Toward sustainable health‐care services: principles, challenges, and a process

Abstract

Sustainable health care combines three key factors: quality patient care, fiscally responsible budgeting and minimizing environmental impact. Although pollution is well understood as a health problem, US health planners have not fully recognized the need to reduce health‐care pollution. Minimizing health‐care pollution, moreover, requires reducing the throughput of energy and materials. Ultimately, sustaining healthy ecosystems requires that health‐care material and energy utilization be limited. However, traditional conceptions of health‐care ethics maintain a philosophy of rescue that makes limiting life‐saving resources, except at a patient’s request, morally worrisome. Moreover, the media image of health care as technologically intensive, together with the common medical view that nature is the enemy, render suspect philosophical perspectives respectful of Earth’s limits. Nevertheless, academic medical centers have advantages as sites for pursuing sustainability: students often uphold environmental ideals, a public health perspective, and an interest in providing services universally; basic biomedical research on campus permits innovative research combining health and environmental considerations; opportunities exist for including environmental concerns in health professional education; some academic medical centers have already stated environmental criteria for purchasing contracts; and health‐care professionals and institutions are increasingly addressing such environmental concerns as mercury use, latex allergies, dioxin pollution, and waste volume. To address these challenges, a visioning process is proposed, designed to formulate a practical plan by means of public, local, and professional participation in the process of articulating creative and morally sound proposals for change.

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