How Should Clinicians Weigh the Benefits and Harms of Discussing Politicized Topics that Influence Their Individual Patients’ Health?

Abstract

Health implications of politically charged phenomena are particularly difficult for physicians to discuss with their patients and communities. Addressing climate change and its associated health effects involves trade-offs between health and economic prosperity, necessitating that physicians weigh the potential benefits and risks of discussing climate change health effects. We argue that the potential benefits of physician communication and advocacy ultimately outweigh the potential risks. Therefore, physicians should be supported in their efforts to educate their patients and communities about climate change health effects. Furthermore, democratic deliberation could prove helpful in addressing disagreements among physicians within a practice about such politicized health topics. CaseDr. Schwartz is one of four family medicine physicians at a rural, private group practice. He has been part of the practice for more than three decades and has developed strong relationships with many local families. One of his major areas of interest is preventative medicine, and he is viewed as a local expert. He has been instrumental in many community health initiatives, including the creation of smoking cessation and weight loss programs for patients in his practice.One of Dr. Schwartz's biggest concerns in his community is a large coal-burning power plant located about a mile outside of the town center. Generally, other community members don't seem to mind the power plant, and many are grateful for the employment it brings to their remote region. However, Dr. Schwartz has recently been concerned by rising rates of respiratory illnesses, such as asthma, among his patients. He is aware that living in a zip code containing a fossil fuel-fired power plant is associated with higher rates of respiratory disease including asthma, chronic obstructive pulmonary disease, and acute respiratory infection [1]. Moreover, he knows that coalfired power plants are the largest source of toxic substances in the air in the United States and that exposure to pollutants from power plants is associated with asthma, low infant birth weight, and premature mortality in adults [2]. Dr. Schwartz is worried about

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