Ethical Considerations in the Management of Orthopedic Surgery Waste: Balancing Environmental Protection and Participant Safety.

The healthcare sector significantly contributes to global greenhouse gas (GHG) emissions, with orthopedic surgery generating substantial waste, including single-use devices and hazardous materials. These practices exacerbate climate change and environmental degradation. This article explores the environmental and ethical implications of waste management in orthopedic surgery, focusing on the need for sustainable practices. Key approaches include recycling and reusing materials, implementing closed-loop supply chains, and promoting sustainable procurement. Case studies from various countries, such as Asia (India, Pakistan, Bangladesh), Africa, and Latin America, highlight the challenges and progress in managing medical waste, emphasizing the substantial potential for recycling preoperative waste. Ethical considerations revolve around ensuring safe waste handling to protect healthcare workers, patients, and communities while maintaining high standards of care. This should be done as per infection control and biomedical waste protocols. National and international ethical guidelines extend their discussion to the principles of biomedical and health ethics (autonomy, beneficence, non-maleficence, and justice), especially regarding informed consent and the reuse of medical devices. Patients should be fully informed about environmental and waste management practices, with an emphasis on transparency and voluntary participation. The reuse of external fixators, while cost-effective, raises questions about ownership, safety, and cost transparency. The article underscores the importance of adopting eco-friendly practices and green technologies in healthcare to mitigate the sector's carbon footprint. Initiatives such as energy-efficient buildings, renewable energy sources, and comprehensive recycling programs are vital. The conclusion calls for regulatory bodies and healthcare organizations to enforce guidelines for ethical waste management, balancing cost-effective practices with patient autonomy and environmental responsibility. Ethical waste management in orthopedic surgery is crucial for protecting the environment and the service providers and ensuring the well-being of all stakeholders involved.