Does minimising the healthcare sector’s environmental impact require making tragic choices?
Bridget Pratt1, Queensland Bioethics Centre, Australian Catholic University 1Queensland Bioethics Centre, Australian Catholic University
Abstract
We face an ever-worsening climate crisis to which healthcare systems substantially contribute. Strong moral grounds exist for the healthcare sector having a duty to minimise its environmental impact. However, upholding the duty will require changes to healthcare delivery and procurement. This paper explores whether upholding it then can simultaneously advance and violate social and environmental justice and thereby result in societies facing tragic choices. It argues that taking actions to reduce the environmental damage caused by healthcare delivery and procurement can generate tragic choices, where they comprise delivering equally effective care at higher cost, delivering less effective healthcare and services (at a higher cost or no added cost), and rationing care. Such types of actions can cause preventable morbidity and premature mortality, negative impacts on non-health components of people’s wellbeing, reinforce structural racism, devalue and erase cultural diversity, and/or create discord within a given society. But not taking them means harming the environment in ways that are worsening health and wellbeing, widening health inequity, and reinforcing coloniality and biocultural homogenisation. Given existing evidence indicates it is likely some such actions will be necessary, the paper offers suggestions for determining when it is morally permissible to ration care or to deliver less effective and/or higher cost healthcare and services for environmental reasons.
Biography
Bridget Pratt is the Mater Senior Lecturer in Healthcare Ethics at
the Queensland Bioethics Centre at Australian Catholic University.
Her research interests include the ethics of global health
research and health systems, with a focus on social, ecological,
and global justice. Bridget received her PhD in Bioethics in 2012
and her Masters in International Health in 2009 from Monash
University in Australia.