Climate Warriors are Colonising Medicine

This week, the Royal College of Physicians (RCP) published a ‘Green Physician Toolkit‘. The toolkit from perhaps the world’s oldest professional organisation, founded by royal charter in the early 16th century, has caused an eruption of incredulous comment. Controversy has been created by the fact that, as well as the planet-saving advice such as “Generate less waste” and “Limit the environmental impact of travel”, the toolkit suggested doctors “Reduce unnecessary prescribing” and “Limit diagnostic activities”. Journalists have been asking whether the RCP is asking doctors to put green ideology before care. But worse, the toolkit is evidence of a deadly virus spreading throughout professional institutions. This vicious pathogen erodes professional standards and ethics and dissolves institutions’ founding principles.

The idea of a climate “toolkit” for doctors may sound familiar. That’s because it’s not a new idea. Earlier this year the WHO published precisely the same thing – a “toolkit” that the WHO claimed is “designed to equip health and care workers with the knowledge and confidence to effectively communicate about climate change and health”. But the toolkit seemed more designed for GCSE students than for people with advanced degrees in medicine. Trite, condescending, shallow in detail and containing conjecture in place of fact, the WHO’s missive was an injunction – holy green orders – to proselytise. And now it seems that the RCP has done the WHO’s bidding.

There is not much more to say about the RCP’s reproduction of the WHO’s toolkit itself that has not already been said. Suffice it to say that if doctors are running too many diagnostic tests, or prescribing drugs unnecessarily, then these are problems in their own right, and the doctor’s first and only duty is towards the patient’s health, not the planet’s “health”, which should be of no concern to doctors and nurses, nor their managers. The tension between these two putative beneficiaries of clinicians’ work speaks to the antagonism posited by environmentalism between “Nature” and humanity. On the green view, industrial and economic development, which have indubitably raised living standards, are unsustainable at current rates. The greater good can only be served by limiting or reversing that development. And that has to have consequences for human welfare. In other words, the WHO’s and RCP’s toolkits really are a green utilitarian ‘greater good’ injunction to begin rationing medicine for Gaia’s benefit. That tension is intractable.

Here on the Daily Sceptic, our in-house doctor advises that most physicians will simply ignore the RCP toolkit. But the danger, he adds, is in the institutional capture made possible by just a small number of administrators, and perhaps people with clinical expertise, taking the WHO and RCP’s work at face value. Already, notes the doctor, the Royal College of Psychiatrists (RCP2) and the General Medical Council (GMC) have made climate interventions. And the problem must be taken seriously: institutional capture cannot be challenged by doctors merely ignoring their colleagues’ cult-like behaviour. And the RCP2 and GMC are not the only institutions of medicine that are now annexes of the Green Blob.

Founded in 1823, the Lancet is yet another British medical institution. Though it is privately owned, it is a prestigious weekly journal that publishes research and commentary on a range of public policies, sometimes only very loosely connected with medicine. According to its Editor Richard Horton, “the climate emergency that we are facing today is the most important existential crisis facing the human species”. It is nonsense, of course. There is no science, for example, produced by the Intergovernmental Panel on Climate Change to support the claim that climate change is an “existential crisis”, much less evidence showing how that crisis compares to other risk factors. Even the RCP’s toolkit, for example, claims that globally, climate change “is projected [by the IPCC] to cause an excess of 250,000 deaths per year by 2050”. A quarter of a million deaths each year is certainly nothing to be blasé about. But on a global scale, how does it compare to other risk factors? Data on mortality risk compiled by Oxford University’s Our World in Data website put that figure into perspective.

The IPCC itself says those annual deaths in 2050 will be caused by “heat, undernutrition, malaria and diarrheal disease”. Horton is simply wrong. Grotesquely wrong. And the IPCC itself is likely also wrong. Deaths from malaria are half what they were in the early 2000s – down by more than three times the IPCC’s estimate of climate-related deaths in 2050. Diarrheal diseases claimed 1.17 million lives in 2021 – a fall of 1.76 million since 1990. That’s seven times the 2050 mortality estimate. 778,091 were killed by nutritional deficiencies in 1980. Mortality from that cause in 2021 was more than two thirds lower, at 222,274 – again, by a multiple of the number of climate-related fatalities predicted for 2050. And even if one could make an argument that climate change could negatively influence such grim statistics, the fatalities attributed to Nth-order effects of climate change are much lower-order consequences of poverty. Solve the problem of poverty – a far better understood and far less intractable ‘problem’ than climate change – and the “existential threat” of climate change goes away.

But is Horton interested in facts, or is the notion of an “existential threat” serving some other purpose? Horton goes on to claim that, “since medicine is all about protecting and strengthening the human species, it should be absolutely foundational to the practice of what we do, every single day”, and so “doctors and all health professionals have a responsibility and obligation to engage in all kinds of non-violent social protest to address the climate emergency”. If Horton was truly interested in human welfare over ideological partisanship, he would surely have commissioned studies showing how the progress of developing and emerging economies in eliminating poverty had been dependent on fossil fuels – including the half of the world’s population that is dependent on synthetic fertiliser, produced from natural gas. But instead, the Lancet produces an annual report called ‘Lancet Countdown‘ which emphasises false, misleading and unscientific claims in order to influence political decisions, rather than inform wider public debate.

Another prestigious organisation is the British Medical Association (BMA) – a trade union for physicians, founded in the early 19th Century – which also publishes a weekly journal, the British Medical Journal (BMJ). And the BMA and BMJ, too, have been on quite a journey from their founding purpose to green ideological activism. In 2016, the two organisations helped to set up the U.K. Health Alliance on Climate Change (UKHACC) – an association of 48 member organisations in healthcare, including the Association of Anaesthetists, the British Dental Association, the Paediatric Critical Care Society and many more.

The UKHACC, though nearly a decade old, and housed at the BMA’s address in Tavistock Square, London, recently became a charitable organisation, but has no shame in explaining its purpose as political lobbying. It published a manifesto in the run-up to the 2024 U.K. General Election and clearly states its intention to “influence decision makers to strengthen policies responding to the climate and ecological crisis”, among other equally questionable things. When the General Medical Council’s (GMC) Medical Practitioners Tribunal Service suspended Just Stop Oil protester Dr. Sarah Benn, following her criminal prosecution, the UKHACC lobbied the GMC, demanding that it “avoid being on the wrong side of history”. The UKHACC appears not to believe that doctors should face any consequences for criminal acts, despite their privileged and respected positions in society.

But what do the doctors, nurses, dentists and other healthcare professionals who are members of the 48 associations that comprise the UKHACC membership think of their representative organisations’ commitment to this political campaigning organisation? Was there a vote? Was there a debate? What happens to members of the BMA itself, or the UKHACC’s membership, who want to disagree? UKHACC boasts that is “an alliance of U.K.-based health organisations representing about one million health professionals”, providing “leadership, and amplifying the voice of health professionals”. But what is the substance of this association?

With no debates, no votes and apparently no deliberation, the “alliance” looks less like an association of people with expertise than something resembling the Midwich Cuckoos – Midwit Cuckolds, perhaps. The alignment of so many professional organisations with such ease should strike us as suspicious.

The point of a professional association, be it teachers, lawyers, architects or clinicians – all of whom have been drawn into the climate wars – is surely to reciprocate and secure the trust that society places in these professionals. They are exceptional, and so held to higher standards by these self-governing organisations of peers. But when we look closely at the work, for example, of the Lancet and its Editor, we find extremely high-pitched rhetoric and unscientific claims where we would expect expertise. Back in 2020, I asked Horton to explain how he had determined that climate change is “the most important existential crisis”, compared with other mortality risks. No reply was forthcoming. I have also exchanged views with doctors defending the Lancet’s, RCP’s and UKHACC’s interventions. Their replies are invariably little more than to call me a “denier”. Their views, then, are no better substantiated than those of a bloke at the pub. And he has a didgeridoo and a dog on a string, the worse for wear on so much cider and ketamine.

The point of the professional association, therefore, seems less about enforcing standards than lowering the standards expected of “professionals”. Rather than vehicles through which peers hold each other to account, putting the reputation of the profession above everything else, the associations have become mechanisms for enforcing political dogma. The goal of professional associations like the RCP now is, in part, to leverage the trust the public places in medical professionals to make green propaganda more likely to be believed. That’s a long way from their original scientific ethos.

The condition of this infection is anomie – “instability resulting from a breakdown of standards and values or from a lack of purpose or ideals”. Only doctors – those who have yet to be infected by it – can stop the spread. But it cannot be stopped by ignoring it and hoping it will get better. Doctors must form their own new associations, to argue that it is enough to be a doctor, and that aspiring to be a planet-saving superhero risks undermining the commitments that doctors make: make doctors doctors again. Physicians, heal thyselves!