‘stability’ of the community requires intergenerational justice. The resulting vision of justice in healthcare—one that takes climate and environmental justice seriously—could offer health workers an ethic fit for the future.