AMA Journal of Ethics®

Illuminating the art of medicine

Journal of Ethics Header

AMA Journal of Ethics®

Illuminating the art of medicine

AMA Journal of Ethics. December 2017, Volume 19, Number 12: 1183-1185.
doi: 10.1001/journalofethics.2017.19.12.coet1-1712.

The Code Says

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The AMA Code of Medical Ethics’ Opinions Related to Climate Change

The AMA Code of Medical Ethics’ opinions related to climate change.

Annalise Norling

Although climate change has a negative effect on public health [1], health care professionals’ perceived role in educating patients about climate change is often overlooked [2]. However, the American Medical Association (AMA) recognizes the importance of climate and health. The AMA adopted a policy (“Global Climate Change and Human Health,” H-135.938) 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. The policy states that the AMA “supports educating the medical community on the potential adverse public health effects of global climate change” and “encourages physicians to assist in educating patients and the public on environmentally sustainable practices, and to serve as role models for promoting environmental sustainability” [3]. While the 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.

Opinion 8.11, “Health Promotion and Preventive Care” [4], states that physicians should “consider the health of the community when treating their own patients and identify and notify public health authorities if and when they notice patterns in patient health that may indicate a health risk for others.” Physicians can utilize this guidance to observe and report patterns of illnesses for which climate change poses increased risk, such as asthma, respiratory allergies, skin cancers, cataracts, food and waterborne illnesses, cardiovascular disease, and stroke, among others [1]. Opinion 8.11 continues with guidance stating that physicians should “recognize that modeling health behaviors can help patients make changes in their own lives” [4], which suggests that physicians should make a serious effort to model environmentally conscious behaviors that promote health, such as wearing sunscreen, in order to encourage patients to make behavioral changes and also states that physicians should advocate for healthier communities and the resources to make this happen.

Another piece of guidance, Opinion 8.3, “Physicians’ Responsibilities in Disaster Response and Preparedness” [5], discusses the role of physicians in responding to large-scale public health crises. The opinion states, “individual physicians should: Take appropriate advance measures, including acquiring and maintaining appropriate knowledge and skills to ensure they are able to provide medical services when needed” [5]. This points to the need for physicians to gain knowledge and tools to effectively manage and prevent disease outbreaks like Zika, to which climate change contributes [6].

Potential public health concerns such as those related to climate change should be carefully analyzed by physicians and other health care workers in order to ensure that education, treatment, and relief is available if and when it is needed. Physicians can also play a role in the education and dissemination of important health-related information concerning environmental degradation and climate change [3].



References

  1. National Institute of Environmental Health Sciences. Research: cancer: climate and human health.
    https://www.niehs.nih.gov/research/programs/geh/climatechange
    /health_impacts/cancer/index.cfm. Accessed August 7, 2017.
  2. Sheffield PE, Durante KT, Rahona E, Zarcadoolas C. Emerging roles of health care providers to mitigate climate change impacts: a perspective from East Harlem, New York. Health Hum Rights. 2014;16(1):113-121.
  3. American Medical Association. Global climate change and human health H-135.938. https://policysearch.ama-assn.org/policyfinder/detail/climate%20change?uri=%2FAMADoc%2FHOD.xml-0-309.xml. Updated 2014. Accessed August 7, 2017.
  4. American Medical Association. Opinion 8.11 Health promotion and preventive care. Code of Medical Ethics. https://policysearch.ama-assn.org/policyfinder/detail/opinion%208.11?uri=%2FAMADoc%2FEthics.xml-E-8.11.xml. Updated 2017. Accessed August 3, 2017.
  5. American Medical Association. Opinion 8.3 Physicians’ responsibilities in disaster response and preparedness. Code of Medical Ethics. https://policysearch.ama-assn.org/policyfinder/detail/opinion%208.3?uri=%2FAMADoc%2FEthics.xml-E-8.3.xml. Updated 2017. Accessed May 30, 2017.
  6. Yang YT, Sarfaty M. Zika virus: a call to action for physicians in the era of climate change. Prev Med Rep. 2016;4:444-446.

Annalise Norling is a fourth-year undergraduate at Loyola University Chicago, where she studies philosophy and biology with a concentration in bioethics. During the summer of 2017, she was an intern for the American Medical Association’s Ethics Group.

Are Physicians Obliged to Lead Environmental Sustainability Efforts in Health Care Organizations?, December 2017

Caring for the Health of the Community Means Caring for the Health of the Environment, June 2009

Climate Change and Human Health 101, June 2009

How Should Clinicians Weigh the Benefits and Harms of Discussing Politicized Topics that Influence Their Individual Patients’ Health?, December 2017

Physicians’ Duty to Be Aware of and Report Environmental Toxins, June 2009

Should Health Professionals Speak Up to Reduce the Health Risks of Climate Change?, December 2017

The viewpoints expressed in this article are those of the author(s) and do not necessarily reflect the views and policies of the AMA.