A bio-psycho-socio-planetary model of health and Iris Marion Young’s concept of responsibility as foundation for a medical ethos during environmental crises

Aim: In October 2022, the World Medical Association integrated environmental sustainability, public health, global health, considerations of inequities as well as the well-being of future generations into its revised International Code of Medical Ethics for physicians. Broader responsibility for environmental and societal issues was thereby codified into medical professionalism. Theoretical work on a normative foundation for such a comprehensive understanding of responsibility is scarce. This paper aims to contribute to the normative side of a contemporary professional identity formation (PIF) in medicine. It develops an “ethos in connection” which helps to justify broadening physician responsibility and integrating environmental and societal dimensions. Methods: It is asserted that defining and understanding health and responsibility are the decisive elements of the normative foundation for a contemporary PIF. The paper proposes a comprehensive bio-psycho-socio-planetary model of health. Relevant elements of the philosophical work by Iris Marion Young on responsibility are summarized. These comprise the social connection model, distribution of responsibility and relational egalitarianism. Results: The bio-psycho-socio-planetary model of health and Young’s theory of responsibility are integrated to establish an “ethos in connection” to provide the normative foundation guiding the PIF of today. Some challenging issues are discussed, for instance concerning whether and how it differs from a public health ethos and what practical implications follow. Conclusion: The paper concludes that the climate and environmental crises are not the decisive driving forces behind what this paper calls an “ethos in connection”, as the need for such an ethos has been prevalent long before these crises became issues of highest priority. Nonetheless, the severity of health impacts and the inequality in causation and distribution of the multi-layered climate and environmental crises increase the urgency to further develop the PIF of today.