Doctors must engage in climate change action

By Barbara Sibbald | CMAJ | Aug. 22, 2016

Dr. James Orbinski urged the CMA to establish a standing committee on health and climate change during his keynote address. (Photo credit: Barbara Sibbald)

The spread of Lyme disease. Record high temperatures for two years running. Massive wild fires. All have affected the health of Canadians and all are related to climate change, argued international humanitarian Dr. James Orbinski in his keynote address at the Canadian Medical Association (CMA) annual meeting today.

Doctors have a professional responsibility to get involved, said the University of Toronto professor who cofounded  Médecins Sans Frontières Canada (1991) and Dignitas International.

“CMA showed enormous engagement until around 2010.” In 2009, CMA contributed to the World Medical Association policy on climate change and then developed its own action plan.

“The time now is ripe for an even stronger assertion and an even stronger engagement.” He urged CMA to establish a standing committee on health and climate change that would allow members and experts to advocate for health-in-all-policies strategies, including economic and energy policies.

The CMA could also help individual physicians address climate change in their practices and communities by giving them the resources and support to weigh in on issues such as urban planning, water usage and public transit.

“As clinicians, we need to see and accept that this isn’t clinical or public health — it’s both,” said Orbinski. “We need to engage at the local community level. It’s part of our professional responsibility and we need to bring that into our daily practice.”

“No one action will change the reality of the problem,” he added. ”It requires collective action.”  Projected on the screens beside him was a call to phase out coal, leave 80% of fossil fuels in the ground, stop fracking and bolster educational materials and policy perspectives.

“It’s time for the CMA to step out and step up, to be genuinely courageous.”

Following his keynote, which garnered a standing ovation, the 265 delegates from the provincial and territorial medical associations voted overwhelmingly in favour of the CMA board of directors developing a policy on climate change.

As clinicians, we need to see and accept that this isn’t clinical or public health — it’s both.

“We understand this is a really important issue for Canadian physicians and we’re reviewing our role going forward,” said CMA President Dr. Cindy Forbes. “We can’t ignore climate change and its severe impact on individual and planet health.”  By next year’s annual meeting, CMA will be “well on its way to establishing a new role in dealing with climate change.”

“This is not an academic question anymore,” said Dr. Ewan Affleck, a delegate from Yellowknife who pushed CMA to act on climate change. Two years ago, Yellowknife was shrouded in smoke and almost evacuated. There were respiratory and mental health problems.  There have always been forest fires, he allowed, but the scope and frequency have changed.

“Canada is affected disproportionately,” said Orbinski. The rate of global warming is about twice what it is elsewhere. “This has profound implications for virtually all domains of our society.” Those implications include loss of permafrost, wild fires, heat waves, ice melt and storm surges.

The 2015 United National Climate Change Conference in Paris set a goal of limiting rising global temperatures to 1.5 degrees, but with the rapid acceleration of climate change, that “threshold will be impossible to meet,” said Orbinski.

Canadians are baffled by science, paralyzed by fear, and “that combination leads to inertia, to the inability to act appropriately,” Orbinski told delegates, as he urged CMA to take a leading role.

The CMA, which represents 83 000 physicians across Canada, is holding its annual meeting in Vancouver, Aug. 21–24.

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