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Dr. Jessica Pierce is a writer and bioethicist. She has published a number of books, including Wild Justice: The Moral Lives of Animals, Contemporary Bioethics: A Reader with Cases (forthcoming in October, 2009) Morality Play: Case Studies in Ethics and The Ethics of Environmentally Responsible Health Care. Dr. Pierce is Associate Faculty at the University of Colorado Health Sciences Center, Center for Bioethics and Humanities. She lives in Longmont, Colorado. Her website is www.jessicapierce.net.
The first sentence of The Ethics of Environmentally Responsible Health Care reads, “The foundation of human health rests on healthy, stable ecosystems.” One rarely encounters this view expressed in medical literature, yet it lies at the heart of creating a sustainable modern healthcare system.
By far the majority of analyses of the American healthcare focus narrowly on reform –slight to dramatic- through rebalancing the (allegedly) three core issues of the 1) cost, 2) coverage and 3) quality of care. Pierce and Jameton locate medicine in the context of ecological sustainability, which correctly subsumes –not negates- these three issues.
As is often the case when great social change is occurring, few scholars see it coming and also offer a cogent outline of the ethical challenges posed by such momentous upheavals. Pierce and Jameton’s is one of those books.
For example, typically “medical ethics” is devoted to issues stemming from the (allegedly) sacrosanct value of what’s best for the patient. Questions about humanity’s organic connection to and responsibility to the natural environment are not asked or are given short shrift. These authors show how the earth is not a passive, inert and inexhaustible repository of goodies for medicine to dip into at will at no cost or consequence.
This book articulates an alternative discourse integral to the viability of healthcare in the 21st century, as its chapter titles evidence:
1) The Challenge of Environmental Responsibility; 2) Linking Health and Environmental Change; 3) Population and Consumption; 4) Environmental Aspects of Healthcare; 5) The Green Health Center; 6) At the Bedside; 7) Global Bioethics and Justice; and 
New Ways of Thinking About Bioethics.
Click here to listen to Jessica’s discussion with Dan Bednarz
Editors Note: The following two articles appeared in Public Health Reports / January-February 2009 / Volume 124. They appear here through the kind permission of the Journal. Mainstreaming articles discussing these issues are an important step for education and acceptance.
Energy and the Public’s Health: Making the Connection (PDF) – Michael T. Osterholm and Nicholas S. Kelley
Rarely does a scientific article come along that begs to be read by a much broader audience than the subscribers of a niche journal. Frumkin and colleagues have achieved such a feat in this issue of Public Health Reports. Their article, “Energy and Public Health: The Challenge of Peak Petroleum,” should be required reading for every public policy leader, business executive, health-care provider, and general public health professional. It makes a connection between an old world where the use of carbon-based energy was largely related to wood burning and simple crop production, and a current world that is growing closer to exhausting the fossil fuel stores created by many millions of years of geologic processes. Frankly, it’s quite hard to imagine that we have largely cannibalized the “easily obtained carbon-hydrogen bound energy” that is as much a part of our planet earth’s history as is evolution. But the depletion is happening, just as Frumkin and colleagues have detailed…
Energy and Public Health: The Challenge of Peak Petroleum (PDF) – Howard Frumkin, Jeremy Hess, Stephen Vindigni
Petroleum is a unique and essential energy source, used as the principal fuel for transportation, in producing many chemicals, and for numerous other purposes. Global petroleum production is expected to reach a maximum in the near future and to decline thereafter, a phenomenon known as “peak petroleum.” This article reviews petroleum geology and uses, describes the phenomenon of peak petroleum, and reviews the scientific literature on the timing ofthis transition. It then discusses how peak petroleum may affect public health and health care, by reference to four areas: medical supplies and equipment, transportation, energy generation, and food production. Finally, it suggestsstrategies for anticipating and preparing for peak petroleum, both general public health preparedness strategies and actions specific to the four expected health system impacts…
Nov 20, 2008 (CIDRAP News) – A new report from the University of Minnesota warns that an influenza pandemic could disrupt the coal industry, thereby endangering the nation’s significantly coal-dependent electric power system and everything that depends on it.
“Despite regional differences in coal usage, a pandemic is likely to break links in the coal supply chain, thus disrupting electrical generation. This has the potential to severely endanger the bulk electrical power system in most of the United States,” says the report from the university’s Center for Infectious Disease Research and Policy (CIDRAP), publisher of CIDRAP News.
[Edited by: Paul R. Epstein and Jesse Selber, Published by: The Center for Health and the Global Environment, Harvard Medical School]
When significant deposits of oil were discovered in the 19th Century, this fossil fuel appeared to offer a limitless source of energy to drive development. While oil and the energy it supplies provide multiple benefits to human society, every stage in the life cycle from exploration to use can have harmful effects on our health and the environment. This report examines the health and environmental impacts of oil exploration, drilling, extraction, transport, refining and combustion. Drilling and extraction carry acute and chronic hazards, including fires and blowouts, occupational injury and disease, and can lead to longterm harm to plant and animal communities. Oil spills and leaks along coastlines pose risks for marine life and fisheries, and can threaten the livelihoods of human communities. Refining exposes workers and wildlife to petroleum, its by-products and the chemicals used in the refining process. At the pump, gasoline can be both toxic and carcinogenic.
Refining and combustion result in air pollution and acid rain. Pollutant chemicals can be toxic to humans, other animals and plants, while acid rain has impacts on terrestrial, aquatic and marine coastal systems. Finally, the aggregate of gas and particulate emissions from burning oil have begun to alter the world’s climate system; with implications for human health, agricultural productivity, vulnerable ecosystems and societal infrastructure.
This report, while not exhaustive, is intended to provide a comprehensive framework for evaluating the true costs of our use of oil. The authors hope it will serve as a resource for further study.
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