# Applying One Health Bioethical Principles to Climate Change: The Planetary Patient Paradigm

## TL;DR

This paper introduces a new ethical framework for tackling climate change by treating Earth as a 'Planetary Patient' and applying One Health and bioethical principles.

## Contribution

The novel contribution is the development of the Planetary Patient paradigm, integrating One Health and bioethics for climate change decision-making.

## Key findings

- The Planetary Patient framework includes dimensions like community autonomy and intergenerational justice.
- Case studies show the framework's practical use in scenarios like coastal relocation and urban heat mitigation.
- The approach supports ethical decision-making through interdisciplinary collaboration and institutional reform.

## Abstract

Background: Climate change represents a contemporary challenge for global health, requiring frameworks that extend beyond traditional anthropocentric approaches. The One Health paradigm offers a comprehensive framework for addressing these interconnected challenges, yet practical, case-based guidance through bioethical applications remains underexplored.

Objective: To develop and apply a novel analytical framework based on One Health frameworks and bioethical principles for addressing climate change challenges, introducing the ethical metaphor of Earth as a "Planetary Patient" requiring ethical care and treatment.

Methods: We employed a conceptual analysis approach, integrating classical bioethical principles within One Health frameworks. The methodology involved a structured narrative review, principle mapping, case study application, and iterative framework refinement to develop a comprehensive analytical tool for climate health issues.

Results: The theoretical Planetary Patient paradigm provides a structured dimensional approach for evaluating climate interventions: (1) autonomy and self-determination of communities, (2) beneficence and non-maleficence across domains, and (3) justice risk distribution and concepts of intergenerational responsibility. Case study applications demonstrate practical utility across diverse scenarios, including coastal relocation, urban heat mitigation, and agricultural adaptation.

Conclusions: This framework demonstrates how One Health and bioethical principles can be cohesively integrated and systematically applied to the challenges of climate change, offering a practical tool for ethical decision-making in climate adaptation and mitigation efforts. Implementation requires interdisciplinary collaboration and institutional reform but provides significant advantages for comprehensive climate action.