Jan Buts, Assistant Professor, Boğaziçi University
Mona Baker, Affiliate Professor, SHE
Global efforts towards sustainable development have to strike a difficult balance between social, economic, and environmental concerns. In their effort to prevent disease and preserve human life through research and service provision, healthcare services and medical research significantly contribute to the depletion of the earth’s resources, and to environmental pollution. At the same time, climate change, habitat destruction and the ensuing loss of biodiversity may exacerbate existing threats to human health, for instance through the potential increase in zoonotic virus transmission. The double bind that seemingly pits public health against planetary health is further complicated by the fact that the health system’s public mandate in large part depends on the circulation of private capital, thus creating a conflict between conceptions of progress and growth that prioritize either the accumulation of wealth, or the attainment of human well-being. The documents relevant to this subsection of the corpus serve to highlight, and consequently help disentangle, the variety of framings and expectations accrued by the contested terminology surrounding key concepts such as sustainability, growth, care and environment in health and health-related discourses.
Recognizing opportunities to effect positive change in the field of healthcare and beyond depends upon the capacity to discern active and latent constraints that shape our current practices and institutions, and the conceptual frameworks that support them. The process of educating change agents, as envisaged by SHE, must therefore go beyond the formulation of aims and aspirations. It must encourage the critical assessment of current and past discursive articulations of principles and goals that, in their appeal to common sense, gloss over a variety of challenges and contradictions. Future-oriented thinking requires both learners and educators to navigate the complex set of interactions that mediate between abstract ambitions and concrete cases, and the subset of texts included in the OMC that address the topic of environmental sustainability will facilitate this by emphasizing the interplay between conceptual analysis and contextualized understanding. The recognition that considerations of human well-being must balance the conflicting priorities of people, planet and profit should not lead to a complacent acknowledgement of the importance of compromise and consensus. Instead, it should encourage an active appraisal of a variety of narratives and perspectives as strategically motivated choices that are shaped by a set of linguistic, social, and ideological constraints, none of which are exempt from inspection, or impervious to change.
Book-length publications illustrating the evolution of economic thought on sustainability
D’Alisa, G., Demaria, F., & Kallis, G. (2015). Degrowth : A vocabulary for a new era. Routledge.
Meadows, D. L. et al. (1972). The Limits to Growth. Potomac Associates.
Strategic outlines by supranational bodies concerned with public health and the environment
European Commission. (2021). EU Biodiversity Strategy for 2030: Bringing back nature into our lives.Publications Office of the European Union.
World Health Organization. (2017). Environmentally Sustainable Health Systems: a strategic document. WHO Regional Office for Europe.
Academic research on the entanglement of health, well-being, and climate change
Fritze, J. G. et al. (2008). Hope, Despair and Transformation: Climate change and the promotion of mental health and wellbeing. International Journal of Mental Health Systems, 2(13).
Lenzen et al. (2020). The Environmental Footprint of Health Care: a global assessment. Lancet Planet Health, 4, e271–e279.
Reports and recommendations on health and the environment by non-profit civil society organizations
Edger, R. et al. (2020). Healthy Recovery Plan: For a safe and sustainable future. Canadian Association of Physicians for the Environment.
Ruiz, E. (2021). Improve animal welfare to ensure responsible use of antibiotics. Health Care Without Harm.
Advocacy and publicity produced by individuals and activist networks on health and the climate
Andrews, C. et al. (2021). Letter to JP Morgan. Doctors for Extinction Rebellion
Hickel, J. (2020). Degrowth: a response to Branko Milanovic. Jason Hickel.
POTENTIAL MA/MD PROJECTS
The corpus can be used to address one or more of the following questions as the focus of an MA or MD dissertation. SHE will undertake the responsibility to locate a suitable supervisor in each case.
- How is the environment conceptualized in the corpus? In medical discourse, environmental factors are often seen as a potential determinant of disease. In this sense, our surroundings are framed as a reservoir of pollutants and microorganisms that necessitate the containment of people, or of the perceived dangers themselves. The environment is also perceived as increasingly hostile in the context of climate change, particularly in relation to phenomena such as droughts, floods and food scarcity. Since environmental threats and the health impacts they entail manifest unequally across the globe, social movements are increasingly calling for environmental justice. How is this agenda framed in the corpus, and what does it involve? While the environment often figures in the corpus data as a destructive force, there is also a large number of texts concerned with environmental protection which seem to envisage the biosphere as a more passive and fragile domain. How do such conflicting ideas play out on the textual level, and can they be properly contextualized with reference to the Anthropocene, or the era in which humans affect and are affected by the changing ecosystem in equally unpredictable measure? What does the corpus tell us about the ideological and situational factors that determine whether the environment is presented as something that should be sustained, or something that should provide sustenance?
- Over the last century, humanity has seen astounding economic growth and population growth, the latter in no small part due to significant advances in medicine. Yet, what other types of growth are imaginable, are different types of growth necessarily compatible, and is growth always considered to be a positive evolution? Industrial and urban growth, for instance, is putting remarkable strain on social cohesion, as well as on our lifeworld, and the corpus features numerous voices that critique the quest for ever-extending economic activity, as the current rate of extraction and exploitation is increasingly considered unsustainable. Degrowth, or the reduction of economic activity, has therefore come to figure as a prominent theoretical alternative to our current model of indefinite expansion. Based on the corpus data, can one identify recurrent priorities in the argument for degrowth? Who, for instance, are the envisaged actors that might set this process in motion? Who or what are considered antagonistic forces, and what obstacles need to be overcome? Which industries seem to attract particular attention, and what is the envisaged role of the healthcare sector in the degrowth model? Finally, growth is often conceptually connected to terms such as progress and development. Are such notions also subject to critique and revaluation, and if so, how are alternatives articulated?
- Health is a state of the whole. In the human body, for instance, one can neither rigidly separate the health of the digestive, the respiratory and the circulatory system, nor the fitness of the physical and mental components that constitute a person. Human bodies are in symbiotic relationships with a variety of organisms ranging from bacteria to fungi, and in turn are embedded in a complex network of flora, fauna, and inanimate aggregates that make up our habitat. Healthcare, therefore, can extend beyond providing aid to a particular patient to concern for the set of relationships that sustain the permeable boundaries of the body, of society, and of the natural world. The capacity to care, in this sense, depends upon the perception of continual interactions, both hostile and hospitable, between and beyond organisms from an ecocentric rather than anthropocentric perspective. In contradistinction to this view, the spatiotemporal boundaries of modern healthcare interventions seem to be carefully guarded, as attested in the corpus data: healthcare providers employ healthcare professionals in healthcare facilities, which are conceptualized as the proper place for medical intervention. Yet what, in essence, constitutes a healthcare setting, and what are the risks of conceptually circumscribing the proper place and time for care?