Blog18th November 2025
Ethics is providing a key pivot for deliberation and action at COP30. A further crucial aspect of this year’s COP came in last week’s launch of the Belém Health Action Plan (BHAP): a strategic framework that advances linkages in action on health and climate change. The plan sets out a number of measures that will “strengthen the health sector’s adaptation and resilience to climate change”, such as promoting evidence-based policy making and fostering innovation and sustainable production in the sector.
Significantly, the BHAP itself incorporates two key ethical commitments: first, enhancing health equity and climate justice, and secondly, leadership and governance with social participation. These commitments reflect the need to conjoin consideration of health and the environment. And their framing reflects the need to recognise and respond to doing so as ethical challenges. From questions of substantive fairness, such as the distribution of the burdens of climate change, to issues of procedural justice, such as assuring methods of inclusive and transparent decision-making, ethics is rightly placed on the face of climate and health policy and practice.
The theme of environment and health is one of the Nuffield Council on Bioethics’ priority areas, as set out in our ‘Making Ethics Matter’ strategy. In the environment and health workstream, we are focused on the important—and complex—intersections between health and climate change and the multiple ethical challenges that arise in that space. The umbrella of ‘climate change, health, and ethics’ is very broad. It of course covers questions concerning health systems, health care provision and priorities, and public health. But, insights from our broad-scale review of what it means to embed ethics in health and climate change policy and decision-making show that there is much more to consider. For example, public health is an expansive field that cuts across systems and sectors; we are interested in health beyond human health; we are interested in health impacts of climate (in)action, as well as health rationales for framings of and responses to the climate crisis.
Previous blogs have shed light on some of the ethical considerations at play. Michael Reiss, for instance, systematised the ethical challenges, distinguishing them by reference to, first, climate change itself, secondly, responses to climate change, and thirdly research into responses. And in this piece, Melanie Challenger, my co-chair of the environment and health priority area, challenges fundamental understandings of the meaning and scope of the ‘bio’ in bioethics.
Our current focus in the environment and health priority area is on the research and development of solar radiation modification (SRM): that is, potential methods of reflecting sunlight back from the earth to reduce temperatures. SRM is of interest to UK research funders. But the ethical questions here are not straightforward. At more headline levels, there are questions about whether these interventions are an ethically-sound priority even in theory. And in more grounded ways, there are the sorts of ranging practical questions that come up time and again in relation to agendas concerning climate change and health, including those regarding coordination of action, uncertainty, and unintended consequences.
For my part, as a scholar interested in law, governance, and the philosophy of public health, I am particularly interested in matters of regulation and responsibility. Within this context, I would encourage a broad understanding of who a ‘regulator’ is. Research funders would certainly fall within the term’s embrace as their generation of systems and structures monitor and guide what does and does not happen: they open up, incentivise, disincentivise, and indeed foreclose different opportunities. Then there are researchers themselves, and the distinct sorts of institutions and organisations within which they work. And there are the different actors involved in development, who again operate within distinct structural frameworks, in line with their own constellations of norms, incentive structures, and constraints. On such knotty and multifaceted issues as climate change and efforts to create coordinated responses to it, locating responsibility—including responsibility for oversight and regulation—is a monumental challenge.
Ethical analysis in relation to SRM must rise to this challenge. It is no easy task, but we need to address the structural complexity in this area, ensuring that there is engagement across a fragmented array of societal, governmental, and other parties. The spread and range of actors make consolidated forms of regulation very difficult: both in identifying exhaustively who to include in decision-making and in establishing how to devise effective policies. Ethical analysis requires accommodation of its real-world points of application. For example, there are more and less obvious power imbalances that provide crucial ethical context in the governance of SRM across the disjointed regulatory terrain.
Our work on SRM is at its early stages. We are currently seeking to garner views and insights from ranging perspectives. We need to understand the possibilities and plans for the science in this area, and its potential applied consequences: for better and for worse, including ideas of opportunity cost and addressing uncertainty. Trade-offs are inevitable, as are conflicts in the ethical evaluations of these. With those two key principles of the BHAP (amongst others) firmly in our minds, I look forward to the work ahead and to the Council’s work bringing clarity on the most salient ethical questions raised by SRM as one possible part of humanity’s response to climate change.