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Abstract

This article argues for a more critical, transformative and philosophically-underpinned approach to teaching Sustainable Development Goals (SDGs). The standard approach presents the SDGs as uncontested and universally agreed-upon targets, which oversimplifies their complexity and inherent contradictions and engages only superficially with the central unifying theme of sustainability. Whilst environmentally friendly healthcare practices and reducing healthcare’s carbon footprint are important goals, conflating them with the sustainability agenda conveys an overly narrow message about what sustainability is and how we might achieve it. To address these issues, the article proposes a more radical approach that integrates critical medical humanities into sustainable healthcare education and SDG discussions. The Centre for Sustainable Health Education (SHE) at the University of Oslo is presented as an example of this approach. SHE delivers a radical curriculum which aims to raise awareness of the challenges, conflicts and compromises involved in striving for a fair and sustainable future. SHE's teaching methods encourage collaborative, critical, and interdisciplinary reflection, which helps students to engage with ongoing controversies and debates surrounding sustainability and the SDGs. Ultimately, this approach broadens our understanding of health, illness, and sustainability by illuminating and interrogating the power structures that shape these concepts.
Arcle Type: Comment
Title: Teaching Sustainable Healthcare through the Crical Medical Humanies
Authors: Eivind Engebretsen, Rika Sharma, Tony J. Sandset, Krisn Heggen, Ole Pe&er O&ersen,
Helen Clark, Trisha Greenhalgh
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L3;CF>;>;;
3K4
7 G
(>2%2%C(>
:6;;;:A
3347;O6
3;>;
;41GC
C;>3-34+6>;;3
3;>>33331#%DK
;;C3>33
3;;3
34##76633;;
33<34#2
73>B3;3
47>6LL3
3;#&#/36
;;34=D>F>6;K
+@>3;>H3G>3
3GI4#$73
;3>6347;
;K>34
D3;3:AL3>
;4#E#03C3;>;
>;4 ;>:A
>;;B3;3;3
;6>;>3D:A4#1+
>D>;3
43PO;;;F
DG;3>6
3FK;;42%
;3;K
4+3;36;6
3;;>33
32#;;L4;
3>;;>3F;
34
Example topic How it is covered in a ‘crical medical humanies’ informed curriculum
+3

;;3Q>G;C3
3K>36B3;;Q
>GM>3;33R
;3R


3
3L3;R33
3;;;
>;33R334
3
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;
76 ;;;;
333;3R;
D>>O6>
6>;>C;
: KS
C3
3 *6>;33
3Q<3K;G;;33
;K3K>;3
P3;3443;
6R33;>
>;;33
42#
+;>6 ; ;T3K
C;K
;;C422G
>63;CL
3 47K33
G>>;:A33;F
;;334#0
7>6;>3;;3
;;6>L
;;C3L
4*;>363
;;:A4
6;;;K;;>
;>6C;3O3
;36;33;3
33;C;3334
D33;>
G3;3;336>3
;;3;33
4
References
#4 )+4)U0%U#473>-2%&%;34
(A+3(>,642%#$S2$4
24 < :;8!!>J68444V=47
;L-;;47@42%#/S&'&11#0E&%KEE04
&4 < 4 J=:K#1;;3
4(42%2%S26###E02K#E0&4
/4864);=;3;);-
36 J=:K#1;347@42%2#S&1'#%21$#%#K#%&4
$48:93++6@+8!W9344447@
333 J=:K#1;347@42%22S/%%#%&$1#22/K
#2'%4
E4!64)673343
2%224
04 7+(3+;@(>37)4=OP
442%#0S22#-#&'E%/24
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... As highlighted by Kahn (2010), there is a pressing need to address the crisis of environmental education being used as a mere 'greenwash'-a superficial commitment to ecological causes that acts as a smokescreen, obstructing rather than fostering meaningful engagement with the inherent complexities of sustainability. Through health humanities, we have an opportunity to debunk misconceptions, diminish academic isolation and inspire the collective critical reflection required for a genuine commitment to sustainability (Engebretsen et al 2023). ...
... This transformative process of learning remains underanalysed and underincorporated in sustainability studies, contributing to failure to achieve substantial change. Despite setting out to effect transformation, current sustainability initiatives often fail to trigger profound changes, particularly in confronting deeply rooted colonial assumptions within the SDG discourse itself (Engebretsen et al 2023). ...
... The transformative approach to health humanities I seek to promote underscores the second of these two interpretations of modernity: it prioritises the possibility of profound change, of the future as a terrain that is amenable to being critiqued and rethought beyond the logic of production, science and the economy. Accordingly, the educational approach I propose is informed by the following key principles (Engebretsen et al 2023): 1. Inspiring students to question the very systems that have engendered both the crises associated with sustainability and the dominant discourses about resolving them, in line with Audre Lorde's enduring wisdom, 'The Master's Tools Will Never Dismantle the Master's House'. We must motivate students to envision beyond the confines of existing structures and discourses, especially those already implicated in creating the current crises. ...
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The adoption of the United Nations' Sustainable Development Goals (SDGs) marks a significant shift in global political agendas, emphasising sustainability in various fields, including health. To engage meaningfully with sustainability, a transformative educational approach is essential. Lange’s concept of transformative learning encompasses three levels: personal and cognitive change (micro level), changes in our interactions with others and the environment (meso level) and societal changes (macro level). This paper posits that applying health humanities approaches, particularly narrative medicine, can enhance transformative education at these three levels, leading to a powerful, transformative health humanities framework for teaching sustainability and the SDGs. This interdisciplinary method, which includes reflective self-assessment, exploration of different relational perspectives and social reality comprehension, facilitates transformative learning. However, implementing this transformative strategy requires a critical reassessment of some core principles and methods within the existing health humanities paradigm.
... 3 But these cases seem to have one unique and salutary feature: conflicts were actively harnessed to strengthen the project rather than glossed over or denied. 4,5 For example, instead of lamenting implementation failure, the many stakeholders in the Nigerian polio eradication effort transformed their differences, initially seen as obstacles, into valuable resources (panel). Rather than attempting to erase disputes over interpretations, values, and priorities, these differences were embraced as constructive disagreements to be confronted and used as catalysts for change. ...
... Rather than attempting to erase disputes over interpretations, values, and priorities, these differences were embraced as constructive disagreements to be confronted and used as catalysts for change. 4 The Nigerian example illustrates an important theoretical point. If we approach the SDGs as fixed goals to be addressed through programmes and plans to be implemented and cascaded at national, regional, and local levels, we create a paradox of unimplementability. ...
... The view of sustainability as a topic that is hard to act on in the clinical setting could perhaps be due to how sustainability is taught, or not taught. As argued by Engebretsen et al, 22 there is a need for a 'radical transformation' of medical education and to use the 2030 Agenda as a basis for fostering critical thinking regarding sustainability. The authors call for decolonisation, not only of global health education but rather of the overall medical education and practice. ...
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Introduction The role of global health and sustainable development in medical education is often debated. However, research regarding medical doctors’ views on the application of their global health knowledge in the clinical setting remains scarce. This study aimed to explore junior doctors’ perceptions of global health and sustainable development, the education they have received on these issues and the relevance of this knowledge in their current and future work. Methods This was a qualitative study based on individual interviews conducted between May and June 2022. 16 junior doctors, in mandatory clinical training after completing medical school, were purposively sampled from five Swedish hospitals. Transcripts were analysed using qualitative content analysis. Results Three themes were identified. The first theme (1) ‘medical doctors have a role in the transition to a sustainable society’, shows that sustainable development is increasingly perceived as relevant for junior doctors’ clinical work. The second theme (2) ‘global health and sustainable development teaching is inconsistent and somewhat outdated’, highlights that there is an assumption that global health and sustainable development can be self-taught. A discrepancy between what is being taught in medical school and the clinical reality is also recognised. This causes challenges in applying global health interest and knowledge in the clinical setting, which is described in the third theme (3) ‘application of global health and sustainable development is difficult’. This theme also highlights opportunities for continued engagement, with the perceived benefit of becoming a more versatile doctor. Conclusion This study emphasises the need for conceptual clarity regarding global health in medical education and raises the need for clarification regarding the level of responsibility for integrating sustainable practices in Swedish healthcare settings.
... More deliberate engagement with sustainability would imply advancing highly dynamic, vernacular, strong sustainability approaches that recognize human dependence on the earth's ecosystems while integrating the complex interconnections within nature and culture, ecology and (human) societies in a wide variety of different contexts. Doing so would also require engagement with eco-social transformation in a way that surfaces the potential, complexities, and ambivalences of sustainability and its alternatives (Engebretsen et al., 2023;Ferreira, 2017). And it would imply driving "system-wide . . . ...
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Background: Sustainability has become a ubiquitous imperative across all sectors of society, including healthcare. Building on the broader discourse on sustainable development, sustainability is used in relation to social, ecological, and economic concerns with varying degrees of emphasis and often related to a sense of durability. Objective: To provide a detailed analysis of the concept of sustainability in current physical therapy literature and advance its deliberate future implementation. Methods: Setting out from a critical exposition of prevalent models of sustainability, we conducted a critical discourse analysis to (1) examine the implementation of the concept of sustainability in physical therapy academic literature and (2) critically evaluate its hitherto use in light of the broader discourse surrounding sustainability. Results: Our analysis identified a focus on the cost-effectiveness of healthcare interventions, and the use of so-called "weak" and "strong sustainability" models in the physical therapy literature. Other models and the broader critical discourse surrounding sustainability are only gradually finding their way into physical therapy literature. Conclusion: Physical therapy lacks comprehensive exploration of both general and profession-specific understandings of sustainability. Nuanced engagement with sustainability and its alternatives is necessary to ensure its meaningful implementation in physical therapy research, education, and practice.
... Det må arbeides videre med å utvikle hva baerekraft kan bety for ulike fagfelt og profesjoner. Ett av bidragene fra Senter for baerekraft i helseutdanningene har vaert å arbeide frem et kritisk perspektiv på baerekraftsutfordringer der studenter blir i stand til å analysere premisser, verdi-og interessemotsetninger og løsningsforslag for ulike baerekraftsproblemer (11). Vindkraftutbyggingen på Fosenhalvøya kan tjene som et eksempel. ...
... We acknowledge examples of medical faculties around the world where impressive efforts have been made to blur the disciplinary boundaries between social sciences and medicine. For example, one of us is a Visiting Professor in a medical faculty in Norway where innovative approaches are used to teach sustainable development to undergraduate medical students (Engebretsen et al., 2023). But such examples underscore rather than undermine the main point we are making in this paperthat countering the 'decoupling' described in the introduction requires vision, sustained collective effort, and resources; it occurs only in rare exceptions. ...
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... De e elektive kurset om klimaendringer og helse er e av flere initiativer ved Senter for baerekraft i helseutdanningene ved Universitetet i Oslo (7). Det er et tilbud for legestudenter som ønsker å fordype seg saerskilt i temaet. ...
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