Salon CMAJ

Physicians’ contribution to climate change

ost people, except perhaps, a in 1951 to the present of 1.13 billion. few diehard oil executives, The solution is not violent or ex- Mhave accepted that climate treme. Nor should it become mired in change is largely due to human activities. ideology. The solution lies in using the Scientists have blamed carbon dioxide– science of medicine and the power of emitting vehicles, coal-burning industries, advocacy to bring about real change. forest-burning communities, methane- And physicians around the globe have a belching cattle, and even cremation. crucial role to play. Advocacy for family Nobody has yet dared point a finger planning starts with educating all pa- at the physicians’ role. But as a consci- tients of child-bearing age, and extends entious member of this profession, it’s up to advocating for funding and real time to consider whether we are inad- change from government officials at all vertently contributing to this vital global levels. Physicians can also affect the problem that affects the health and even policies of medical associations, who of- the very existence of our species. ten have significant lobbying clout, and Many factors have been included in can provide financial and professional the climate change equation, but the input to family planning organizations.

missing number, the number that seems Fred Sebastian Citizens and the scientists who to have been ignored is the effect of the would like to slash our carbon footprint total number of humans living on this In 1792 in Ireland, Jonathan Swift’s also need to consider the unsustainable planet. The world’s population was 1 parody1 suggesting harvesting human number of humans on this planet and billion in 1802; it’s now 6.5 billion, and infants as food to solve the problem of acknowledge that this is a critical factor another billion are added every 12 years. overpopulation and starvation, was met and that reducing our number is funda- The more people we have, the more with indignation. Emigration was seen mental to efforts to curtail climate electricity we will need to heat and light as the solution. change, as well to improving the qual- our homes, to cool our food in refrigera- Today we have different solutions in ity of life for all. Physicians have the tors. We will need more coal burning or the form of family planning education, glorious opportunity to rise above the thermonuclear power plants. And as contraceptives, and interventions such boundaries of nations, race, and reli- cities grow, more people will commute as vasectomies and tubal ligations. gion for this very worthwhile cause. longer distances in cars or buses. We Sadly, these medical solutions have will need more housing, more furniture, sometimes become politicized. For ex- Arun Mehta MBBS more gadgets. Here’s the back-of-the- ample, in 2001, then US president Assistant Director of Rehabilitation envelope equation: total number of George W. Bush reinstated the restrictive Medicine (retired) humans × average greenhouse gas pro- global gag rule, which prohibited giving Veteran’s Affairs Medical Center duced by 1 human = total greenhouse family planning assistance funding to any Sepulveda, California, USA gases due to human activities. organization that provided or supported So, where do physicians fit in all this? abortion services. International organiza- If we accept that the total number of hu- tions providing reproductive health care REFERENCES 1. Swift J. A modest proposal for preventing the chil- mans living on this planet as an important that desperately needed US funds were dren of poor people in Ireland from being a burden contributor to climate change, then we faced with a dilemma: They could either to their parents or country, and for making them beneficial to the public. In: The writing of must look to who is responsible for this accept the money and not even talk about Jonathan Swift. New York (NY): WW Norton & exponential increase in population. Physi- abortion as an alternative or reject US as- Company; 1973. p. 502-9. 2. Ahman E, Shah I. Unsafe abortion: global and re- cians willingly take the credit for their sistance and cut services or close the gional estimates of incidence of unsafe abortion part in reducing mortality and morbidity, clinic. In 2003, 19 million women world- and associated mortality in 2003. 5th ed. Geneva: World Health Organization; 2007. for all the wonderful medicines that they wide underwent unsafe abortions and 3. Chadney JG. Family planning: India’s Achilles dispense, for the hospitals, diagnostic and 67 000 women died after one.2 At the heel? J Asian Afr Stud 1987;22:218-31. myriad surgical interventions that save other extreme, in the 1970s coercion was lives. Sure, it’s a pleasure to take credit used in India in promoting family plan- Have you got an opinion about this for the good news, but is it fair to pass the ning methods such as vasectomy. Since article? Post your views at www.cmaj.ca. buck for the bad news? If the problem is then family planning has become a dirty Potential Salon contributors are welcome 3 partly in the purview of the lowly physi- word. The population of India has in- to send a query to [email protected].

DOI:10.1503/cmaj.090769 cian, so too is part of the solution. creased nearly 3 times from 361 million

All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association. 1176 CMAJ • MAY 26, 2009 • 180(11) © 2009 Canadian Medical Association or its licensors