Common ethical issues in material responsibility in the hospital include:
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choosing between reusables vs. disposables
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choosing between single-use vs. multiple-use items
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reprocessing single-use items
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balancing fiscal costs of items with environmental costs
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balancing environmental costs of items with efficacy in patient care
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considering differing environmental costs of different kinds of plastics
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considering the environmental impact of manufacturing and transportation of
health
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care products before reaching the hospital
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considering the environmental costs of packaging and its disposal
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respecting the environmental concerns of individual patients and staff
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meeting policy and legal requirements related to environmental protection
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environmental costs of architecture, capital equipment
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environmental costs of basic building functions, such as heating, air
conditioning, and filtration
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considering what goes down the plumbing and into community water supplies,
both from the hospital and from pharmaceuticals taken home by patients
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environmental costs of cleaning the facilities and risks of cleaning agents to
staff
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problems with incineration of hospital waste and air pollution
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disposal of toxic materials, especially mercury
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and many other concerns
One of the emergent ideas in the 1990s pertinent to reducing the environmental impact of economic activities is the Factor X reduction in resource use, with X being between 4 and 50. —Lucas Reijnders
Philosophies of simplicity and natural limitation
Many patients and clinicians perceive health care as wasteful and burdensome, and through living wills, patients have striven to limit the care offered them. As mentioned above, many religious groups and individuals have tried to delineate a line between what nature or God intended for appropriate health care, and what is prohibited. These views combine considerations of religion, closeness to nature, simplicity, and justice. One of the discussion papers will sympathetically consider the application of these various philosophies to health care, and seek the applicable truths in these philosophies. For example, do the Amish, who limit tools and energy use at home, also limit health care technology? Does closeness to nature in naturopathic methods actually protect nature, or might it incur additional environmental costs?
Balancing environmental features of products against costs and quality of care in medical center purchases
The trinity of patient care values, environmental values, and dollar values provides a rich area for cases and analysis.
Existing practices and plausible additional or alternative ethical
considerations may affect environmental assessment of products.
Including environmental values in hospital architecture
As in most business enterprises, health care buildings represent the major
embodiment of upstream materials, and so they deserve close attention.
Recycling, dematerialization, efficiency, and limitations
Suppose that you were the administrator of a large health system, and your job
was to reduce substantially, by half or more, the material impact of your
organization? Given time, could you achieve this reduction entirely by
recycling, dematerialization, green purchasing, and so on? Or, would you have
to, and should you, cut back on certain health care procedures? How could we
begin to answer this question? It is a key one in resolving tensions between the
technological optimists (“Your life will not change, but the products will be
made more efficiently.”) and the simplifiers (“Realistically, technology lacks
magic; you will have to give up some valued procedures to reach
sustainability.”).
This page was last updated July 2004
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