Moral Hazard Among Health System Workers in the Wake of Climate-Driven Emergency Events

The Sars-Cov-2 pandemic brought attention to moral hazard among health system workers (HSWs). However, empirical investigations of moral hazard in the context of environmental emergencies, particularly those driven by climate change, are limited. This contribution draws from interviews with 28 HSWs from diverse health service roles across British Columbia, Canada to interrogate how moral hazard may be caused or compounded by climate-related emergency events. Findings suggest three discrete pathways by which moral hazard may manifest among HSWs: ethical trade-offs made by HSWs in caring for themselves, their families, and their neighbours versus the populations they are hired to protect; ethical trade-offs stemming from resource allocation and staffing issues that inhibit quality care provision; and the hierarchical organization of health systems and its relationship to societal structures that contribute to climate change in the first place. The paper discusses findings in relation to the moral hazard literature, and implications for research and practice. Specifically, the authors suggest that enhancing upstream attention to the drivers of climate change and person-centred approaches to management may work to limit moral hazard.