Kar Ankita, Pant Apourv, Shah Rahul
Oral Medicine and Radiology, Indian Council of Medical Research, Assam, IND.
Bioethics, Indian Council of Medical Research, Bengaluru, IND.
Cureus. 2024 Sep 27;16(9):e70342. doi: 10.7759/cureus.70342. eCollection 2024 Sep.
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.
医疗保健部门对全球温室气体（GHG）排放有重大贡献，骨科手术产生大量废物，包括一次性器械和有害物质。这些做法加剧了气候变化和环境退化。本文探讨了骨科手术中废物管理的环境和伦理影响，重点关注可持续做法的必要性。关键方法包括材料回收和再利用、实施闭环供应链以及促进可持续采购。来自亚洲（印度、巴基斯坦、孟加拉国）、非洲和拉丁美洲等不同国家的案例研究突出了医疗废物管理中的挑战和进展，强调了术前废物回收的巨大潜力。伦理考量围绕确保安全的废物处理展开，以保护医护人员、患者和社区，同时维持高标准的护理。这应按照感染控制和生物医学废物处理规程进行。国家和国际伦理准则将讨论扩展到生物医学和健康伦理原则（自主性、 beneficence、不伤害和公正），特别是关于知情同意和医疗设备的再利用。应让患者充分了解环境和废物管理做法，强调透明度和自愿参与。外部固定器的再利用虽然具有成本效益，但引发了关于所有权、安全性和成本透明度的问题。文章强调了在医疗保健中采用环保做法和绿色技术以减轻该部门碳足迹的重要性。诸如节能建筑、可再生能源和全面回收计划等举措至关重要。结论呼吁监管机构和医疗保健组织执行伦理废物管理准则，在具有成本效益的做法与患者自主性和环境责任之间取得平衡。骨科手术中的伦理废物管理对于保护环境和服务提供者以及确保所有相关利益者的福祉至关重要。
