Hippocrates4future – a planetary health pledge proposal

In 1948, the Declaration of Geneva was passed by the recently founded World Medical Association, aiming to promote ethical principles underpinning medical practice worldwide. It was grounded in the thinking and practice of the Greek physician Hippocrates and aims to serve as a universally valid set of principles to which doctors should adhere.

Reciting the Declaration with her fellow graduates at the Medical Faculty of Tübingen, Germany in 2018, was a significant moment for Dr Katharina Wabnitz, the lead author of a recently published commentary in The Lancet: “A pledge for planetary health to unite health professionals in the Anthropocene” (DOI: https://doi.org/10.1016/S0140-6736(20)32039-0). This experience sparked the idea of formulating a new pledge, which is broader in scope and audience and engages not only doctors but all health professionals in protecting the health of people and planet.

Health professionals are among the most trusted members of society. In particular, family doctors can play a crucial role in igniting and becoming agents themselves of individual and systemic transformative changes. These changes include a shift from the current predominant focus on acute care to promoting and protecting the health of people and the state of natural systems that underpin the latter through a life-course and intergenerational approach to health and a focus on primary prevention. The authors of this pledge emphasise its suggestive character, published to be used in graduation ceremonies and other events but also to spark further discussion and development of adapted versions to fit local and institutional purposes. We hope that this contribution will be a powerful tool to spark individual and collective action for planetary health.

A Planetary Health Pledge for health professionals in the Anthropocene I SOLEMNLY PLEDGE to dedicate my life to the service of humanity, and to the protection of natural systems on which human health depends. THE HEALTH AND WELL-BEING of people, their communities and the planet will be my first consideration and I will maintain the utmost respect for human life; as well as reverence for the diversity of life on Earth. I WILL PRACTISE my profession with conscience and dignity and in accordance with good practice; taking into account planetary health values and principles. TO DO NO HARM, I will respect the autonomy and dignity of all persons in adopting an approach to maintaining and creating health which focuses on prevention of harm to people and planet. I WILL RESPECT AND HONOUR the trust that is placed in me and leverage this trust to promote knowledge, values, and behaviours that support the health of humans and the planet. I WILL ADVOCATE for intra- and intergenerational equity and justice regarding health and our common habitat by supporting and protecting the systems underpinning a viable planet now and in the future. I WILL ACKNOWLEDGE AND RESPECT diverse sources of knowledge and knowing regarding individual, community, and planetary health such as from Indigenous traditional knowledge systems while challenging attempts at spreading misinformation that can undermine planetary health. I WILL SHARE AND EXPAND my knowledge for the benefit of society and the planet, and I will advocate for and actively promote transdisciplinary and inclusive work to achieve individual, community, and planetary health. I WILL ATTEND to my own health, well-being, and abilities in order to provide care of the highest standard; acknowledging that this requires maintaining the vitality of our common home. I WILL STRIVE to be a role model for my patients and society by embodying planetary health principles in my own life. I WILL NOT USE my knowledge to violate human rights and civil liberties, even under threat; recognizing that the human right to health necessitates maintaining planetary health. I MAKE THESE PROMISES solemnly, freely, and upon my honour. By taking this pledge, I am committing to a vision of personal, community and planetary health which will enable the diversity of life on our planet to thrive now and in the future.