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Medicine for the Outdoors

Dr. Paul Auerbach is the world's leading outdoor health expert. His blog offers tips on outdoor safety and advice on how to handle wilderness emergencies.

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Outdoor Medicine and the Environment 2

In the first post on this topic, I put forward a framework of environmental issues that are among those on the forefront of discussion across science, industry, government, and the media. It is increasingly the case that environmental remediation recommendations are topics of great debate, for many reasons. Some reputable authorities do not agree with the proposed causation or acuity of environmental problems. Others astutely observe that some of the solutions proposed, such as diversion of crops for alternative fuels, may contribute to hunger and economic consequences that are more disruptive than expensive fuel, or even the consumption of fossil fuels.

Because the nature and magnitude of environmental changes have only recently come to be recognized, it is difficult to predict the attribution of inevitable to natural cycles, or whether the forces of nature are becoming unbalanced. Some suggest that while human activities have an effect on climate, there is not proof that this affects global temperature. For instance, there may be years during which global temperature declines. Others acknowledge the inevitability of global climate change, but recommend adaptation or geoengineering solutions.23 Opponents of those who predict irreversible global climate change and warming argue that until the precise nature and rate of these phenomena can be established, governments and industries should be tentative and cautious about making expensive policy decisions.24 Still, others point out that by focusing attention on global warming, there is a risk of not properly addressing more important environmental and health issues.

I am increasingly convinced that persons who argue against the magnitude and timing of global climate change are not doing so out of personal interests. They truly believe that our current surge in environmentalism is an over-reaction to a situation that may not be as dangerous as has been proposed. Wherein lies the burden of proof? Is it upon the conservationists, or those who demand data to support initiation of policies and practices with wide-reaching economic consequences? I think it is a shared responsibility. Beyond the data, we must certainly act with common sense.

Certain issues seem to me to be beyond calculated inaction. Developing alternative sources to substitute for fossil fuel consumption is widely supported. How can preservation of fossil fuels be bad, unless in the preservation, man unleashes some greater hardship upon the planet or its inhabitants? We are probably not yet at the stage where we should accept starvation in Africa as a consequence of our attempts to promote ethanol production for automobile fuel, but if we do not find a solution to pumping oil into our tanks, will be be creating even greater misery downstream? Despite the fact that there is almost universal assent and agreement on many issues, politics, economics, and special interests delay progress.

I cannot speak for everyone, but I have an opinion about the response needed from the medical profession. If one believes that there are situations upon which we should soon act, significant behavioral changes will be needed to begin to reverse apparent deleterious trends. Achieving global environmental change requires public and private efforts, led by a massive educational effort that should include all institutions of higher learning, including schools of medicine. By virtue of their knowledge and experience, physicians are rightfully concerned about individual and population health. However, the germs and disease processes with which we have become familiar may not pose as great a threat as what might result from such environmental eventualities as the melting of the polar caps.

It is my feeling that the time has come to broaden what the medical profession (and in particular, those with an interest in wilderness medicine) must learn, expanding awareness by educating physicians about the best environmental science. Given the hypothetical and known links of global climate change to human health, and the increasing concern that this change is accelerating, it is our duty to become informed.

Accordingly, in response to the environmental imperatives, an educational action plan is appropriate for the medical profession. Nelson25 noted about environmental studies, “ . . . the subject matter is all-encompassing. It includes . . . the air, water, minerals, soil, forests, oceans, lakes and rivers, as well as all living things in the seas and on land, the relationship and influence of each on the others, plus economics, politics, religion, culture, and philosophy. And, although we will never know or understand more than a small fraction of the endless intricacies of nature’s works, we can comprehend and learn the general principles that should guide our conduct as a society, if we are to preserve a livable habitat. The proposition is, quite simply, that we must conduct our activities in such a way as to protect the integrity of our ecosystems and their resources. . . ”

23. Foreign Policy Web site. Why climate change can’t be stopped. Accessed December 9, 2007.
24. Botkin DB. Global warming delusions. Wall Street Journal. October 17, 2007;A19.
25. Nelson G. A clean environment and a prosperous economy: can we have both? J Wilderness Med. 1991;2(1):1-6.

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Preview the 25th Anniversary & Annual Meeting of the Wilderness Medical Society, which will be held in Snowmass, Colorado July 25-30, 2008.

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About the Author

Dr. Paul S. Auerbach is the world’s leading authority on wilderness medicine.