Sterile and Sinister: The Ethics of Plastics in Healthcare

By Lily T. ’24


Introduction

My family and I are no strangers to the hospital. Both my parents are doctors, and each family member has been hospitalized at some point in our lives. Whether it was sitting in the bed being treated, or visiting the other one who was sick, we have grown accustomed to the antiseptic fragrance, scratchy nylon sheets, constant beeping, and shuffling of feet that encompasses hospital life. It was these experiences that drew me to the topic of healthcare, and eventually plastics in healthcare, for my bioethics project. In my research, I seek to answer whether and to what degree the healthcare industry should be held accountable for their contribution to climate change and the plastic pollution problem. 

Benefits and Harms

Plastics have many benefits and harms when it comes to healthcare. Benefits include being cheap, durable, easily sealed, sterile and supposedly disposable. Healthcare facilities have tools constantly contaminated with blood and pathogens that cannot be recycled. Plastic has been able to be designed so that it can be coated with resistant microbes to fight against these bacteria. Plastic pollution, however, is a significant harm, and affects the environment, specifically marine environments. Around 14 million tons of plastic finds its way into oceans each year. 

Real Life Scenario

With these benefits and harms in mind, I want you to imagine this: You have landed yourself in the emergency room with a Hernia, and the repair requires the use of a laparoscope. There are two options in front of you. A plastic-packaged laparoscope, or a reusable one made of metal that has been cleaned in the hospital by a staff member and put into an autoclave. The reusable option has been used on countless patients before you, each with their own set of bacterial spores and viruses, which have a chance of being present on that very same laparoscope if not properly sterilized. Which would you choose for your procedure? Many of you, like me, might have chosen the plastic-packaged laparoscope because it may have sounded like the most safe and dependable option. 

COVID

Image by Alexas_Fotos from Pixabay

The advent of COVID further complicates this issue. During this time, the world turned to a hyper-hygienic way of life. Rise in single-use plastics within materials to help manage the virus revived and strengthened the demand for plastic and part-plastic products. Public safety and protection of front line workers have heavily depended on plastic, using personal protective equipment such as face masks, gloves and gowns. However, “the Covid-19 pandemic is estimated to generate up to 7,200 tons of medical waste every day” (Trafton, MIT). Compared to pre-COVID times, waste has increased within healthcare facilities up to 10 times the amount of what it used to be. 

Final Thoughts

I believe that it is ethical to hold the healthcare industry responsible for their contribution to plastic pollution as it extends to packaging and excess waste from procedures. While biomedical waste must be discarded properly, and certain instruments that are difficult to sterilize, which pose liability risks, should be mandated single-use, cutting down on plastic packaging and excess waste is an essential step that the healthcare industry must take towards becoming more sustainable. 

“Overage” refers to surgical inventory that is readied for surgery but is not used, and therefore wasted. Many hospitals rely on industry-prepared surgical packs to promote efficiency in the operating rooms. However, these packs do not utilize every tool, and once outer packaging is opened, all items included are considered as being exposed to the surgical field and must be discarded. Now, I will ask, what do you think should be done? Do you agree with this course of action? Should the healthcare industry take more aggressive steps to limit its plastic footprint, or do risks to patient safety outweigh the long-term consequences of climate change?