How should institutions help clinicians to practise greener anaesthesia : first-order and second-order responsibilities to practice sustainably

Parker, Joshua and Hodson, Nathan and Young, Paul and Shelton, Cliff (2023) How should institutions help clinicians to practise greener anaesthesia : first-order and second-order responsibilities to practice sustainably. Journal of Medical Ethics. ISSN 0306-6800

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Abstract

There is a need for all industries, including healthcare, to reduce their greenhouse gas emissions. In anaesthetic practice, this not only requires a reduction in resource use and waste, but also a shift away from inhaled anaesthetic gases and towards alternatives with a lower carbon footprint. As inhalational anaesthesia produces greenhouse gas emissions at the point of use, achieving sustainable anaesthetic practice involves individual practitioner behaviour change. However, changing the practice of healthcare professionals raises potential ethical issues. The purpose of this paper is twofold. First, we discuss what moral duties anaesthetic practitioners have when it comes to practices that impact the environment. We argue that behaviour change among practitioners to align with certain moral responsibilities must be supplemented with an account of institutional duties to support this. In other words, we argue that institutions and those in power have second-order responsibilities to ensure that practitioners can fulfil their first-order responsibilities to practice more sustainably. The second goal of the paper is to consider not just the nature of second-order responsibilities but the content. We assess four different ways that second-order responsibilities might be fulfilled within healthcare systems: removing certain anaesthetic agents, seeking consensus, education and methods from behavioural economics. We argue that, while each of these are a necessary part of the picture, some interventions like nudges have considerable advantages.

Item Type:
Journal Article
Journal or Publication Title:
Journal of Medical Ethics
Uncontrolled Keywords:
Research Output Funding/no_not_funded
Subjects:
?? no - not fundedhealth(social science)issues, ethics and legal aspectshealth policy ??
ID Code:
205394
Deposited By:
Deposited On:
26 Sep 2023 14:25
Refereed?:
Yes
Published?:
Published
Last Modified:
19 Sep 2024 02:43