The ethics of climate change and health-care delivery: a national survey of US-based physicians

IF 21.6 1区医学 Q1 ENVIRONMENTAL SCIENCES

Lancet Planetary Health Pub Date : 2025-08-01 DOI:10.1016/j.lanplh.2025.101289

Andrew Hantel MD , Emily Senay MD , Fay J Hlubocky PhD , Thomas P Walsh MPH , Hannah Johnston MD , Angel Cronin MS , Adam S DuVall MD , Anna Revette PhD , Brett Nava-Coulter PhD , Prof Mark Siegler MD , Cristina Richie PhD , Prof Gregory A Abel MD

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引用次数: 0

Abstract

Health harms from climate change are partly driven by health-care emissions. Physician perspectives on the related ethical dilemmas of professional responsibilities, health equity, and trade-offs between individual health choices and the environmental impact of health care are not well described in current literature. We performed a cross-sectional survey of US-based physicians between July 18, 2023, and May 28, 2024 to assess related perspectives, and we analysed the results by the respondents’ perceived impact of climate change on their patients’ health (moderate–high impact vs no–to–low impact). 529 surveys were delivered, of which 304 (57·5%) were returned. 113 (37·4%) of 302 respondents reported that climate change had a moderate–high impact on their patients’ health, whereas 249 (82·5%) respondents viewed climate change as having greater health impacts on patients with less access to health care. 105 (35·0%) of 300 respondents reported that the environmental impact of health care should be reduced even if it requires limiting treatment options of similar effectiveness. In response to hypothetical scenarios, the patients in the moderate-high impact group was more willing to place such limits (adjusted predicted probability=50%) than the no–to–low impact group (adjusted predicted probability=25%, difference=25% [95% CI 13–38]). In addition, the patients in the moderate-high impact group (adjusted predicted probability=86%) was more willing to initially trial a less effective but less environmentally toxic antihypertensive medicine than the no–to–low impact group (adjusted predicted probability=69%, difference=17% [95% CI 6–27]). A sample of US-based physicians accepted their health care-related responsibilities towards climate change and viewed its health impacts as inequitable. Perceptions of the health impact of climate change influenced willingness to accept limited treatment options for environmental reasons.

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气候变化和卫生保健服务的伦理：一项对美国医生的全国性调查。

气候变化造成的健康危害部分是由医疗保健排放造成的。目前的文献没有很好地描述医生对职业责任、健康公平以及个人健康选择与卫生保健对环境影响之间的权衡等相关伦理困境的观点。我们在2023年7月18日至2024年5月28日期间对美国医生进行了横断面调查，以评估相关观点，并根据受访者对气候变化对患者健康的感知影响（中高影响vs无至低影响）分析了结果。共发放问卷529份，回收问卷304份（57.5%）。302个答复者中有113个（37.4%）报告说，气候变化对其病人的健康有中高影响，而249个（82.5%）答复者认为，气候变化对获得卫生保健机会较少的病人的健康影响更大。300名答复者中有105人（35.0%）报告说，即使需要限制类似效果的治疗方案，也应减少卫生保健对环境的影响。在假设情景下，中高冲击组患者比无低冲击组（调整后的预测概率为25%，差值为25%）更愿意设置这样的限制（调整后的预测概率为50%）。此外，中高影响组患者（调整后的预测概率为86%）比无至低影响组患者更愿意最初试用效果较差但环境毒性较小的降压药（调整后的预测概率为69%，差异为17% [95% CI 6-27]）。一组美国医生接受了他们对气候变化的卫生保健相关责任，并认为气候变化对健康的影响是不公平的。对气候变化对健康影响的认识影响了出于环境原因接受有限治疗方案的意愿。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Lancet Planetary Health Multiple-

CiteScore

28.40

自引率

2.30%

发文量

272

审稿时长

8 weeks

期刊介绍： The Lancet Planetary Health is a gold Open Access journal dedicated to investigating and addressing the multifaceted determinants of healthy human civilizations and their impact on natural systems. Positioned as a key player in sustainable development, the journal covers a broad, interdisciplinary scope, encompassing areas such as poverty, nutrition, gender equity, water and sanitation, energy, economic growth, industrialization, inequality, urbanization, human consumption and production, climate change, ocean health, land use, peace, and justice. With a commitment to publishing high-quality research, comment, and correspondence, it aims to be the leading journal for sustainable development in the face of unprecedented dangers and threats.