On climate change, physicians should think globally, act locally


“Climate change is the greatest threat to global health in the 21st century”—that is the World Health Organization’s dispatch for immediate action. Expected consequences include the spread of disease, drought and forced migration due to expected weather events and trends. Despite the gravity and medical relevance of these phenomena, there is a lack of clarity on the roles of health professionals, organizations and governments in responding to, or implementing, policies and action plans in this vital area.

This month’s AMA Journal of Ethics® features numerous perspectives on clinical and ethical questions about the nature and scope of physicians’ roles in responding to health consequences of climate change.

A family medicine physician is concerned about rising rates of respiratory illness in his community, which is adjacent to a coal-burning power plant. Is it ethical for the physician to counsel individual patients about the power plant’s potential impact on their health?

  • No, because this would overstep the physician’s role.
  • Yes, but only if he limits his expression of concern to the power plant’s health impacts.
  • Yes, he should share any environmental concerns that he feels are relevant.

Give your answer and find responses to this question in the December issue of the AMA Journal of Ethics.

Articles include the following.

Mitigating the Impact of Climate Change on Human Health: The Role of the Medical Community.” Many medical societies and organizations have recently vocalized its stance supporting climate change mitigation and adaptation. With severe, mounting risks to the health of individuals and populations worldwide, the medical community faces a patient population increasingly affected by climate change. Voices from health professions communities can help motivate social change.

“Should Health Professionals Speak Up to Reduce the Health Risks of Climate Change?” Many physicians have chosen to learn about, and work to, change environmental conditions that can undermine health and to speak out about these issues in public. But does the fact that physicians can be effective advocates on environmental issues mean that advocacy to address climate change is an ethical obligation for physicians or other health professionals? This article’s authors argue that physicians should deliberately consider seven criteria when considering their responsibility to advocate on this issue.

“Is Editing the Genome for Climate Change Adaptation Ethically Justifiable?” As climate change progresses, humans might have to inhabit a world for which we are increasingly maladapted. If it were possible, should we use gene editing not only to prevent significant disease but also to enhance our ability to function in the world? 

“The Importance of Physician Climate Advocacy in the Face of Political Denial.” Widespread, organized, political denial of climate change is hazardous to physicians’ advocacy for an effective public health and health care response to climate change. Physician climate advocacy is ethical and many forms of health climate advocacy already under way.

The AMA recognizes the importance of a stable climate for human health. The AMA adopted a policy that underscores the reality and urgency of climate change and the necessity for a physician role in protecting public health as it relates to climate change. While the AMA Code of Medical Ethics does not outline specific plans of action for physicians to address climate change, it does provide guidance for physician involvement in public health concerns, specifically in preventive care and disaster response and preparedness.

Climate change’s immense scale and vast consequences may leave health professionals feeling at a loss for how they can tackle such an enormous problem. In the journal’s December podcast, health professionals discuss how they convey the impact of this ongoing crisis. Guests include medical student Jordan Emont, patient Louise Hobden and Kate Weinberger, PhD.

The journal’s editorial focus is on commentaries and articles that offer practical advice and insights for medical students and physicians. The AMA Journal of Ethics call for papers is open. The journal invites original manuscript submissions for-peer review consideration on themes that will be explored in 2018 issues. These include “Religion and Spirituality in Health Care Practice,” and “Ethics in Precision Health.”

The journal also invites original photographs, graphics, cartoons, drawings and paintings that explore the ethical dimensions of health or health care.

In January, the AMA Journal of Ethics will focus on the ethics in clinicians’ responsiveness to violence. February’s issues will examine graphic medicine and health care ethics. Sign up to receive email alerts when new issues are published.