Carbon Accounting in Healthcare and the Ethical Questions It Raises

We face an ever-worsening environmental crisis to which healthcare systems substantially contribute. This article clarifies what the duty to minimise healthcare's environmental impact entails as a matter of environmental and ecological justice. Yet upholding the duty raises further ethical questions around responsibilities and trade-offs: Should responsibility lie at the individual (micro), organisational (meso), or systemic (macro) level? How far should those responsible go to fulfil the duty when it conflicts with ethical duties to deliver health and social goods to patients? This article considers those questions using the case of carbon accounting in the ED. It presents a range of plausible answers, drawing on current debates in the green bioethics space.