In past columns, I have mentioned my penchant for science fiction. For me, this genre of literature is a refuge from a world that seems at times to be hellbent on rushing toward nonsensical decisions, followed by actions unfettered or burdened by overwhelming facts and evidence that would suggest a different course. Moreover, I perceive that facts and the science used to derive them appear to be under assault by numerous political and economic interests with agendas that seem to benefit a privileged minority in this country. This is not the case in my science fiction novels, where decisions and actions concerning humanity are tethered to the unyielding realities of physics and science, and what you can prove experientially trumps what you believe every time.
Interestingly, when I surf the internet concerning this topic, I come across a variety of opinions that would suggest I am not alone in my concern over the assault on scientific knowledge. Anne Applebaum, a Washington Post editorialist who was commenting on the Trump administration, began her essay with the statement, “We live in an age that denigrates knowledge, dislikes expertise and demonizes experts.” Tom Nichols, a U.S. Naval War College professor, wrote in his book “The Death of Expertise,” “Americans have reached a point where ignorance—at least regarding what is generally considered established knowledge in public policy—is seen as an actual virtue.”
One does not have to look far within the current headlines for examples where hard science is discounted in favor of “alternative facts” that support a particular myopic, albeit personally lucrative, point of view. From my perspective, one of the clearest examples of this trend is the ongoing denial of the existence of climate change driven by human activity from burning fossil fuels on this planet; many leaders in politics and business continue to cling to that view despite the crushing preponderance of science that states otherwise.
If you are a healthcare provider, climate change is no joke. The World Health Organization in the publication, “Climate Change and Health,” outlines a number of health-related consequences tied to climate change. The key facts outlined in this manuscript are quoted as follows:1
- Climate change affects the social and environmental determinants of health—clean air, safe drinking water, sufficient food and secure shelter.
- Between 2030 and 2050, climate change is expected to cause approximately 250,000 additional deaths per year from malnutrition, malaria, diarrhea and heat stress.
- The direct damage costs to health (i.e., excluding costs in health-determining sectors such as agriculture and water and sanitation), is estimated to be between $2 to $4 billion/year by 2030.
- Areas with weak health infrastructure—mostly in developing countries—will be the least able to cope without assistance to prepare and respond.
- Reducing emissions of greenhouse gases through better transport, food and energy-use choices can result in improved health, particularly through reduced air pollution.
As a healthcare professional, I have always believed I had a responsibility to represent the science of any health issue to my patients as dispassionately and accurately as possible. If science was not important, why did I invest a decade of my life slogging through biology, chemistry, math and physics for a medical degree as many would-be health professionals are doing today? We employ this science knowledge to assist our patients in making life-altering (possibly even ending) decisions concerning their health and the therapeutic options they employ.
Occasionally the science is ignored by the healthcare consumer and the consequences of this decision are often brutally unforgiving. Even a personality as brilliant and wealthy as the Apple CEO, Steve Jobs, is not immune to ignoring the best medical evidence. Before his death, he apparently regretted his decision to avoid the recommended surgery for his pancreatic cancer in favor of therapies with little to no supporting evidence for his diagnosis.
I have no issue with a patient making a choice concerning their individual health outside of my recommendations, once they have digested the best science. I do take issue with politicians and business interests making decisions concerning the climate that impact on my personal health, my children’s health and their children’s health.
As healthcare professionals, we depend on science and the empirical evidence it provides to effectively care for our patients. The science for climate change and the negative impact it will have on humanity’s health on this planet is as least as compelling as any science concerning medicine I have used to advise patients on their personal health.
I am convinced that, in order to be a good clinician for my patients, I have to be an active advocate for and consumer of science. That science advocacy, from my perspective, has to include all aspects of scientific endeavor that may impact on patient health to include the health impact of their environment. I believe climate change is the most significant challenge to the future health of humanity, therefore I feel this has to be a primary issue for the health community, if for no other reason than it promotes health in our patients.
Science is our tool to keep charlatans, medical or otherwise, at bay. I have and will remain an active proponent on the science of this issue, since it is in my patients’ self-interest (not to mention my own). Furthermore, I will resist the positions and activities of those that denying climate science for personal gain. I recommend consumers of this editorial, interested in health, do the same.
1http://www.who.int/news-room/fact-sheets/detail/climate-change-and-health. Accessed July 13, 2018.