Several philosophers claim that the greenhouse gas emissions from actions like a Sunday drive are so miniscule that they will make no difference whatsoever with regard to anthropogenic global climate change (AGCC) and its expected harms. This paper argues that this claim of individual causal inefficacy is false. First, if AGCC is not reducible at least in part to ordinary actions, then the cause would have to be a metaphysically odd emergent entity. Second, a plausible (dis-)utility calculation reveals that such (...) actions have a not-insignificant amount of expected harm. One upshot is that the near-exclusive focus in the literature on AGCC as a collective action problem is too restricted. The paper also provides several moral psychological explanations of why it is so difficult to comprehend individual responsibility with regard to global phenomena, including a reappraisal of Thomas Nagel’s view of the absurd. (shrink)

Many of us believe that we can and do have individual obligations to refrain from contributing to massive collective harms – say, from producing luxury greenhouse gas (GHG) emissions; however, our individual actions are so small as to be practically meaningless. Can we then, justify the intuition that we ought to refrain? In this paper, we argue that this debate may have been mis-framed. Rather than investigating whether or not we have obligations to refrain from contributing to collective action, perhaps (...) we should ask whether we have reason to do so. However, this framing brings challenges of its own, and so we close by asking what problems are generated if we focus on these questions of ‘contributory ethics’. (shrink)

The National Health Service (NHS) was the first healthcare system globally to declare ambitions to become net carbon zero. To achieve this, a shift away from metered-dose inhalers which contain powerful greenhouse gases is necessary. Many patients can use dry powder inhalers which do not contain greenhouse gases and are equally effective at managing respiratory disease. This paper discusses the ethical issues that arise as the NHS attempts to mitigate climate change. Two ethical issues that pose a barrier to moving (...) away from metered-dose inhalers are considered: patients who decline an inhaler with a smaller carbon footprint and increased cost. I argue that while a patient is not morally justified in refusing a more environmentally sustainable inhaler due to the expected harms, a doctor may still prescribe a metered-dose inhaler if they believe that switching without consent might undermine trust or substantially worsen the patient’s health. Turning to cost, I argue that the imperative to combat climate change means the NHS should accept small increased financial costs for lower carbon inhalers, even though this provides no additional direct benefit for the patient. I then go on to consider the implications of the preceding analysis for policy and practice. I argue for a policy that minimises the impact of inhalers on the climate by advocating for a principle of environmental prescribing and explore decision-making in practice. While the arguments here pertain primarily to inhalers, the discussion has broader implications for debates around healthcare’s responsibility to be environmentally sustainable. (shrink)