New conceptions of nursing ethics rise from the fire of climate change

(Background) In recent years, there have been many excellent APHA presentations on climate change and public health nursing. The right things are being said, but climate mitigation advocates tend to understate systematically the degree and nature of the challenges to public health posed by climate change. Current patterns of fossil fuel use (and the recent semi-failure at Copenhagen) indicate that is likely that we will not be able to mitigate climate change sufficiently rapidly to maintain high levels of public health (not even in developed countries). Greenhouse gas emissions are rising more rapidly than a decade before and action is lagging; there will likely be no comfortable compromise between climate and public health. This likelihood is transformative enough to require changes in professional philosophy. (Project Description) The purpose of this project is to indicate possible new philosophical approaches that may spur more forceful action and enhance our ability to cope. (Lessons Learned) Some elements of nursing ethics are more helpful than found in other public health professions' ethics. But, sufficient climate activism falls outside traditional professionalism. The factors requiring broader action – global scarcity, international injustice, multi-generational needs, fundamental needs for altruism, and the need for concreteness in ethics – are covered here. (Recommendations) We canvass three promising and strikingly different approaches to ethics here (different from professional ethics and different from each other). A Gandhian approach centering on putting oneself publicly at risk for the truth; a Kantian approach that counters the usual purposive or "rational" framework of public health goal setting and evaluation; and a revision of utilitarianism that explicitly includes long term costs to the natural world globally. These approaches are defended as containing promising elements for promoting public health nursing activism regarding climate change.