Chapter 17: Sustainable Health Care and Emerging Ethical Responsibilities:
• The declining conditions of the natural environment is beginning to affect the
health of populations in many parts of the world.
• In the long term, human health requires a healthy global ecosystems.
• Linking Health Care and the Environment:
• Health care figures both as a solution to environmental decline and as a problem
• Environmental cost are most evident at the downstream end of health care: the by-
products that leave the systems as waste.
• The problems of medical waste, particularly infectious materials and
• Health care services rely on an enroumous array of natural resources including
common and rare metals, naturally occurring pharmaceutical porecursors, rubber,
petroleum, biomass and water.
• The environmental costs of natural resource consumption in health care have not
been carefully studied, so the degree to which health care activities contribute to
environmental deterioration is difficult to assess.
• Sustainable Health Care:
• One way to represent the scale of consumption is to use the econological
footprint: an estimate of the amount of space it takes to generate the energy, food,
pasture, consumer goods and so on that it takes to maintain each of us.
• The ecological footprints of nations study calculates that humanity as a whole
uses over one third more resources and econservices than what nature can
• The ethical arguments for considering sustainability in health care arise from
basic ethical commitments common to environmental and medical ethics.
• First today’s generation have responsibilities for the welfare of future generations.
• Second humans have a responsibility towards the natural world for the sake of
both nature and ourselves.
• Third because about 80% of the world’s wealth benefits only 20% of its people,
the vast majority have very little.
• Poverty is on the main factors contribution to the poor health and it reduces the
ability of populations to cope with environmental decline.
• Justice and sustainability require that health care services to be more equitably
allocated on a gl