PPT75 Medical ethics and environmental sustainability – practical applications of environmental duties in palliative medicine

<h3></h3> Failure to address anthropogenic climate change is widely recognised to be ‘the greatest threat to global public health’.¹ The inclusion of a sustainability duty in the latest iteration of Good Medical Practice has highlighted the necessity for all doctors to consider the environment in their work.² Palliative services encounter patients when they are most vulnerable to the impacts of climate change, and by virtue of intensive healthcare utilisation in the last year of life, potentially contribute the most to healthcare-generated greenhouse gas emissions. Conversations about the realistic goals of treatment and patient priorities can have dual benefits for patient experiences and the environment. Sustainability duties can be met by increasing the reach of palliative services. Staff and patient education is vital to achieving this and ensuring the capacity of both specialist and non-specialist services. Additional research is needed to understand palliative patients’ perceptions of the interaction between climate change and health, to ascertain the best way to approach conversations. When physicians deem that patients are well enough to engage, and that conversations would not damage trust, they should explore patient preferences about healthcare sustainability as part of discussions on priorities of care. If patients are interested, physicians have a duty to provide available information on the environmental impacts of treatment options to facilitate informed consent and promote patient autonomy. Furthermore, physicians must educate patients about health promoting actions that will limit their vulnerability to extreme weather and strengthen community resilience and caring capacity, as well as safeguarding the health of future patients by engaging with health system sustainability and resilience plans. <h3>References</h3> Lukoye Atwoli and others, ‘Call for Emergency Action to Limit Global Temperature Increases, Restore Biodiversity, and Protect Health’ (2021) 385(12) New England Journal of Medicine 1134 General Medical Council, ‘Good Medical Practice’ (2024) &lt;https://www.gmc-uk.org/-/media/documents/good-medical-practice---english-20200128_pdf-51527435.pdf?la=en&amp;hash=DA1263358CCA88F298785FE2BD7610EB4EE9A530&gt; accessed 11/05/2025