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Reconciling Subsistence Emissions and Prevention in Environmentally Sustainable Healthcare
1Lancaster Medical School, Health Innovation One, Bailrigg, Lancaster, LA1 4YW, United Kingdom. Joshua.parker@doctors.org.uk.
Journal of Bioethical Inquiry
|July 2, 2026
Summary
Decarbonizing healthcare requires balancing emissions reduction with quality care. This study reconciles "subsistence emissions" and "prevention" approaches, arguing that preventing illness is compatible with ensuring a basic level of health for all.
Area of Science:
- Environmental science
- Public health policy
- Healthcare sustainability
Background:
- Healthcare systems globally are committed to reducing greenhouse gas emissions.
- Reconciling emissions reduction with high-quality care delivery presents a policy challenge.
- Two distributive ideals for a just transition to decarbonized healthcare have emerged: subsistence emissions and prevention.
Purpose of the Study:
- To explore the apparent conflict between subsistence emissions and prevention frameworks in healthcare decarbonization.
- To determine if a subsistence emissions approach can accommodate prevention strategies.
- To propose a reconciled framework for fair healthcare decarbonization.
Main Methods:
- Conceptual analysis of two distributive ideals: subsistence emissions and prevention.
- Examination of the ethical and practical implications of each approach.
- Argument for the compatibility of prevention within a subsistence emissions framework.
Main Results:
- The subsistence view permits healthcare emissions necessary for "enough health" and requires mitigation above this threshold.
- The prevention approach prioritizes efficient emissions use by focusing on illness prevention and healthy living.
- A conflict exists as subsistence prioritizes those below the health threshold, while prevention focuses on the relatively well-off.
Conclusions:
- A subsistence emissions approach can ethically and practically incorporate prevention strategies.
- Reconciling these frameworks supports decarbonizing healthcare fairly while ensuring essential health needs are met.
- This integrated approach allows for emissions to be justified for measures preventing individuals from falling below a health threshold.
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