Restorative Commons as an Expanded Ethical Framework for Public Health and Environmental Sustainability

Abstract

Pollution is currently responsible for 16% of premature deaths worldwide and poses the greatest long-term threat to public health due to the effects of climate change. The current framework of public health cannot justify sustainability measures at an appropriate scale and timeframe to prevent further irreversible damage to the environment. To handle the issue of environmental degradation and its effect on humans, a revised framework for public health that gives more thought and consideration to the non-human environment is required. Restorative Commons theory can bridge environmental ethics and medical ethics by emphasizing the mutual benefits of environmental stewardship to nature and humans. This reflects an expansion of the environmentalist land ethic to a new ‘global health ethic’. In light of this, medicine should engage with the community and the environment, in addition to treating individuals.

KEYWORDS:

• Sustainable healthcare
• restorative commons
• ecology
• public health
• health policy
• global health ethic

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes on contributor

Robert Gurevich is a third year medical student at SUNY Downstate Health Sciences University in Brooklyn, NY. His interest in sustainability began in Brooklyn College, where he majored in Business for Health Professions, following an urban ecology project that involved tracking coyote migrations through green corridors in NYC. Robert later presented at the 2018 National Conference for Undergraduate Research about justifying sustainable healthcare from ethical and business perspectives. At SUNY Downstate, Robert is CFO of the student run Brooklyn Free Clinic, where he is piloting a Produce RX program to improve glycemic control in uninsured diabetics. Eligible patients will receive health education and a subsidized share of a CSA, thus mutually helping farmers and patients.

Notes

1 Which is not to say that greenspace reduces air pollutants overall, rather, there is evidence to the contrary (Markevych et al. 2017).

2 However, Restorative Commons and the three pathways are limited in scope by their focus on high-income countries.