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As doctors, we must use our powerful voices to communicate climate threats and solutions clearly, and demonstrate how deeply we care about addressing the climate impacts on the health of Australians.
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.
The statements or opinions expressed in this article reflect the views of the authors and do not necessarily represent the official policy of the AMA, the MJA or InSight+ unless so stated.
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Thank you Shaun for your excellent article.
Thank you to everyone who has left comments as well.
The basic fact remains, global warming and biodiversity loss is due to the burning of fossil fuels. No doubt.
Many people have been directly affected. If you haven’t been, then at this rate, it is just a matter of time. The urgency to reduce carbon emissions will become clear.
If you haven’t been affected by flood, drought, heat or fire, then you have been affected financially by climate change with the increase in insurance premiums due to paying for climate events. Just wait till the insurance costs from the last 2 USA hurricanes kick in!
One of the issues that becomes relevant is the messaging around the solutions to climate change. It is interesting that people get so “fired up”. This is not random. We must all be careful not to fall into the trap of misinformation and malinformation. Hopefully, as doctors, we will be able to see that.
Dear anonymous,
1) Are we ready to accept the consequences of unmitigated climate change?
2) Individual choices have some value but we cannot meaningfully change the trajectory of greenhouse gas emissions without corporate and government action as the vast majority of emissions (and other pollution) are “embodied” in the products and services we buy and use
3) “As for EV cars, has anyone looked at the entire value chain for the production of such things?”
Of course they have! EVs are more emissions intensive to produce but the avoidance of oil use and far greater engine efficiency quickly repay that difference (depending on kilometers travelled) – https://www.iea.org/data-and-statistics/data-tools/ev-life-cycle-assessment-calculator
Dunning Kruger hard at work. It’s fine for a neurologist to care about the climate, but when it comes to energy policy, we need to stay in their lane. Thanks to making energy decisions based on ideology, Germany is burning brown coal and wood. And is losing industry. Look in the bright side, for LOLs: in 2023, the MJA called for nuclear disarmament.
Good article reflecting the health implications of established science and our responsibility and role to respond.
But it never ceases to amaze me that there are Doctors still feeling the need to respond with factually incorrect and frankly ignorant and ideologically driven climate denial tropes.
Not only are global heating related events and changes already impacting peoples health and security on a large scale, they are disproportionately affecting the poorest, most vulnerable and those with least resources.
It is completely irresponsible to the point of medically negligent to argue that we ignore or delay actions that can and will avert large scale suffering, displacement and mortality.
The goals are Idealistic and some are impractical.
Banning all new fossil fuels projects and investing more on unreliable renewables – wind and gas has been shown to be a disaster in Germany. After spending 1 trillion dollars on closing their nuclear and coal plants and developing solar and wind projects Germany has realised that wind and solar energy sources are expensive and unreliable sources of energy. They have turned to Russia for gas and are opening coal fired energy plants to keep industries from abandoning Germany for countries with lower energy costs. Once an industry powerhouse they are on the road to economic ruin. Australia should learn a lesson from Germany. Besides it is easy to lecture from a position of relative wealth -as doctors we are least likely to experience the cost of soaring energy prices. There are many older Australians who have shivered through winter and families struggling to put food on the plate as they must cope with big utility bills. Besides the cost and environmental effect of disposing used solar panels, wind turbines, lithium batteries and the mining of nickel (to make solar panels) and lithium (for batteries) needs to factored in.
What about taking a pledge as doctors not to travel by air. Flying is a very carbon intensive activity! Do we need to holiday or attend conferences overseas or interstate? Fortunately, we are in the 10 % of the world that can afford to fly. Let’s also not forget that mobile phones and internet and all wonderful digital innovations in health are currently predominantly powered by fossil fuels.
As doctors we need to advocate for common sense and pragmatism, we should advocate that the govt work towards safely constructed and maintained nuclear plants and help educate the health and wider community that nuclear generated electricity is a practical way forward. France has managed to keep energy prices affordable as 60-70% of their electricity is from nuclear plants.
The cold hard reality is that we cannot continue to live the way we live without fossil fuels. Until such time cleaner sources of energy are reliably available and affordable we should stop demonising fossil fuels but instead advocate for practical alternatives and each of us as individuals try to reduce our carbon emissions.
Thanks Shaun for your true words, commitment and generosity in the most important health issue of our time.
Comparing climate change with tobacco and alcohol , which doctors rightly preach about, is drawing a long bow. Catastrophising climate change can be counterproductive when it is not supported by general observation over time. The AMA president, in a recent missive, talked about the ‘climate emergency’. As doctors we should be precise with our words and careful about using the term “emergency, (a sudden situation requiring immediate action ) in relation to this issue. Most if us accept that our climate is changing , for whatever reasons and sensible measures are need to mitigate its effects. But when the author of this article talks about the need to quit coal, oil and gas he is, in my opinion straying from medical science and into environmental activism
I’m all for caring about the impact of pollution on public health and being a good steward, including the environment. However, think for a minute the following implications:
Many of our day-to-day conveniences that afford us the ease of modern-day life (car, gadgets, home appliances) and paraphernalia that allow us to make a living as doctors (think equipment, drugs) are fossil-fuel derived.
1) Are we really that ready to give up such things for the sake of climate change?
2) What about the annual ski trips for medical conferences? Btw, carbon credits are a formal of greenwashing, if we’re entirely honest.
3) As for EV cars, has anyone looked at the entire value chain for the production of such things? From sourcing the rare metals to the carbon-producing activity of solar panels through which we charge our EV’s?
Let’s be realistic. We should certainly be making a move towards renewables but until we have the technology that can replicate the efficiency, cost and scale of fossil fuel, banning such en masse will relegate societies back to pre-industrial era. Would love to see the DEA lead us all by example. (No mobile phone use btw…it’s fossil fuel derived too….unfortunately)