This is our lane: why doctors must care about climate change

As doctors, care is at the heart of what we do.

We experience a calling to care and a duty of care. Doctors are trusted and respected by the community because we care. Our patients trust us because they know we care deeply for their lives, their health and their wellbeing.

Our capacity to care depends on human qualities such as compassion and empathy, high quality education and ongoing guidance by the very best scientific evidence.

Scientific evidence that is critical to care is not only the randomised controlled trials that tell us that medication A is better than medication B and that medication C is harmful. Scientific evidence also includes the broader socio-economic and environmental factors that impact the health of our communities and our individual patients.

That climate change is escalating and is having real health impacts is incontrovertible. To provide the best possible care in the twenty-first century, we as doctors need to deal with these uncomfortable facts.

Australia is especially vulnerable to the impacts of climate change, with eight of the nine warmest years on record occurring since 2013. The 2024 State of the Climate report by the CSIRO and the BoM reveals that Australia’s climate has warmed by an average of 1.51°C since records began in 1910, while sea surface temperatures have increased by an average of 1.08 °C since 1900. These changes have major flow-on effects for all Australians, including the increase in extreme heat events, longer fire seasons, more intense heavy rainfall, and a rise in sea level — increasing the risk of inundation and damage to coastal infrastructure and communities.

Globally, the 2024 Lancet Countdown, an annual assessment of how we’re tracking towards the climate goals of the 2015 Paris Agreement, reveals concerning findings.

Around the world, annual mean surface temperature reached a record high of 1.45°C above the pre-industrial baseline in 2023, and new temperature highs were recorded throughout 2024. As a result, last year, people were exposed to on average 50 more days of hazardous temperatures than expected. The higher frequency of heatwaves and droughts saw 151 million more people experience moderate or severe food insecurity than the annual average between 1981 and 2010. Heat-related deaths among the over-65-year-olds rose 167% in 2023, compared with the 1990s. High temperatures also led to a record 6% more hours of lost sleep in 2023 than the 1986–2005 average. Life-threatening diseases such as dengue, malaria and West Nile virus continue to spread into new areas.

Some might argue that doctors should stick to treating patients, particularly when there are doctor shortages and waiting times can be long. This begs the question: if we as doctors are at the frontline of climate impacts and we are aware of the harm to our patients’ health, do we not risk our duty of care by failing to address the risks?

Doctors have played a critical role in fighting the harms of tobacco, asbestos, junk food and many other threats to human health. Now in addition to these, we have a duty of care to address the health threats posed by climate change — the biggest single threat facing humanity.

Why then does it feel confronting to bring up the issue of climate change?

As doctors, it can feel as though we need to be granted permission to hold opinions and speak out on “controversial” matters.

Rightly or wrongly, as junior doctors we perceive that we depend on the favour of senior doctors for career advancement and a rewarding clinical experience. We worry that we will be penalised if we say or do anything that disappoints. We come to conform to what we assume our mentors think about issues such as climate change, which might be different from their actual opinions.

But, if we are grappling with these issues, it is likely that many of our colleagues and mentors are deeply concerned about the health impacts of climate change and our need to act.

The AMA and Doctors for the Environment Australia (DEA) have entered into a memorandum of understanding, and the WHO and many specialty colleges and societies have made strong statements on the climate health emergency. Furthermore, the Medical Council of Australia has mandated education on sustainability and climate health for all undergraduate and postgraduate curricula.

As doctors, we understand medical emergencies and we’re currently not seeing much evidence of the action we expect to see in an emergency when it comes to addressing escalating climate change. The words are on paper and at times even on the lips of our medical leaders, but it will take the care of many of us to transform words into necessary emergency action.

The scientific evidence is clear on what needs to be done: similar to addressing the health impacts of tobacco by first quitting smoking, to address climate change, we must first quit coal, oil and gas.

DEA recently launched a report highlighting that we must:

• ban all new fossil fuel projects and accelerate investment in renewables;
• stop financial subsidies to fossil fuel industries and redirect them to carbon-free initiatives;
• ban fossil fuel advertising and industry sponsorship, just like we did with smoking;
• ban single-use and non-recyclable plastics and switch to reusable and/or compostable products;
• protect biodiversity and ban native forest logging;
• prepare health care and the wider community for what we can no longer avoid.

Other organisations have called time on fossil fuels. For example, in 2023 the World Organization of Family Doctors (WONCA) and health organisations, representing three million health professionals in Australia and worldwide, called for an end to fossil fuels.

Despite the dangers of climate change to public health, a recent climate change poll showed that strong public support for climate action is facing “emerging threats”.

As a new year approaches, we as doctors must show that we truly deserve the trust and respect shown to us by our patients and the broader community by using our powerful voices to communicate climate threats and solutions clearly, and by demonstrating how deeply we care about addressing the climate impacts on the health of Australians.

And for those of us with children and grandchildren or nieces and nephews, or who care about this generation of young people and those to come, taking action on mitigating climate change will ensure that they will grow to enjoy healthy and fulfilling lives — just like generations before them.

Dr Shaun Watson is a neurologist and Chair of NSW Doctors for the Environment Australia.