A pledge for planetary health to unite health professionals in the Anthropocene

Abstract

In 1948, the Declaration of Geneva 1 was passed as one of the first official acts of the World Medical Association. The Declaration updated the ancient Hippocratic oath and defined ethical principles applicable to the medical profession worldwide. 2 Other health professions have similar pledges and oaths that guide their practice, generally based on the four bioethical principles of justice, autonomy, non-maleficence, and beneficence. Over time, these pledges have been updated to account for evolving societal norms, expectations, and challenges, 3 and many students and health education institutions use adaptations of the original oath. 4,5 A pledge for planetary health to unite health professionals in the Anthropocene national and international levels for predicting future disease outbreaks and pandemics, analogous to the US National Weather Service and the European Centre for Medium Range Weather Forecasts, which use extensive data from multiple sensors and supercomputing. So far during the COVID-19 pandemic in the USA, there has been inadequate central coordination and command in public health surveillance, response, and innovation. Although ACTIV and RADx have been established, it is unclear how such efforts work together. Further more, there are challenges for the coordinated implementation of innovations. A lack of coordination between US state and local public health departments, for example, led to difficulties in delivery of contact tracing programmes. 16 Globally, there is inadequate financing to sustain a coordinated strategy for COVID-19 innovations. The ACT-Accelerator, for example, brings together governments, health organisations, scientists, businesses, civil society, and foundations to accelerate development, ensure equitable allocation, and scale up delivery of new COVID-19 tools. But the ACT-Accelerator is principally dependent on funding from donor countries and foundations, which is an insufficient and unsustainable way to finance a global public good. The ACT-Accelerator will require long-term, predictable, and sustained financing based on global solidarity. Innovation to tackle COVID-19 must be centred within strategy, command, coordination, and sustainable financing. VJD served previously as a member of the Board of Medtronic Inc, ending in June, 2014, and received deferred compensation until 2018, unrelated to the topic of this Comment. CB declares no competing interests.

What do Final Year Medical Students in Germany know and think about Climate Change? – The ClimAttitude Study

“…It is well established that health professionals are among the most trusted members of society [13]. As skilled communicators and as mediators between science, policy and practice [14], health professionals may be particularly well placed to become climate crisis and planetary health educators [15], although only some physicians are actively involved in scientific and clinical research [16]. Of course, it should not go unmentioned thatdue to the central social position and the high reputation of the physician -any topic of social relevance could somehow be associated with medicine, which, however, does not oblige every physician to also stand up for these topics.…”

“…The belief that climate change is adversely affecting human health and therefore calls for immediate action is the basis of a new 'Hippocratic Oath' that various representatives of health professions have put forward for discussion in 2020. This 'pledge for planetary health to unite health professionals in the Anthropocene' [14] was developed especially for the generation of young physicians, as an oath is classically used in many graduation ceremonies. But is there any evidence at all that members of a new generation of medical students and future physicians have an interest in planetary health or recognize their responsibilities?…”

Climate change and the different roles of physicians: a critical response to "A Planetary Health Pledge for Health Professionals in the Anthropocene"

“…Some authors are convinced that new ethical rules must become visible in a pledge for health professionals. Therefore, in November 2020, "A Planetary Health Pledge for Health Professionals in the Anthropocene" was published in The Lancet (Wabnitz et al 2020 ). In light of the dramatic environmental changes, the authors want to define a new ethical basis for healthcare professionals and to “transform human values, behaviours, and societal structures” (Wabnitz et al 2020 , p. 1472).…”

“…Therefore, in November 2020, "A Planetary Health Pledge for Health Professionals in the Anthropocene" was published in The Lancet (Wabnitz et al 2020 ). In light of the dramatic environmental changes, the authors want to define a new ethical basis for healthcare professionals and to “transform human values, behaviours, and societal structures” (Wabnitz et al 2020 , p. 1472). Here, critical remarks should be raised, especially from the perspective of professionalism.…”

Medical responsibility in the climate crisis-the investment strategies of German Doctors’ pension funds: a conflict between ethics and monetisation

“…As climate change is primarily caused by anthropogenic emissions of greenhouse gases, the British Medical Journal, the World Medical Association and some other major national medical associations have called for divestment, i.e., the withdrawal of capital from industries in the fossil energy sector and its associates [1,2] . Divestment is considered to be a social tipping point for the necessary and extensive transformation process towards a climate-neutral economy that operates within planetary boundaries [3] .…”