Ecological Medicine Statement

Ecological Medicine: A Call for Inquiry and Action

February 2002

Ecological Medicine is a new field of inquiry and action to reconcile the care and health of ecosystems, populations, communities, and individuals.

The health of Earth's ecosystem is the foundation of all health. Human impact in the form of population pressure, resource abuse, economic self-interest, and inappropriate technologies is rapidly degrading the environment. This impact, in turn, is creating new patterns of human and ecosystem poverty and disease. The tension among ecosystem health, public health, and individual health is reaching a breaking point at the beginning of the Twenty-First Century.

Public health measures, education, and medical advances have significantly reduced death and disease in many parts of the world, but some advances come at considerable cost, and the benefits are not equally distributed. Public health systems charged with creating healthful conditions for all have suffered in competition with technologically intensive health care aimed at individual consumers. Health care systems struggle to keep up with the changing patterns of disease that result both from a rapidly changing and degraded Earth and from the way people live. New and old diseases spread with increasing speed within and across national borders. Meanwhile, industrially based medicines and technologies that heal also contribute to the growing burden of environmental toxins in people, air, water, fish, animals, and plants. (See "The Case for Ecological Medicine")

Healing disciplines and movements of public health, ecology, conventional medicine, complementary and alternative medicines, conservation medicine, conservation biology, and campaigns such as Health Care Without Harm have sought to address this cycle of conflict among individual health, public health, and ecosystem health in different ways. Ecological Medicine honors these contributions and builds upon them. Ecological Medicine invites the biomedical community, ecologists, scientists, activists, and individuals who are concerned for personal health as well as the health of communities and future generations to learn from each other and to embrace a balanced, ecological approach to sustaining health.

Ecological Medicine integrates the following concepts and values:

• Interdependence. Each of us is deeply connected with Earth's ecosystems; each of our lives is only a moment in the grand scale of time. Ultimately, we all depend on the health of the global community and of Earth's biosphere for our own health and happiness. Individuals cannot live healthy or happy lives in poisoned ecosystems and unhealthy communities. By the same token, healthy communities and biological systems depend on human restraint and responsibility in technologies, population, production, and consumption.
• Resilience. Health in humans and ecosystems is not a steady state but a dynamic one marked by resilience. Both medicine and ecosystem science and management should focus on promoting and restoring the innate ability of biological systems to protect themselves, recover, and heal. Systems that draw upon or mimic the elegance, economies, and resilience of nature offer promising paths for health care research and development.
• "First, do no harm." Health care should not undermine public health or the environment. This precautionary principle should be applied to decisions affecting the ecosystem, populations, communities, and individuals.
• Appropriateness. "Medicine," in its Greek origins, means "appropriate measures." The goal is to achieve maximal health with minimal intervention, promoting good health that is appropriate to an individual's stage of life without overburdening Earth's life-sustaining processes.
• Diversity. Health is served by diverse approaches, including many traditional healing systems, local adaptations, and indigenous science around the world. Ecological Medicine encourages freedom of medical choice, guided by informed consent and compassionate practice.
• Cooperation. In order to gain knowledge and improve practices, patients should be partners with practitioners, and medical professionals should cooperate with ecologists and other students of the natural world. Health care organizations should be managed with the active participation of the communities they serve, while communities must learn to integrate their welfare with that of their regional ecosystems.
• Reconciliation. Individual health care services should be economically sustainable, equitable, modest in scale, of high quality, noncommercial, and readily available to all. Societies should build and maintain infrastructures that assure all citizens the capability to meet basic needs such as health, nutrition, family planning, shelter, and meaningful work while minimizing harm to the Earth. Societies should increasingly devote their material and creative resources to policies and projects that restore and maintain the health of biological and human neighborhoods. All efforts to improve human welfare must be conducted within a cooperative framework established by the health of the Earth.

Ecological Medicine sounds an urgent call to action. Understanding the ominous changes in the biosphere compels us to act, individually and collectively. Whether it is in the way we build clinics and hospitals; make, grow, and use medicines; choose areas for scientific study; communicate across disciplines; conduct public health services globally and in particular communities; or choose the means of maintaining our own health, we must do so with a commitment to enhancing life on this planet.

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Signatories

Kenny Ausubel	Founder, Bioneers*
Janine M. Benyus, Natural Sciences Writer and Author, Biomimicry: Innovation Inspired by Nature	The Biomimicry Guild*
Charlotte Brody, RN, Executive Director	Health Care Without Harm
Gary Cohen, Executive Director	Environmental Health Fund*
Tracey Easthope, MPH, Director	Environmental Health Project, Ecology Center
Kathy Gerwig, Director	Environmental Stewardship and National Environmental, Health, and Safety Operations Kaiser Permanente
Tom Goldtooth	Indigenous Environmental Network*
Robert M. Gould, MD	Physicians for Social Responsibility
Louis J. Guillette, Jr., PhD, Distinguished Professor of Zoology	University of Florida
Andrew Jameton, PhD, Professor	Department of Preventive and Societal Medicine
John M. Last, MD, Emeritus Professor of Epidemiology	University of Ottawa
Michael Lerner	Commonweal
Michael McCally, MD PhD, Professor of Public Health and Preventive Medicine	Oregon Health and Sciences University
Laurie Monti, PhD, Assistant Professor	Ecological Restoration Institute Northern Arizona University
Nancy Myers, Communications Director	Science and Environmental Health Network*
Gary Nabhan, PhD, Director	Center for Sustainable Environments Northern Arizona University
Jonathan A. Patz, MD MPH, Director	Program on Health Effects of Global Environmental Change Department of Environmental Health Sciences Johns Hopkins University, Bloomberg School of Public Health
Carolyn Raffensperger, MA JD, Executive Director	Science and Environmental Health Network*
Eric Rasmussen, MD FACP, Commander	Medical Corps, U.S. Navy Adjunct Professor of Public Health San Diego State University Carebridge*
Satinath Sarangi, Managing Trustee	Sambhavna Trust* Bhopal (India) People's Health and Documentation Clinic
Ted Schettler MD, MPH, Science Director	Science and Environmental Health Network*
Julia Walsh, MD DTPH, Adjunct Professor	Maternal and Child Health and International Health University of California, Berkeley Bay Area International Group*
Mark Jerome Walters, DVM	Harvard Medical School
Peter Warshall	Peter Warshall and Associates
*represents organization's endorsement. Other affiliations are for identification only.