Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Global Health Academy, University of Edinburgh, Edinburgh, Scotland.
Yale J Biol Med. 2023 Jun 30;96(2):257-260. doi: 10.59249/RTYB9681. eCollection 2023 Jun.
The climate crisis is a planetary existential threat, disproportionately affecting the poorest populations worldwide. People in low- and middle-income countries (LMICs) experience the most detrimental consequences of climate injustice, endangering their livelihoods, safety, overall wellbeing, and survival. Although the 2022 United Nations Climate Change Conference (COP27) put forth several internationally salient recommendations, the outcomes fall short to efficiently tackle the suffering that exists at the intersection of social and climate injustice. Individuals with serious illness living in LMICs have the highest burden of health-related suffering globally. In fact, more than 61 million people experience serious health-related suffering (SHS) each year that is amenable to palliative care. Despite this well-documented burden of SHS, an estimated 88-90% of palliative care need is unmet, the majority in LMICs. To equitably address suffering at individual, population, and planetary levels in LMICs, a palliative justice approach is crucial. The interplay of human and planetary suffering requires that current planetary health recommendations be expanded to incorporate a whole-person and whole-people perspective that recognizes the need for environmentally conscious and community-based research and policy initiatives. Conversely, palliative care efforts should incorporate planetary health considerations to ensure sustainability in capacity building and service provision. In sum, the optimal health of the planet will remain elusive until we can holistically recognize the value of relieving all suffering due to life-limiting conditions, as well as the value in preserving the natural resources of countries in which all people are born, live, age, suffer, die, and grieve.
气候危机是对地球存在的威胁，它不成比例地影响着全世界最贫困的人口。中低收入国家（LMICs）的人民遭受着最严重的气候不公后果，危及他们的生计、安全、整体福祉和生存。尽管 2022 年联合国气候变化大会（COP27）提出了几项具有国际重要意义的建议，但这些成果远远不足以有效解决社会和气候不公交叉点所存在的苦难。生活在 LMICs 的患有严重疾病的个人承受着全球与健康相关的苦难的最大负担。事实上，每年有超过 6100 万人经历可通过姑息治疗缓解的严重健康相关苦难（SHS）。尽管有明确记录的 SHS 负担，但估计有 88-90%的姑息治疗需求未得到满足，其中大部分在 LMICs。为了在 LMICs 的个人、人口和行星层面公平地解决苦难，姑息正义方法至关重要。人类和行星苦难的相互作用要求当前的行星健康建议扩大范围，纳入一个整体人的和整个人群的视角，认识到需要进行有环境意识和以社区为基础的研究和政策举措。相反，姑息治疗工作应该纳入行星健康考虑因素，以确保能力建设和服务提供的可持续性。总之，只有当我们能够全面认识到减轻所有因生命限制条件而产生的苦难的价值，以及保护所有人生存、生活、衰老、受苦、死亡和悲伤的国家的自然资源的价值时，我们才能实现地球的最佳健康。
