Week Thirteen 4/12/15 to 4/18/15 Sustaining Innovative Environments: Considerations of Time and Scope.

Brazil Rio+20

Sustainability and Innovative Environments

We talked about innovators and change agents in past weeks, so let’s discuss sustainability. Sustainability builds and maintains the conditions to ensure human health and the environment is protected; and living in productive harmony (United States Environmental Protection Agency (EPA), n.d.). This definition comes from the EPA, but the concept still applies to health care. Do we have the materials and resources to acquire and maintain human health?

The United Nations’ drafted 17 sustainable goals (deadline is 2030) and they focused on ending poverty, hunger, and  discrimination against women. It also listed equitable and quality education; ensuring healthy lives through prevention; affordable energy; and sustained economic growth (The Guardian, 2015). These goals would take trillions of dollars. Let me state this more clearly, ending poverty would approximately take 66 billion dollars a year; and sustaining infrastructure (e.g., water, agriculture, power, and transport) would be 17 trillion annually (The Guardian, 2015). The World Health Organization drafted a Health Impact Assessment to determine which health indicators can indicate if we are advancing sustainable development (WHO, 2015). For instance, if we can prevent pollution then pulmonary and cardiovascular diseases may decrease (WHO, 2015).

Sustainability and Death with Dignity

Since Death with Dignity does not exist in the State of Arizona it makes it difficult to have dialogue about sustainability. Looking at states like Oregon, Washington, and Vermont it is important to mimic what they have done to legalize and maintain death with dignity. As time moves on, so does healthcare. It will be imperative the laws reflect these changes. For instance, there may be a day where the definition of physician-assisted death may include nurse practitioners. To date, only physicians can write a lethal prescription (Death with Dignity National Center, 2015).

As stated in previous weeks, I believe sustainability of the Death with Dignity movement hinges upon continued education of the American people, especially in states where this end-of-life option does note exist. Also, bills modeled after the Oregon Death with Dignity Act will help those drafting the bill utilize correct verbiage; and  (most importantly) Oregon has years of data to prove its safely enforced (Death with Dignity National Center, 2015).


Final Thoughts…on Sustainability

While researching this topic, I found the very essence of true sustainability. This story is truly for our green readers. It appears the funeral business has been causing havoc on our Mother Earth. Here are some alarming facts about the funeral business and waste:

  1. Approximately 30 million board feet of chemically-treated hardwood; 827,000 gallons of embalming fluid; and tons (in the thousands) of concrete, steel, copper and bronze are used yearly.
  2. Embalming fluid, containing formaldehyde, has been found in groundwater; and is carcinogenic.
  3. The wood used for some caskets, mahogany, that is endangered.
  4. Cremations cause approximately 600 pounds of mercury (i.e., fillings from teeth) to be released into the atmosphere. There have been legislative attempts for filters with cremations.
  5. A 10-acre cemetery has enough wood to build 40 houses (Death with Dignity National Center, 2015).

The Green Burial Council is a non-profit organization dedicated to environmentally sustainable death care (Death with Dignity National Center, 2015). It starts with choosing a designated conservation burial ground that is owned by a non-profit. There will be no vases or plastic flowers at burial sites, but only indigenous plants and flowers; and 5% of burial costs go towards an endowment to invest back into the land (Death with Dignity National Center, 2015).

This was the first time I heard of a green burial. Just a thought for those literally worried about sustainability (even in death).


Death with Dignity National Center (2015). Dying to give back to the Earth. Retrieved from http://www.deathwithdignity.org/2014/03/04/dying-to-give-back-to-the-earth

Death with Dignity National Center (2015). Death with dignity around the U.S. Retrieved from http://www.deathwithdignity.org/advocates/national

The Guardian (2015) Sustainable Goals:All you need to know. Retrieved fromhttp://www.theguardian.com/global-development/2015/jan/19/sustainable-development-goals-united-nations

United States Environmental Protection Agency (2015). What is sustainability. Retrieved from http://www.epa.gov/sustainability/basicinfo.htm

World Health Organization (2015). Health indicators for sustainable goals. Retrieved from http://www.who.int/hia/health_indicators/en/


2 thoughts on “Week Thirteen 4/12/15 to 4/18/15 Sustaining Innovative Environments: Considerations of Time and Scope.

  1. SHEllis

    I also focused this week on the fact that certain states may lead the way in terms of creating an innovative healthcare policy environment. These political and healthcare leaders have the creativity to move new thoughts into realities, improving the lives of their patients and constituents. The “followers,” or those states not as motivated to be on the forefront of a particular healthcare policy issue have it lucky, because there often is not a need to “reinvent the wheel.” Like you said, Oregon has a strong Death with Dignity bill that has data to support its safety and efficacy. Other states, such as Arizona, can simply model a future bill after Oregon. However, healthcare is constantly evolving. Modifications and improvements on existing legislative acts are always in our future.

    I found your statistics regarding sustainability very interesting. Our environment is directly tied to our health and wellness, not just in terms of pollutants but also in regards to safety, fitness, nutrition, etc. In a pediatric endocrinology rotation, I have been challenged with finding creative ways for adolescents to reduce their risk factors for type 2 diabetes. It can be incredibly difficult to encourage an adolescent youth to spend time outside exercising, when the neighborhood has a startlingly high incidence of home break-ins. Additionally, when a child relies on eating two meals each day at school but is faced with limited nutritional choices, how can I increase his or her fruit and vegetable intake? Your post this week highlights the importance of sustainable environments, as where we live most definitely affects our health.

    Liked by 1 person

  2. leahyamada

    Your thoughts on sustainability are very thought-provoking. While I am still ambivalent about whether I would be able to provide services to an assisted death, I do believe that there needs to be options for those who wish. That being said, many NPs are right there seeing the patients suffer and perhaps knowing more about the patients’ conditions than the overseeing physician who might make the ultimate decision for or against assisted death. In order to make this policy fully sustainable, we do need to include NPs on the final say. Not to get back on the “we are nurses first” soapbox, but I do feel that NPs have the compassion and insight to really understand and respect the wishes of the terminally ill.



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