Healing The Healthcare System While Helping People Get Well
Healthcare Comes At A Significant Cost To The Environment
When it comes to healthcare, the association feels obvious: hospitals make the sick healthy. It is true for almost every individual. But for society as a whole?
A number of bioethicists and philosophers think not – that the world’s premier system for healing individuals does so at considerable cost to the environment, the economy, even the public health itself. They cite a list of factors as evidence of the industry’s unsustainability: ever-increasing costs, a dependence on single-use products, a mindset that has patients demanding – and often receiving – every resource available, to name a few. The result is that more resources, both economic and environmental, get fed into healthcare every year.
These are the same hospitals, of course, that have launched recycling, green purchasing and green design programs aimed at reducing those twin impacts. But bioethicists tend to view those changes as the environmental equivalent of a tummy tuck. A truly healthy and sustainable system, they say, will not emerge until the nation overhauls how it views and uses its resources.
“In order to have this wonderful healthcare system, we’re doing things to undermine our environmental health,” said Andrew Jameton, a bioethicist at the University of Nebraska and coauthor of the recently published book, “The Ethics of Environmentally Responsible Health Care” (Oxford University Press, 2003).
“You look at every stage of it, and hospitals are sort of the example of the general toxicity of the overall economy.”
Jameton and co-author Jessica Pierce, a philosopher at the University of Colorado, Boulder, see not just a problem with healthcare. On almost every level, they argue, America’s production and consumption of goods and services is unsustainable.
They take their battle to healthcare, however, because an industry with a moral imperative to promote good health also has an imperative to lead the change, they say. Instead, they see it failing on several fronts: – Americans spent $1.6 trillion on their health in 2002, a 9.3 percent increase that outstripped the economy’s growth for the fourth straight year. Spending averaged $5,440 per person – 13 percent of the country’s total economic output – and accounted for almost 50 cents of every dollar spent worldwide on healthcare.
- American hospitals used and tossed 12 billion examination gloves in 1994, according to a 1998 study. The trash hauled away from a typical medical center contains twice as much plastic as ordinary municipal waste. While most gets landfilled, California alone incinerates 5 to 10 million pounds annually, according to state estimates.
Hospital administrators are just starting to turn from a design and architecture that strands patients – and workers – in a sea of vinyl, concrete and asphalt, locking out Mother Nature and her widely recognized powers to heal.
- The industry uses a number of chemicals that do little for health, from cleaners that put janitors at risk to toxic plasticizers in IV bags that leach into potions administered to patients. healthcare organizations have spent the past few years trying to remove every last bit of mercury from their confines, but efforts to remove the plasticizer went nowhere until California OK’d a rule, set to take effect in October, requiring warning labels on all products with the chemical.
At the same time, the healthcare industry – and society as a whole – gives short shrift to efforts more likely to improve public health, said David Magnus, co-director of the Center for Biomedical Ethics at the Stanford University Medical Center.
“There’s no doubt our main focus is on developing high-tech solutions that allow us to get ever better at diagnosing … diseases,” he said.
Take heart disease. The fight against it can take either of two routes: encouraging people to change their lifestyles – eat better, exercise more, use less chemicals – or continuing to develop new cardiovascular drugs and surgeries.
“We focus most of our resources on the latter,” he said. “And that does have environmental consequences.”
And while other industries – notably manufacturing – have taken steps to reduce their “environmental footprint,” the nation’s healthcare system in many respects is just beginning to pluck the lowest hanging fruit.