Q&A with Jessica Pierce: Sustainability in Medical Education

We asked bioethicist Jessica Pierce, author of the chapter “Teaching Doctors to Care for Patient and Planet” in Worldwatch’s EarthEd: Rethinking Education on a Changing Planet, about what motivated her to write about transforming medical schools to face future global challenges.

Many people talk about the importance of environmental education or ecoliteracy. How does your chapter go beyond that?

My chapter is about how medical education needs to evolve to face global realities. But medical education can’t really evolve unless the broader systems of health care and delivery also change. It is impossible for a physician to truly care for patients in sustainable ways, given the systems within which they currently have to work. And all of us, as patients, are also going to need to alter how we think about our own health and health care. So “sustainable health” goes way, way beyond the medical classroom.

What questions do you want medical students and educators to take away from your chapter?

In my chapter, I’ve included some discussion questions for future bioethical courses that address ecological stability and intergenerational justice. Questions could include, for example, “Can you be a responsible physician and yet also be a climate denier? How, if at all, should climate change influence counseling of patients about lifestyle choices?” or “Who is the patient? Is it just the person in front of the doctor, or is it the broader community, the Earth?”

What event or situation changed the way you saw your own connection to the planet?

The way I understand my connection to the planet is a result of numerous small shifts in perspective and moments of learning throughout my life. Backpacking around the southern Sierras with my father when I was a child helped inspire a passion for rocks and trees and wild spaces; seeing an open-air metal transport truck hauling cattle to slaughter in a bitter ice storm in Nebraska fueled my sense of outrage at how we treat other creatures; a devastating flood in my hometown a few years ago gave me an appreciation of what it means to be vulnerable to environmental change; and having a daughter created a feeling of urgency about the future of our planet and the impact of choices we make now on the well-being of our children and their children.

My perspective continues to change every day. My goal is to always remain open to new lessons and new inspirations.

If you were to write another chapter, what would it be about?

I would write a collection of case studies highlighting some of the diverse ethical tensions that arise in trying to balance environmental sustainability with medical care. These could be used as teaching tools for medical students.

For example, you might have a case on reproductive counseling and access to birth control, for family and OB/GYN residents; a case involving antibiotic overprescribing and the growing threat of antibiotic-resistant bacteria; a case highlighting the work of a family doctor who is a climate activist and outspoken advocate of plant-based meal plans; a case exploring the accumulation of anti-depressants in waterways, perhaps involving a marginally appropriate request by a patient for a prescription.


Jessica Pierce is a bioethicist and faculty affiliate at the Center for Bioethics and Humanities at the University of Colorado Anschutz Medical School. She is a contributing author to the Worldwatch Institute’s EarthEd: Rethinking Education on a Changing Planet.

About EarthEd

00-cover-SOTW2017_mg-768x989With global environmental changes locked into our future, what we teach must evolve.

Worldwatch’s EarthEd, with contributions from 63 authors, includes chapters on traditional environmental education topics, such as ecoliteracy, nature-based learning, and systems thinking, as well as expanding the conversation to new topics essential for Earth education, such as character education, social emotional learning, the importance of play, and comprehensive sex education.

Ultimately, only by boldly adapting education do we stand a chance in adapting to our rapidly changing planet.

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