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Should GPs promote sustainable living as part of health advice?



dr mike forsyth

It has been widely reported recently, to nobody’s real surprise, that we are destroying the planet.

I should clarify at this point that by ‘we’ I am referring to the human race, rather than doctors specifically, but perhaps there is a role for clinicians in the preservation of the environment.

After all, if predictions from scientists are accurate and we really do only have a dozen years to prevent irreversible damage to the planet from climate change, the implications of drought, floods, extreme heat and poverty will affect the health of everyone.

Do we have a responsibility, then, to encourage patients to limit their own environmental footprint? An argument could certainly be made that in the same way we recognise the detrimental impact that obesity has upon our patients, and encourage exercise and healthy living, we should be highlighting the importance of a lifestyle that doesn’t overly impact upon the environment.

Is an opinion on the plight of climate change a personal belief or a proven fact that threatens millions?

It is interesting to consider how this might work from a practical point of view. The UN Intergovernmental Panel on Climate Change tempered its gloomy assessment of the severity of the situation with an acknowledgement of the role individuals can play in ensuring a sustainable future.

There were suggestions that individuals may not have much control over, such as home insulation and transport methods, but there were also recommendations that have far more relevance. Eating less meat and dairy, for example, is considered by some scientists to be the single most effective way of reducing your impact on the environment. We regularly provide patients with dietary advice, so should this affect the nature of our recommendations?

The GMC’s Good Medical Practice offers guidance on expressing individual opinions, stating that doctors ‘must not express their personal beliefs [including political, religious and moral beliefs] to patients in ways that exploit their vulnerability or are likely to cause them distress’.

There will certainly be patients out there who would be distressed at being advised to eat less beef by their doctor for instance, but is an opinion on the plight of climate change, backed up by evidence-based studies, a personal belief? Or is it a proven fact that threatens the health and wellbeing of millions around the world?

There are issues beyond dietary advice that delve far deeper into the murky waters of ethical uncertainty. A recent study suggested that having fewer children was the single greatest impact individuals can make on reducing their carbon footprint, but no doubt the GMC would take a dim view on doctors advising patients against reproducing on the basis of environmental preservation.

So what is the answer? Do we as doctors have an obligation to advise our patients how best to minimise their impact on the environment? Or is our role merely to focus on each patients’ individual health, rather than the long term health of society as a whole?

Dr Mike Forsythe is a GP trainee in south-west London