Cristina Richie
Graduate Student in Christian Ethics
Boston College
Chestnut Hill, Mass. 

In Laudato Si': On Care for Our Common Home, Pope Francis acknowledged that "numerous scientists, philosophers, theologians and civic groups have enriched the Church's thinking" on sustainability.¹ Hospitals and health care organizations may not be an obvious resource for ecological inspiration, but they have been responsible for shaping the contours of sustainability as well. While some Catholic health care organizations have already established measures to mitigate climate change, Laudato Si' challenges all of Catholic health care to reflect the dual concerns for "God's creation and the poor and outcast."² Concretely, two ways this can be achieved are by cutting carbon emissions and reducing water footprints.

Cutting Carbon Emissions
Francis writes, "there is an urgent need to develop policies so that, in the next few years, the emission of carbon dioxide and other highly polluting gases can be drastically reduced " (26). The medical industry is taking stock of their carbon emissions in an effort to curb climate change. In 2009, the Journal of the American Medical Association estimated the carbon output of the health care sector in the United States at 546 million metric tons of carbon dioxide in 2007 alone.³ Hospitals and health care facilities are major contributors to carbon emissions due to electricity, air conditioning, and single-use instruments. Realizing their impact, Catholic organizations have made strides to reduce carbon emissions.

Dignity Health, for example, lays claim to being the first hospital system to join the California Climate Action Registry and voluntarily measures and reports all emissions of greenhouse gases.⁴ Carbon-saving initiatives of Dignity Health include mercury free hospitals, water saving devicesin their facilities, being PVC/DEHP-free since 2005, and utilizing sustainable design energy retrofits. Health care facilities often work from a position of resource abundance, which translates to a large carbon output. But Catholic hospitals and health care facilities are investing in a sustainable future through curbing CO₂.⁵

Pope Francis writes, "Reducing greenhouse gases requires honesty, courage and responsibility, above all on the part of those countries which are more powerful and pollute the most."⁶ Laudato Si' verifies the urgency of cutting carbon emissions in the health care sector. The carbon emissions of the medical industry — from services offered to prescription drugs — must be quantified as systematic policies make strides towards sustainability. A further issue for human health and the environment is water scarcity and use.

Reducing Water Footprints
Almost one fifth of the world's population, about 1.2 billion people, lives in areas where water is physically scarce.⁷ Pope Francis calls us to recognize that "every day, unsafe water results in many deaths and the spread of water-related diseases."⁸ Countless people take the availability of water for granted, but growing recognition of water as a limited commodity is a concern of health care ethics and theological ethics.⁹ Laudato Si' also recognized "in some places there is a growing tendency, despite its scarcity, to privatize [water], turning it into a commodity subject to the laws of the market."¹⁰ The privatization of water comes in many forms like land-ownership rights and corporate buy-outs. Yet, in the developed world, we most often encounter the privatization of water in the form of a plastic, "disposable" bottle, with a significant environmental impact.¹¹ Again, we see Catholic health care organizations leading the way in ethical reflection on the water crisis, water purchase, and consumption.

Catholic Health Initiatives [CHI], based outside of Denver, Colorado, notes "of the estimated 2.7 million tons of plastic used each year to make water bottles, only about 20% of these bottles are recycled." Therefore, CHI decided to eliminate purchasing bottled water at its national offices as a show of solidarity for those without water, and as an environmental action.¹² Hospitals are being asked to address both the health effects of unclean water and the environmental effects of bottled water, even as Laudato Si' indicates water as a global health care issue and an environmental concern. The Holy Father's encyclical may call us to go one step further and eliminate bottled water from all hospitals and health care facilities.

Conclusion
In the 1970s, environmental bioethics made connections between pollution, carbon emissions, and human health.¹³ By 1976, James Gustafson linked ecology, the common good, theology, and health care.¹⁴ Catholic health care has been attentive to the theological imperative to conserve resources through numerous avenues. With the promulgation of Laudato Si', Catholic health care facilities have one more tool in support of their mission to care for people and planet, whether by cutting carbon emissions, reducing water footprints, or the innumerable ways people of good will aspire to care for our common home.

1. Pope Francis, Laudato Si': On Care for Our Common Home (Rome: Vatican Press, 24 May 2014), 7.
2. Francis, Laudato Si',10.
3. Jeanette W. Chung and David O. Meltzer, "Estimate of the Carbon Footprint of the U.S. Health Care Sector," JAMA 302, no. 18 (2009): 1970-1972.
4. Dignity Health, "What's Good for the Patient is Good for the Planet: Other Environmental Partnerships and Initiatives," (n.d.) at http://www.dignityhealth.org/cm/content/pages/Environmental-Focus.asp
5. See Catholic Health Association of the United States and Practice Greenhealth, Environmental Suitability: Getting Started Guide (St. Louis: The Catholic Health Association of the United States, 2010.)
6. Francis, Laudato Si', 169.
7. United Nations Department of Economic and Social Affairs, "Water Scarcity," (n.d.) at http://www.un.org/waterforlifedecade/scarcity.shtml
8. Francis, Laudato Si', 29.
9. Christiana Z. Peppard, Just Water: Theology, Ethics, and the Global Water Crisis (Maryknoll, MD: Orbis, 2014).
10. Francis, Laudato Si', 30.
11. Approximately 17 million barrels of oil equivalent were needed to produce the plastic water bottles consumed by Americans in 2006 alone. Pacific Institute, "Fact Sheet: Bottled Water and Energy: Getting to 17 Million Barrels," (December 2007), 1-2 at 1, at http://pacinst.org//wp-content/uploads/sites/21/2013/04/bottled_water_factsheet.pdf
12. Catholic Health Initiatives, "Environmental Stewardship," 2014, at http://catholichealthinit.org/environmental-stewardship
13. Cristina Richie, "A Brief History of Environmental Bioethics," AMA Journal of Ethics (formerly Virtual Mentor)16, no. 9 (2014): 749-752.
14. James Gustafson, "The Contributions of Theology to Medical Ethics," Perspectives in Biology and Medicine 19, no. 2 (1976): 247-272.

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