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What Can Bioethicists Do About Climate Change?: Cheryl Cox Macpherson
Dr. Cheryl Cox Macpherson
PI, CREEii Professor and Head, Bioethics Division St. George’s University
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What Can Bioethicists Do About Climate Change? Dr. Cheryl Cox Macpherson
Industrial policies that drive global emissions higher and higher cause climate change. In that sense, climate change is an unwanted side effect of policy involving globalization, economic development, and industry. Climate change makes our home on planet earth less healthy for our families and for the rest of earth’s growing global population. In addition to the fossil fuel and agricultural industries that are responsible for the lion’s share of global emissions, the healthcare industry is estimated to contribute significantly to global emissions. Healthcare, with its commitment to promoting and maintaining health, undermines health through its emissions. As a wealthy, valued, and influential industry, one can argue that healthcare has both capacity and responsibility to adopt environmentally sustainable policies and practices. Health systems in the United Kingdom, United States, and elsewhere demonstrate that it is possible to deliver current standards of care while making large improvements in environmentally sustainability.
From clinical to research and public health ethics, bioethicists help communicate complex ideas about autonomy, truth telling, patient centered care, and resource allocation, to name a few. They do this for diverse stakeholders in varied locations and contexts. The ability to do this effectively can be applied to climate change, the causes and consequences of emissions, and associated ethical concerns about resources and injustices. Bioethics literature on topics like justice, the built environment, genomics, and One Health is increasingly touching on climate change. Bioethicist authors of such work are thus subtly helping to drive environmental sustainability and reduce global emissions production. Reducing emissions today delays damages to ecosystems and the resources these provide for health and healthcare, and brings present and future benefits. Although advocacy and activism are not the main function of bioethics, and bioethicists have other professional commitments to fulfil, many bioethicists perceive advocacy and activism as inherent to their routine work.
Bioethicists in clinical settings, academia, research, and public health aim to increase public understanding of health issues at stake, improve patient outcomes, and influence policymaking. With emissions wreaking havoc through extreme floods in Puerto Rico, Florida, Alaska, Pakistan, Bangladesh, and beyond (in September 2022 alone), too few bioethicists acknowledge any connection between emissions or environments and their professional aims or work. Examining global emissions or industrial policy in the context of routine bioethics activities can expand and deepen understanding of the trade-offs being made by decision-makers. It might better inform decision-makers and consumers, with global benefit. Such work is a form of advocacy within the realms in which bioethicists function and are influential.
Health is worsened by emissions through extreme weather, sea level rise, global warming, and other manifestations of climate change which weaken the stability of institutions and democracies and escalate unprovoked violence around the world. Bioethics position within healthcare is reason enough to engage.
What can bioethicists do…………..cont’d
It might start (as Bruce Jennings and others have called for) by re-defining individual autonomy as embedded within populations, ecosystems, and the socioeconomic and physical environments that bear on health, access to care, and the type and standard of care available. Individual autonomy exists only within relationships to others and environments. Bioethicists can help improve understanding among diverse stakeholders, from the public to policymakers, students, and others, about the significance of these relationships.
Persistent advocacy and activism by early bioethicists drove the shift from paternalistic and Hippocratic standards of medicine to current standards that value autonomy and informed consent. This same energy can be applied to environmental sustainability within healthcare and healthcare education. Bioethicists (and other professionals) can encourage related discussion within their institutions, among their students, and with their colleagues. The interdisciplinary nature of bioethics lends itself to multidisciplinary collaborations that are needed to make a meaningful difference in global emissions. Bioethicists should learn about and highlight for others the benefits of and for healthcare organizations that implement more environmentally sustainable policy and practices, for example, with respect to supply chains.
Bioethics is embedded in healthcare, and healthcare is responsible for a large percentage of global emissions. Bioethicists can inform and influence at least some health systems and organizations about the benefits of adopting environmentally sustainable policies and practices. They should take industrial emissions production seriously. As consumers, they should reduce their own contributions to the problem (eat local, choose local products and those with less packaging, fly less often, use less energy, produce less landfill waste, etc.). As professionals, they should reflect on ethical concerns about the well documented harms of emissions, and the relationships, harms, and benefits of actions that produce industrial levels of emissions. That the main industrial emissions producers benefit commercially from doing so is one such concern. Bioethicists are positioned to facilitate related dialog in their workplace through webinars, journal clubs, or on coffee breaks. They should integrate the causes and consequences of emissions into their routine work whether in clinical practice, education, research, or policy. Each effort helps build momentum toward environmental sustainability which is needed for a healthy and well future for ourselves, our grandchildren, and people around the world.
Acknowledgment: This article draws from a paper by Cheryl Macpherson in a forthcoming special issue of Perspectives in Biology and Medicine addressing bioethics responses to the ‘deleterious effects of failed health and social policy’ and from her 2022 editorial in Global Bioethics.
MEMBERS’ ACCOMPLISHMENTS
Dr. Derrick Aarons
2022: Ethics Consultant, The Caribbean Public Health Agency (CARPHA) Co-coordinator and Co-Editor of the International Bioethics Committee (IBC) Prelimi nary Draft Report on “The Principle of Solidarity and Cooperation” Tutor – Masters in Bioethics, St. George’s University, Grenada, Universidad Autonoma de Queretaro, Mexico, and Clarkson University, USA –Caribbean Research Ethics Education Initiative
Member – The IBC Bureau of UNESCO
Member – The Executive for the Caribbean Association of Medical Councils (CAMC)
PEER REVIEWED JOURNAL PUBLICATIONS:
Aarons Derrick. Deliberations on Principles of the Universal Declaration on Bioethics & Human Rights: Summary of The Principle of Protecting Future Generations. IBC Newsletter, UNESCO 2022; Vol.3: p.13-14. Aarons Derrick. Ethical considerations during a Pandemic. BioethicsCaribe. Feb. 2022: 9 – 14.
KEYNOTE ADDRESSES:
1. July ’22:“The multi-faceted issue of abortion” and “Legal Prohibition: Public good or legislating morality?” – The Annual Ethics Conference, the Association of General Practitioners of Jamaica
2. Jan. ’22: “The ethical use of social media among medical professionals” – Medical Council of Jamaica Ethics Webinar 2022
3. Dec. ’21: “Final draft Report on the Principle of Protecting Future Generations” –International Meeting of the International Bioethics Committee (IBC) of UNESCO
REGIONAL PRESENTATIONS:
1. Apr.’22: “Vital Communications in Medicine: Informed Consent & communication with
Relatives” – Surgeons Association of Central Jamaica 2. Oct.’21: “Ethical Considerations During a Pandemic” –Conference, Antigua & Barbuda Medical Council
INTERVIEWS:
The Ethics of Organoids – Interviewed by the University of Norway for the new European project, HYBRIDA, on the regulatory framework for organoid research and gene editing and cloning technologies around the world – Jun’21
Prof. Cheryl MacPherson
Accomplishments ….Cont’d
RESEARCH SUPPORT (2 active)
ACTIVE R25 TW009731-01 Administrative Supplement 09/01/22-08/30/23 CC Macpherson PD/PI
ACTIVE R25 TW009731-01 (Renewal) R25 TW009731-01 02/01/20-12/31/24 06/01/14-12/31/18
CC Macpherson PD/PI NIH-Fogarty International Center. Caribbean Research Ethics Education Initiative
PUBLICATIONS
1. Can bioethics do for our planet what it’s done for autonomy? Perspectives in Biology and Medicine. Invited. submitted June 2022. 2. Macpherson C. Global bioethics: it’s past and future. Global Bioethics. January 2022. 31;33 (1):45-9. 3. Jennings NP, Chambaere K, Macpherson CC et al. Medical end-of-life decision-making in a small resource-poor Caribbean country: a mortality follow-back study of home deaths. Ann
Palliat Med 2021. Online First. https://dx.doi.org/10.21037/apm-21-1793
PRESENTATIONS
1. Macpherson, CC. How bioethics can help mitigate climate emissions. Invited speaker. Ethical Perspectives on Health Impacts of Climate Change: NordForsk Conference. Umea, Sweden and virtual. 22-23 September 2022. https://www.nordforsk.org/events/2022/ethicalperspectives-health-impacts-climate-change 2. Jennings N, Chambaere K, Macpherson CC, Cox K, Deliens L, Cohen J. Medical end-of-life decision-making in a small resource-poor Caribbean country: a mortality follow-back study of home deaths. Health systems research 7th global symposium (III HSG Pre-Conference in the Americas). Jan 18, 2022. 3. Macpherson, CC. Promoting research ethics around the globe (panelist). Bioethics Program of Clarkson University and Icahn School of Medicine at Mount Sinai: 20th Anniversary Speaker Series. January 14, 2022. 4. Macpherson, CC. Panelist: Ethics, Climate Change, and Future of Work (in webinar series
‘Ethics and the Future of Work’). The University of Colorado’s Center for Bioethics and Humanities and Center for Health, Work & Environment at Colorado School of Public Health. Nov 22, 2021. 5. Macpherson, CC, Cummins P, Romero Zepeta, H. Bilingual education for research ethics. SGU Research Day, October 24, 2021 6. Noel N, Macpherson, CC. Climate Change and Bioethical Challenges for Low and High Resource Countries. SGU Research Day, October 24, 2021
Accomplishments ….Cont’d
Shereen Cox, Doctoral Research Fellow
MEETINGS
Empirical Bioethics Summer School, Amsterdam UMC & VU university
PUBLICATIONS
Shereen Cox, Jan Helge Solbakk, Rosemarie D. L. C. Bernabe. (2022) Research ethics commit tees and post-approval activities: a qualitative study on the perspectives of European research ethics committee representatives. Current Medical Research and Opinion 0:0, pages 1-11.
2. Cox, Shereen, Seetharaman,Hariharan. (2022) Off-label use of pharmaceutical drugs during the COVID-19 pandemic: Reflections from the English-Speaking Caribbean Redbioetica UNESCO. 2022 https://redbioetica.com.ar/wp-content/uploads/2022/07/RELATO-SOBRE-CARIBE-INGLESCox-Seetharaman.pdf
3. Cox S, Solbakk J, Bernabe Rosemarie, The role of research ethics committees after the approval of clinical trial protocols in the EU and the USA: a descriptive content analysis of international and regional normative documents. Current Medical Research and Opinion https://doi.org/10.1080/03007995.2021.1905621 (2021) 37(6) 1061-1069
PRESENTATIONS
1. Professional Ethics in Pharmacy Practice, Guyana Pharmacy Association, February 2022
2. Data Protection Act and Pharmacist: From Confusion to Compliance T Geddes Grant Virtual Webinar, Jamaica, July 2022
3. A Duty to care: Ethics and Pharmacy Practice, Cayman Pharmacists Association, July 2022
Sherry Ephraim-Le Compte, Vice President, BSEC
APPOINTMENT
Recently appointed member of CARPHA REC
PRESENTATION
Presentation on local REC to the Minister and PS of Health Wellness and Elderly Affairs in Saint Lucia.
Athene Hilary Aberdeen, Facilitator (Retired).
AWARDS
Masters Degree in Global Bioethics Dec. 2021from University of Anahuac, Mexico. A Collaboration of Anahuac, UPRA in Rome and /UNESCO Chair in Bioethics.
Prof. Donald Simeon
Accomplishments ….Cont’d
PUBLICATIONS
1.Bolleddula J, Simeon D, Anderson S, Shields L, Mullings J, Ossorio P, Bethelmey A, Kasafi
Perkins A (2022) No person left behind: Mapping the health policy landscape for genomics research in the Caribbean. The Lancet Regional Health – Americas Volume 15, 100367. https:// doi.org/10.1016/j.lana.2022.100367.
2.Ramdass MJ, Gonzales J, Maharaj D, Simeon D, Barrow S. Breast Carcinoma Receptor Expression in a Caribbean Population. Surg J (N Y). 2022 Sep 19;8(3):e262-e265. doi: 10.1055/s-0042 -1756632. PMID: 36131945; PMCID: PMC9484866.
APPOINTMENT
Member of the Global Steering Group (GSG) of the WHO Evidence-informed Policy Network (EVIPNet)
Balford A. Lewis, Associate Professor
PUBLICATIONS
Co-editor of the Reader: Lewis, Balford, and Luke Plutowski. (Eds.) 2021. The Political Culture of Democracy in Jamaica and in the Americas, 2021: Taking the Pulse of Democracy. Vanderbilt University, Nashville, TN USA https://www.vanderbilt.edu/lapop/jamaica/AB2021JAM-Country-Report-English-Final220411.pdf
Kandamaran Krishnamurthy, Pediatric ICU Consultant
ACCOMPLISHMENTS
FRCPCH UK
MEETINGS
International transplant conference 2021,India gave talk on world Brain death project
https://www.researchgate.net/profile/Kandamaran_Krishnamurthy
Leon Budrie, Clinical ethics Fellow, Baylor College of Medicine, Houston
PUBLICATIONS
Budrie L, Narinesingh A. Locked out: An ethical analysis of Trinidad and Tobago's COVID-19 border closure. Ethics Med Public Health. 2022 Feb;20:100749. doi: 10.1016/ j.jemep.2021.100749. Epub 2021 Dec 7. PMID: 34901364; PMCID: PMC8648578.
Mr. Latelle Barton
Accomplishments ….Cont’d
Accepted into Harvard Medical School Center for Bioethics Fellowship Program for September class 2022-2023.
Dr. Barbara Landon, Professor Emeritus
Saving Brains Grenada have founded the CCCN. A list of publications and other activities can be found at our brand new website: https://cccnd.org/publications/peer-reviewed-journals/
ANNOUNCEMENTS
Caribbean Research Ethics Education initiative CREEi-Hastings Center (CHC) Bioethics Scholar Program
Members who are graduates of CREEi (1 or 2 year program) and hold a master’s degree or higher are encouraged to apply for the new CREEi-Hastings Center (CHC) Bioethics Scholar Program. This is an opportunity for professional development and involves mentored writing over about 9 months. Funded by NIH, the program aims to improve critical thinking and writing skills and thereby enhance contributions to research ethics scholarship, education, and policy development in the region; and to provide opportunities for leadership in advancing ethical issues relevant to your country and region.
All relevant information is provided in the attached document. NIH funding stipulates that only CREEi graduates are eligible.
