Environmental sustainability in palliative care: a narrative review

Climate change represents an escalating threat to human health and disproportionately affects vulnerable populations. The healthcare sector contributes significantly to climate change, accounting for approximately 4.4% of greenhouse gas (GHG) emissions globally. While several medical specialties aim to improve sustainability of clinical practice, there is limited literature within palliative medicine. This narrative review aims to identify and evaluate existing work on the ecologic impact of palliative medicine and highlight climate conscious clinical recommendations within palliative care.

Scholarly databases including Medline, Embase, CINAHL, UBC Summon, Health Business Elite, and TRIP Medical and GreenLine were used for the literature search, and articles up to March 2026 were screened. Studies that described environmental sustainability efforts in palliative care were included. Articles underwent title and abstracts screening, followed by full text screening by two independent researchers. The extracted data was analysed thematically and summarized narratively.

A total of 176 articles were identified through database searches. After screening titles, abstracts, and full texts, eight peer-reviewed academic articles were included in the narrative review. Three major themes emerged regarding sustainability in palliative medicine: (I) conservative and goal-concordant prescribing, (II) minimization of low-value investigations and procedures, and (III) intensity of care and care setting optimization.

The intersection of patient-centered care and planetary health considerations reveal that providing high quality palliative care has the co-benefit of reducing healthcare-associated GHG emissions and resource consumption. By aligning clinical practice with responsible resource stewardship, palliative care can simultaneously enhance patient outcomes and reduce the environmental footprint of healthcare.