{
  "abstract": "There is a common presumption that disease prevention can play a central role in reducing healthcare’s carbon footprint.1 2 Cristina Richie3 concludes that, on the contrary, there is a ‘paradox of prevention’ i: preventive healthcare saves carbon emissions ‘proximally’ by reducing health needs but increases carbon emissions over time by extending lifespans. While I agree with Richie on the preliminaries—big polluters do have a responsibility to lead, healthcare systems can act without compromising patient careii and intranational health disparities should receive greater attentioniii—I reject the characterisation of the ‘paradox of prevention’. Wrapped up here is a complex set of issues, both empirical (ie, how does prevention impact emissions in practice, both in the near term and long term) and ethical (ie, how to consider incommensurable benefits for health and climate). I will first describe the ambiguity of ‘prevention’ in Richie’s argument and then unpack the paradox.",
  "authors": [
    {
      "affiliations": [
        "Bergen Centre for Ethics and Priority Setting in Health (BCEPS), Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway"
      ],
      "name": "Anand Bhopal"
    }
  ],
  "title": "Unpacking the ‘paradox’ of disease prevention and environmentally sustainable healthcare: a response to Richie",
  "uid": "cb00879b-0a96-5bf2-b409-7cfd3c8569c8"
}