A focus group study of ethical issues during climate-informed health decision-making

Healthcare delivery contributes to carbon emissions, exacerbating climate change and its associated health impacts. There is limited understanding of stakeholder views regarding ethical issues at the intersection of health choices and environmental impact. Here we performed a qualitative study involving seven focus groups with 46 participants who were patients and physicians in the northeastern US health systems. Both patients and physicians were amenable to health decisions that are beneficial for the environment and health. A consumptive healthcare system impeded both groups’ assumption of health-related climate responsibilities. Physicians, however, underestimated patients’ interest in discussing the environmental impacts of health decisions. Patients expressed tension between a personal interest in limiting climate change through health choices and ensuring others were also accountable; they were also concerned that physician paternalism might impede climate-informed health conversations. These findings outline barriers to climate-informed healthcare and begin to establish how they can be addressed.