Joshua Parker’s article on green inhaler prescribing is important and timely. I agree with much of it, specifically regarding the institutional duty to make climate-friendly changes (from environmentally expensive prescriptions to ‘greener,’ similarly effective ones). The challenge, however, comes in determining how that institutional obligation impacts the rights and duties of patients. In this commentary, I want to offer a friendly alternative to Parker’s view of individual patient obligation, which I suggest is important for reasons that go beyond this one (...) case. Parker’s broad view is that, because metered-dose inhalers (MDIs) emit far more greenhouse gases (GHG) than do dry powder inhalers (DPIs), and the two are equally effective for most patients, the healthcare system should switch most patients on MDIs to DPIs, and the patients have a pro tanto duty to accept this change.1 The problem is that no individual inhaler use causes harmful climate change, and so it is difficult to explain a duty not to use MDIs. It seems that my individual behaviour ‘makes no difference’ to climate change, so familiar more principles have a difficult time justifying a prohibition of such behaviour. Parker’s response to this worry fits into the consequentialist tradition,2 3 as he argues that each individual contribution to climate change causes some amount of ‘expected harm,’ because it contributes a little bit to future climate changes which will cause harm. And since we have a duty to minimise expected harm, we have a duty not to make such small contributions to climate change. I think we should be sceptical of this sort of argument. It makes the most sense if we endorse a bathtub metaphor, in which the atmosphere is like a bathtub, and once it is full, every …. (shrink)

This paper argues that individuals in many high-income countries typically have moral reasons to limit their beef consumption and consume plant-based protein instead, given the negative effects of beef production and consumption. Beef production is a significant source of agricultural greenhouse gas emissions and other environmental impacts, high levels of beef consumption are associated with health risks, and some cattle production systems raise animal welfare concerns. These negative effects matter, from a variety of moral perspectives, and give us collective moral (...) reasons to reduce beef production and consumption. But, as some ethicists have argued, we cannot draw a straight line from the ethics of production to the ethics of consumption: even if a production system is morally impermissible, this does not mean that any given individual has moral reasons to stop consuming the products of that system, given how miniscule one individual’s contributions are. This paper considers how to connect those dots. We consider three distinct lines of argument in support of the conclusion that individuals have moral reasons to limit their beef consumption and shift to plant-based protein, and we consider objections to each argument. This argument applies to individuals in high beef-consuming and high greenhouse gas-emitting high-income countries, though we make this argument with a specific focus on the United States. (shrink)