The duty of care that health professionals have for their patients needs to be matched with a duty of care for the planet, argues Fran Baum

How did we arrive at the position where we devote so many resources to healthcare and yet have totally dropped the ball on caring for our planet? If the planet were a person she would be assessed as being dangerously, even fatally, ill. Her vital signs are not good.

The Intergovernmental Panel on Climate Change (IPCC)1 has produced six reports based on the work of multiple scientists around the world. The reports found that the health of the planet is declining faster than the reports can keep up with, and that the planet is sicker than the latest report indicated. So the panel has produced more timely indicators on the state of our sick planet.2 It shows that the annual total greenhouse gas (GHG) emissions and concentrations of the three main GHGs in the atmosphere have increased, and the global mean surface temperatures across the whole world and over land have both increased further compared with the 1850-1900 average. It predicts that the next decade is critical, as human induced global warming rates are at their highest historical level, and it expects 1.5°C global warming to be reached or exceeded within the next 10 years, with likely horrible results for human health.

We also have to take into account the threats this poses to the planet’s biodiversity. Our amazing blue planet was full of multiple species, landscapes, and ecosystems. For millennia people have lived in harmony with these diverse ecosystems. From the Sami people of the Arctic to the Aboriginal people of Central Australia, humans have developed complex knowledge systems that enabled sustainable land management.3 In Australia, the Aboriginal people view caring for country as a reciprocal relationship “whereby land is understood to become wild or sick if not managed by its people, and in turn individuals and communities suffer without a maintained connection to Country.”4 Industrialisation and the onslaught of capitalism have seen this harmony badly interrupted. We are now in an era of mass extinctions where these finely balanced environments are disrupted.

As the health of our planet continues to deteriorate, the concerns of planetary health and human health are colliding. Natural disasters create deaths, injuries, longlasting mental health impacts, and trauma. In the US state of Arizona, temperatures are so high that heat departments have been created to help manage and prepare for extreme temperatures. In our unequal world it isn’t a surprise that the first casualties of our sick planet are primarily (though not exclusively) in low income countries. These include Pacific Islands whose very existence is threatened, and northwest Africa, where some of the people with the least resources on Earth are facing severe drought and consequent civil unrest, famine, and war.

So the vital signs are not encouraging. The change to the planet’s climate now poses a grave, and probably existential, threat to human security5 and a worse health crisis than covid-19.6 In the northern hemisphere this summer more extreme climate records have been broken. We have experienced long stretches of temperatures over 40°C in southern Europe and Arizona,7 record breaking droughts, fierce wildfires that can’t be controlled, smoke filled cities, flooded cities, and coastal inundation.8 The diagnosis predicts that things are likely to get much worse. There is one glimmer of hope: while global greenhouse gas emissions are at a long term high, the rate of increase has slowed.2 Thus, if in the next decade we can care for planet Earth, she may heal and continue to provide a good home for humans and wildlife.

Why don’t we act? Why don’t we adopt a wartime-like attitude to cure and care for our warming planet? It isn’t as if people don’t know that the planet is in a dire state. UN secretary general António Guterres said, “The climate time bomb is ticking”9 when a new IPCC report was released in March 2023 which warned that the planet is on the brink of catastrophic warming.

Whose job is it to care for the planet? Should medical journals be as concerned with planetary care as with patient care? What role should healthcare professionals play in this care? Healthcare workers are known for their care and this was recognised at the height of the covid-19 pandemic. Healthcare focuses on caring for individuals, but what is the point of pouring all those resources into curing illness and promoting health when the state of the planet is rapidly becoming a threat to the health of us all? The duty of care that health professionals have for their patients needs to be matched with a duty of care for the planet. The two are intimately linked and planetary care is vital for our survival.


  • Competing interests: FB receives funding from the Australia Research Council, Australia National Health and Medical Research Council, and the Medical Research Future Fund. FB was sponsored to give keynote/plenary addresses in the past three years: the Psychosis Australia (airfare, hotel), Royal Australian College of General Practitioners (airfare, hotel, and speaker fee paid to University of Adelaide), the Global Health and Welfare Forum, Taipei (Taiwan Department of Health Promotion) (airfare and hotel), and the Australian Academy of Health and Medical Sciences annual meeting 2022 (airfare and hotel). FB is also a board member for the Cancer Council of South Australia and advisory council member, People’s Health Movement.

  • Provenance and peer review: commissioned, not externally peer reviewed.


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