BMJ  2008;336:291-292 (9 February), doi:10.1136/bmj.39479.533125.3A

Letters

Doctors and climate change

Impact of medical ethics

The first 150 words of the full text of this article appear below.

At some point, the developed world’s ethical framework will surely have to change.1 The primary focus of ethical decision making in medicine is the patient and his or her immediate environment. Beneficence, non-maleficence, justice, and dignity are subservient to autonomy. Good of the community is obscured within the principle of justice. However, when self interest and inadequate resources harm others, autonomy loses integrity.

As local resources fail, fertility treatments that bring more life into an overpopulated community; or resource intensive treatment of individuals that prevent cheaper and easier treatment of very many others; or heroic life prolonging treatments in a climate of mass death naturally become harder to justify or provide. Hopefully we will soon wake up to the fact that this is becoming the global situation. When we do, let us hope that all that is good about humanity comes to the fore and that the relatively safer communities . . . [Full text of this article]

John C Chambers, Macmillan consultant and medical director

1 Katharine House Hospice, Adderbury, Oxfordshire OX17 3NL

john.chambers@khh.org.uk


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