Standard of “informed consent” could reduce carbon emissions in healthcare - Cristina Richie

Carbon emissions (CO2) contribute to climate change. Safe amounts of carbon in the atmosphere have been exceeded and numerous world organisations, legislative bodies, and economic sectors have explored carbon reduction, including the healthcare industry. And for good reason.

The carbon emissions of global healthcare activities make up 4-5 per cent of total world emissions, placing the healthcare industry’s pollution on par with the food sector. Healthcare carbon emissions are particularly relevant because of the effects of climate on health.

Climate change health hazards include medical burdens and deaths related to extreme heat, outdoor air quality, flooding, vector-borne infection, respiratory disease, and water- and food-related infection. The UK has thousands of hospital admissions and deaths each year attributable to climate change. These are not only financially costly and devastating to individuals and families, but also cause more carbon. People affected by climate change cause an influx in hospital admissions and require medical care. These treatments release more carbon, locking healthcare into a self-destructive cycle whereby medical care causes medical needs. Hence, healthcare has a special interest in carbon reduction, not only as a matter of international priority, but also as a commitment to health and the duty to do no harm.

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Healthcare providers can use the existing standard of “informed consent” to reduce carbon emissions in healthcare and avoid climate change health hazards in the future.

Cristina Richie PhD is a Member of the Scottish Council on Human Bioethics and a Fellow at the Institute for Advanced Studies in the Humanities, University of Edinburgh, and a Lecturer the Philosophy and Ethics of Technology department at Delft University of Technology (Netherlands).

Informed consent is a medical decision-making process whereby the healthcare professional determines appropriate medical treatment, provides clinically indicated options and alternatives for treatment to the patient, and then explores the patients’ values, desires and concerns related to the treatment and outcomes. For instance, if a person is diagnosed with heart disease, a healthcare provider may council lifestyle changes like stopping smoking and healthy eating, medication, or surgery, explaining the chances of success and side effects of each.

If the treatment is clinically indicated and within the competencies of the healthcare provider, the choice of the patient should be respected by providing the care. Informed consent is based on the principle of respect for autonomy, which maintains that mentally capable adults are able to make their own medical decisions when they have proper information.

Patients receiving care should be aware that their healthcare treatments may lead to more medical treatments later, should they encounter climate change health hazards.

Healthcare providers should share climate information with patients, if known, and give patients the option for lower-carbon healthcare options, including the right to decline treatment. Education for healthcare administrators on the risks of readmission due to climate change health hazards can be provided by already existing networks like the Scottish Public Health Network and the Scottish Managed Sustainable Health Network.

Climate change is one of the most pressing and well-documented social issues facing not only the globe, but also healthcare. Highlighting climate change health hazards through the informed consent process would address one of the root causes of climate change – the carbon emissions of healthcare – and respect the right for patients to know all possible side effects of treatments.

Cristina Richie PhD is a Member of the Scottish Council on Human Bioethics and a Fellow at the Institute for Advanced Studies in the Humanities, University of Edinburgh, and a Lecturer the Philosophy and Ethics of Technology department at Delft University of Technology (Netherlands).

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