Medicine in a Warming World: The Physician's Role in Climate Action

Should physicians, whose collective practices contribute significantly to climate change, respond to its health hazards as part of their professional responsibilities? Or are healthcare practices, often deemed essential, exempt from reevaluation through an environmentally sustainable lens? If not, how can physicians who provide direct patient care make clinical decisions that balance individual patient benefit with environmental impact, and align with standards of medical ethics? While qualitative insights from physicians and patients are valuable and prevalent in the clinical literature, this paper does not aim to synthesize those perspectives. Instead, it examines the growing, though still limited, body of bioethics literature that argues physicians have an ethical and clinical responsibility to respond to the health hazards of climate change. This responsibility is grounded in the foundational goals of medicine, preventing disease and promoting health, and the longstanding principles of bioethics that inform clinical practice. Proposed approaches to fulfilling this responsibility include green informed consent, prescription stewardship, care involving assisted reproduction, and clinician advocacy on the health impacts of climate change.