The carbon emissions of global healthcare activities make up 4-5% of total world emissions, placing the healthcare industry on par with the food sector. Hospital care and physician and clinical services are the two largest carbon contributors to health care—exceeding even healthcare structures. While significant work is already being done on carbon reduction in health care, less attention has been paid to the “paradox of prevention.” While preventive care can prevent major medical events, which can reduce the disease burden, and therefore medical resource use, preventive health care may extend lifespans and thus increase the carbon of health care, both in an individual’s life and in the medical industry overall. Similar to the concept of health care cost/ per life year, an environmental metric of the impact of preventive health care and longevity might be carbon impact/ per life year or an individual medical carbon footprint. This presentation will, first, overview the importance of sustainability in the medical industry. It will, second, present the “paradox of prevention.” In the discussion, the paper will put forth a number of proposals to navigate between environmental ethics and biomedical ethics, with on the one side—the necessity of carbon reduction—and on the other—for good predictive and preventive care. The conclusion will contemplate how ethicist might think about sustainability in preventive health care in the future.
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