General Practitioners Should Ask Patients to Reduce Their Carbon Footprints

Climate change is a 21st century problem, and we must be ready to adapt our practices in order to confront it. Current philosophical efforts to reconcile our obligations to make healthcare sustainable with important principles of patient care have been successful up to a point, but do not go far enough. We consider a specific novel intervention that could be adopted by doctors as part of healthcare systems' efforts to reduce carbon emissions, which is an extension of the Pendleton consultation model asking General Practitioners (GPs) to explore patients' Ideas, Concerns, and Expectations (ICE). Our model, which we call ICE2, includes wider questions in which GPs also ask patients about how they might adapt their lifestyle to reduce its environmental impact. We consider the moral-theoretical underpinning of this new model and argue for its consistency with patient-centred care. We also consider specific objections to the adoption of ICE2: that there will be a backlash from patients that will lead to their being hesitant to seek healthcare going forward; that it will open the door to doctors moralising about other issues that are inappropriate; and that clinicians do not have the training or expertise required to discuss climate change. We discuss our responses to these objections, finding that they all fail to provide a knockdown reason against at least embarking upon a trial of the ICE2 model in settings where an individual doctor deems it appropriate to discuss it with a particular patient.