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Decarbonizing Health Care: A Call to Action

Gabriella Mickel


  • Explores climate change as the greatest threat to public health.
  • Analyzes the legal field’s opportunity to help decarbonize health care.
  • Asks attorneys to think about they ways in which they can help address healthcare-related emissions.
Decarbonizing Health Care: A Call to Action
Sean Anthony Eddy via Getty Images

Physicians, and many other health-care providers, take an oath to do no harm. Yet, the health-care sector is a prominent source of environmental pollutants, which have deleterious effects on human health. Dubbed by more than 200 medical and health journals worldwide as the “greatest threat” to public health,climate change also threatens the resiliency and equity of our health-care system. From historic deep freezes to record-breaking heat waves, climate change has resulted in supply chain disruption, hospital and emergency department overcrowding, and exacerbated health inequities. 

The legal field faces a tremendous opportunity to help decarbonize health care. For example, legal scholars have spilled significant ink about decarbonizing other hard-to-decarbonize industries, while health-care decarbonization has remained largely under-addressed. Policy makers, many of which are attorneys, can give further thought to both opportunities for regulation that would reduce health care’s climate impact and for modifying existing regulation that drives waste-creating and carbon-intensive health-care practices. Additionally, two ABA resolutions urge all lawyers to consider climate change and environmental justice, beckoning practitioners to consider avenues in their everyday work for decarbonizing health care. This article highlights opportunities for practitioners specifically to contribute to the cause.

First, practitioners should inform their health-care-sector clients of climate-related risks, including transition, physical, and regulatory risks. For example, the forthcoming U.S. Securities and Exchange Commission climate disclosure rules, which will require publicly listed health-care companies to disclose climate-related information, present a regulatory risk. Companies not prepared to disclose climate-related information will be at a significant disadvantage when it’s time to comply. Properly informing health-sector clients, in many cases, will likely result in efforts to reduce emissions.

Second, practitioners could act preemptively and offer their health-care clients ideas for decarbonization. Public and private sector actors are increasingly turning to the procurement process to help achieve their environmental goals. For example, as Professor Michael P. Vandenbergh has pointed out, “A 2007 study concluded that roughly half of the companies in eight of the largest global sectors included environmental provisions in supply chain contracting, and more recent research suggests that the total has now reached roughly 80%.” Companies and other organizations can use contract provisions to incentivize or require sustainable practices from their suppliers and partners. Sanofi, a multinational pharmaceutical company, requires its goods suppliers to measure their Scope 1 and 2 carbon dioxide emissions and have plans to measure Scope 3 and disclose their Carbon Disclosure Project (CDP) climate assessment.

Similarly, health-care companies use due diligence questionnaires (DDQs) in a variety of contexts, from selecting suppliers to understanding potential investments. These lists of questions inform important decisions. DDQs could easily have questions, including:

  • Do you have a designated sustainability coordinator? If so, please provide their name and contact information.
  • What are your company’s environmental policies?
  • Does your company have environmental goals and guidelines that are provided to your employees?
  • What potential sustainability concerns are associated with your business operations (e.g., waste streams, disposal practices, chemical hazards, etc.)?
  • What climate-related impacts are associated with your business operations, particularly related to Scope 3 emissions (e.g., emissions related to manufacturing, transportation, etc.)?
  • What sustainability initiatives has your company implemented? Please describe all related to your everyday business operations, including impacts along your supply chain.
  • Please describe your progress and successes in implementing those sustainability initiatives.

Attorneys without health-care–sector clients could also engage with this issue. What techniques do you use that could work for attorneys who do have health-care–sector clients? What techniques should be explored or developed? How can policy change to enable and incentivize health-care decarbonization?

This industry needs our help. The words of Professor Jodi Sherman, M.D., from her testimony in front of the Committee on Ways and Means emphasizes this reality. “Each time I take care of a patient, which gives me great satisfaction and sense of purpose in life, I also suffer moral injury knowing I am also causing harm to someone else through health care pollution.”

This article is in no way comprehensive. The goal of this article is to get attorneys to think about ways they can help address health-care–related emissions, help begin to rectify related environmental injustices, and help physicians keep their oath to do no harm.