A pledge for planetary health to unite health professionals in the Anthropocene

DOI: https://doi.org/10.1016/S0140-6736(20)32039-0

In 1948, the Declaration of Geneva1 was passed as one of the first official acts of the World Medical Association. The Declaration updated the ancient Hippocratic oath and defined ethical principles applicable to the medical profession worldwide.2 Other health professions have similar pledges and oaths that guide their practice, generally based on the four bioethical principles of justice, autonomy, non-maleficence, and beneficence. Over time, these pledges have been updated to account for evolving societal norms, expectations, and challenges,3 and many students and health education institutions use adaptations of the original oath.4, 5 The public commitment to take responsibility for other people’s lives and health at the transition from student to professional is an act of great personal and professional significance.

Current and future generations of health professionals, and the populations they serve, face the challenges of the Anthropocene epoch in which human activity is the main driver of global environmental changes.6 The climate crisis, ocean acidification, and biodiversity loss, among others, are major threats to human health.In response to these challenges, the transdisciplinary field of planetary health has emerged centred on the interconnectedness of human health with the state of all natural systems.8 Planetary health seeks to safeguard the health of present and future generations and promote intergenerational and intragenerational equity and justice.A core objective is to transform human values, behaviours, and societal structures to maintain the “safe and just operating space for humanity” we depend on to thrive.10

Health professionals are among the most trusted members of society.11 We believe that to sustain this trust in the Anthropocene, health professionals need to expand the interpretation of primum non nocere (first do no harm) and beneficence and consider the vitality of the planet as a bedrock for human wellbeing. This approach requires striving for planetary health to truly do no harm. As mediators between science, policy, and practice, and as trained communicators, health professionals are well placed to become agents of individual and systemic transformative changes to increase resilience to environmental changes and reduce the ecological footprint of societies.


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