Managing greenhouse gas emissions in the terminal year of life in an overwhelmed health system: a paradigm shift for people and our planet

Myles Sergeant; Olivia Ly; Sujane Kandasamy; Sonia S Anand; Russell J de Souza

doi:10.1016/S2542-5196(24)00048-2

Managing greenhouse gas emissions in the terminal year of life in an overwhelmed health system: a paradigm shift for people and our planet

Lancet Planet Health. 2024 May;8(5):e327-e333. doi: 10.1016/S2542-5196(24)00048-2.

Authors

Myles Sergeant¹, Olivia Ly¹, Sujane Kandasamy², Sonia S Anand³, Russell J de Souza⁴

Affiliations

¹ Department of Family Medicine, Michael G DeGroote School of Medicine, Hamilton, ON, Canada.
² Department of Child and Youth Studies, Brock University, St Catherine's, ON, Canada.
³ Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada; Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada; Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON, Canada. Electronic address: anands@mcmaster.ca.
⁴ Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada; Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON, Canada.

PMID: 38729672
DOI: 10.1016/S2542-5196(24)00048-2

Abstract

Health care contributes 4·4% of global net carbon emissions. Hospitals are resource-intensive settings, using a large amount of supplies in patient care and have high energy, ventilation, and heating needs. This Viewpoint investigates emissions related to health care in a patient's last year of life. End of life (EOL) is a period when health-care use and associated emissions production increases exponentially due primarily to hospital admissions, which are often at odds with patients' values and preferences. Potential solutions detailed within this Viewpoint are facilitating advanced care plans with patients to ensure their EOL wishes are clear, beginning palliative care interventions earlier when treating a life-limiting illness, deprescribing unnecessary medications because medications and their supply chains make up a significant portion of health-care emissions, and, enhancing access to low-intensity community care settings (eg, hospices) within the last year of life if home care is not available. Our analysis was done using Canadian data, but the findings can be applied to other high-income countries.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Canada
Greenhouse Gases* / analysis
Humans
Terminal Care*