Dual duties to patient and planet: time to revisit the ethical foundations of healthcare?
When weighing up which inhaler to prescribe, a doctor may prioritise a patient’s preferences over the expected harms from the associated carbon emissions. Parker argues that this is wrong.1 Doctors have a pro-tanto duty to switch from a high-carbon metered-dose inhaler (MDI) to a low-carbon dry-powdered inhaler (DPI)—even though this provides no direct patient benefit—unless switching would undermine trust or significantly worsen a patient’s health. He goes on to state that even if DPIs are more expensive for the National Health Service (NHS) then this is justified so long as it does not ‘sign...
Source: Journal of Medical Ethics - January 24, 2023 Category: Medical Ethics Authors: Bhopal, A., Baeroe, K. Tags: Commentary Source Type: research
'Green bioethics widens the scope of eligible values and overrides patient demand: comment on Parker
Introduction Parker’s article is a welcome attempt to address the importance of environmental sustainability in the realm of clinical ethics.1 We support the recent movement to seriously consider the environmental impact of healthcare institutions in bioethics.2 3 Still, we find two partly linked weaknesses of Parker’s analysis and guideline suggestion. These relate to a need in ‘green’ bioethics to see beyond the normal healthcare ethical focus on health-related values related to individual patients, and to primarily adopt institutional ways of framing central decision problems. ‘Green’...
Source: Journal of Medical Ethics - January 24, 2023 Category: Medical Ethics Authors: Herlitz, A., Malmqvist, E., Munthe, C. Tags: Commentary Source Type: research
Green inhaler prescribing and the ethical obligations of physicians
In an accompanying feature article, Parker argued that general practitioners should support efforts by the National Health Service to reduce greenhouse gases by avoiding metered-dose inhalers and by prescribing similarly effective inhalers with smaller carbon footprints.1 He also argued that patients are not morally justified in declining to use dry powder inhalers which do not contain greenhouse gases and when judged to be readily available and similarly effective, unless, when patients resist that option, their trust in the professional relationship is undermined.1 Prescribers should, therefore, take account of factors n...
Source: Journal of Medical Ethics - January 24, 2023 Category: Medical Ethics Authors: Coverdale, J. Tags: Commentary Source Type: research
Barriers to green inhaler prescribing: ethical issues in environmentally sustainable clinical practice
The National Health Service (NHS) was the first healthcare system globally to declare ambitions to become net carbon zero. To achieve this, a shift away from metered-dose inhalers which contain powerful greenhouse gases is necessary. Many patients can use dry powder inhalers which do not contain greenhouse gases and are equally effective at managing respiratory disease. This paper discusses the ethical issues that arise as the NHS attempts to mitigate climate change. Two ethical issues that pose a barrier to moving away from metered-dose inhalers are considered: patients who decline an inhaler with a smaller carbon footpri...
Source: Journal of Medical Ethics - January 24, 2023 Category: Medical Ethics Authors: Parker, J. Tags: Open access Feature article Source Type: research
Research in the USA on COVID-19s long-term effects: measures needed to ensure black, indigenous and Latinx communities are not left behind
The SARS-CoV-2 (COVID-19) pandemic continues to expose underlying inequities in healthcare for black, indigenous and Latinx communities in the USA. The gaps in equitable care for communities of colour transcend the diagnosis, treatment and vaccinations related to COVID-19. We are experiencing a continued gap across racial and socioeconomic lines for those who suffer prolonged effects of COVID-19, also known as ‘Long COVID-19’. What we know about the treatment for Long COVID-19 so far is that it is complex, requires a multidisciplinary approach and there is still much research needed to fully understand the effe...
Source: Journal of Medical Ethics - January 24, 2023 Category: Medical Ethics Authors: Medeiros, M., Edwards, H. A., Baquet, C. R. Tags: Open access, Editor's choice, COVID-19 Current controversy Source Type: research
