The US healthcare industry emits an estimated 479 million tonnes of carbon dioxide each year; nearly 8% of the country’s total emissions. When assessed by sector, hospital care, clinical services, medical structures, and pharmaceuticals are the top emitters. For 15 years, research has been dedicated to the medical structures and equipment that contribute to carbon emissions. More recently, hospital care and clinical services have been examined. However, the carbon of pharmaceuticals is understudied. This article will focus on the carbon emissions of pharmaceuticals since they are consistently calculated to be among the top contributors to healthcare carbon and assess the factors that contribute to pharmaceutical carbon emissions. Specifically, overprescription, pharmaceutical waste, antibiotic resistance, routine prescriptions, non-adherence, drug dependency, lifestyle prescriptions, and drugs given due to a lack of preventive healthcare will be identified. Prescribing practices have environmental ramifications. Carbon reduction, when focused on pharmaceuticals, can lead to cleaner, more sustainable healthcare.

Approximately 47 percent of women ages fifteen to forty-four are currently without children, and slightly more than 20 percent of white women in America will never bear children, the highest percentage in modern history. Many fertile women who are childless are voluntarily so. Although any competent person twenty-one years or older is legally eligible for voluntary sterilization, many doctors refuse to sterilize childfree women. This essay explores various reasons a woman would want to continue in her childfree lifestyle, evaluates the accessibility of sterilization for women who are childfree by examining the reported reasons for denial of sterilization-both from the woman's and the physician's perspective-and assesses the legal status of voluntary sterilization for nonparous women. The essay also urges physicians to follow recommended guidelines for counseling women who, regardless of parity, desire sterilization and to provide this contraception if, after careful consideration, there are no outstanding health or other reasons that the procedure should not be performed.

Through the use of assisted reproductive technologies (ARTs), multiple children are born adding to worldwide carbon emissions. Evaluating the ethics of offering reproductive services against its overall harm to the environment makes unregulated ARTs unjustified, yet the ART business can move towards sustainability as a part of the larger green bioethics movement. By integrating ecological ethos into the ART industry, climate change can be mitigated and the conversation about consumption can become a broader public discourse. Although the impact of naturally made children on the environment is undeniable, I will focus on the ART industry as an anthropogenic source of carbon emissions which lead to climate change. The ART industry is an often overlooked source of environmental degradation and decidedly different from natural reproduction as fertility centres provide a service for a fee and therefore can be subject to economic, policy and bioethical scrutiny. In this article, I will provide a brief background on the current state of human-driven climate change before suggesting two conservationist strategies that can be employed in the ART business. First, endorsing a carbon capping programme that limits the carbon emissions of ART businesses will be proposed. Second, I will recommend that policymakers eliminate funded ARTs for those who are not biologically infertile. I will conclude the article by urging policymakers and all those concerned with climate change to consider the effects of the reproductive technologies industry in light of climate change and move towards sustainability.

In 2014, the United States health care industry produced an estimated 480 million metric tons of carbon dioxide (CO2); nearly 8% of the country's total emissions. The importance of sustainability in health care — as a business reliant on fossil fuels for transportation, energy, and operational functioning — is slowly being recognized. These efforts to green health care are incomplete, since they only focus on health care structures. The therapeutic relationship is the essence of health care — not the buildings that contain the practice. As such, this article will first postulate reasons for a lack of environmental sustainability in US health care. Second, the article will focus on current green health care initiatives in the United States in which patients and physicians participate. Third, the rationale for participation in green initiatives will be explained. Fourth, the article will propose that, based on the environmental values of patients and physicians, health care insurance plans and health care insurance companies can be targeted for green health care reform, thereby closing the loop of sustainable health care delivery.

Artificial intelligence (AI) can transform health care by delivering medical services to underserved areas, while also filling gaps in health care provider availability. However, AI may also lead to patient harm due to fatal glitches in robotic surgery, bias in diagnosis, or dangerous recommendations. Despite concerns ethicists have identified in the use of AI in health care, the most significant consideration ought not be vulnerabilities in the software, but the environmental impact of AI. Health care emits a significant amount of carbon in many countries. As AI becomes an essential part of health care, ethical reflection must include the potential to negatively impact the environment. As such, this article will first overview the carbon emissions in health care. It will, second, offer five reasons why carbon calculations are insufficient to address sustainability in health care. Third, the article will derive normative concepts from the goals of medicine, the principles of biomedical ethics, and green bioethics—the very locus in which AI in health care sits—to propose health, justice, and resource conservation as criteria for sustainable AI in health care. In the fourth and final part of the article, examples of sustainable and unsustainable development and use of AI in health care will be evaluated through the three‐fold lens of health, justice, and resource conservation. With various ethical approaches to AI in health care, the imperative for environmental sustainability must be underscored, lest carbon emissions continue to increase, harming people and planet alike.