Attending to scalar ethical issues in emerging approaches to environmental health research and practice

Abstract

Accelerated changes to the planet have created novel spaces to re-imagine the boundaries and foci of environmental health research. Climate change, mass species extinction, ocean acidification, biogeochemical disturbance, and other emergent environmental issues have precipitated new population health perspectives, including, but not limited to, one health, ecohealth, and planetary health. These perspectives, while nuanced, all attempt to reconcile broad global challenges with localized health impacts by attending to the reciprocal relationships between the health of ecosystems, animals, and humans. While such innovation is to be encouraged, we argue that a more comprehensive engagement with the ethics of these emerging fields of inquiry will add value in terms of the significance and impact of associated interventions. In this contribution, we highlight how the concept of spatial and temporal scale can be usefully deployed to shed light on a variety of ethical issues common to emerging environmental health perspectives, and that the potential of scalar analysis implicit to van Potter's conceptualization of bioethics has yet to be fully appreciated. Specifically, we identify how scale interacts with key ethical issues that require consideration and clarification by one health, ecohealth, and planetary health researchers and practitioners to enhance the effectiveness of research and practice, including justice and governance.

Addressing the Environmental, Community, and Health Impacts of Resource Development: Challenges across Scales, Sectors, and Sites

“…Recognition of the ways that the health of other species (plants, animals, wildlife, ecosystems) have far-reaching implications for human health include the international attention to 'One Health" [28], "Wetlands and Health" [29], and "Parks and Health" [30,31]. Ongoing attention to ecohealth-or ecosystems approaches to health-are characterized by systems approaches that promote the health of people, animals, and ecosystems in the context of social and ecological interactions [5,[32][33][34][35][36][37][38]. These efforts are supported by an expanding range of integrative approaches that underscore the relevance of cumulative impacts on health across time and space, such as the Lancet Commission on Planetary Health [39] and the 2015 "State of Knowledge report on Biodiversity and Health" co-produced by World Health Organization [40].…”

“…Noting that the impacts of resource development manifest across the life span and generations raises questions about intergenerational equity. These considerations are especially pressing for those whose jurisdictional mandate is to protect and promote health and wellbeing over the long-term and across multiple generations [10,61] and demands attention to the complexity of interactions, outcomes, and intersectoral effort over time and space [32].…”

Does One Health require a novel ethical framework?

“…OH calls attention to the need for major structural change and reform in contexts where it is more common to focus narrowly on individualising risk and responsibility. OH frequently brings into view alternatives that are more distant in space and time such that they may be less obvious in their immediate impact and visibility 31. This is in a political environment where the prevailing political imperatives are to institute high visibility strategies that appear to demonstrate definitively to the public that action is being taken.…”

Guest Editorial

“…In the first paper, Buse et al (2019) argue that the concept of scale-already implicitly entailed in holistic approaches such as OH-should be discussed explicitly in ethical discussions of OH policies and practices. They define scale as the "temporal and spatial dimensions of human health-environment interconnections and the forms of environmental public health practice deployed to respond to such dynamics."…”

“…Put simply, thinking in terms of 'scale' may contribute to our understanding of how change effected in one part of the world has consequences in others. Buse et al (2019) then discuss questions concerning two common issues in traditional public and global health: justice and stewardship/governance. From a justice perspective, should we and how can we devise just interventions with the consideration not only of future human generations but also non-human future generations and ecosystems?…”