gms | German Medical Science

Background/research question: Academic publications in planetary health often entail empirically informed ethical recommendations, that is, recommendations for moral actions based in empirical knowledge and ethical thinking. These often address practitioners and policy makers. A considerable example is the Planetary Health Pledge for Health Professionals in the Anthropocene [1]. However, how these and other recommendations are derived from empirical evidence and value assumptions is often far from clear and has led to heated debates [2]. Against this background, this work aims at identifying weaknesses and pitfalls in the development and reporting of ethical recommendations in planetary health debates.

Methods: Based on our conceptual work about transparent reporting of so-called bridge principles in empirically informed ethical recommendations [3], we review and conceptualize arguments from the Planetary Health Pledge as exemplary instances with a special focus on the development and reporting of ethical recommendations. The ethical recommendation to respect indigenous healing practices is reviewed in greater depth. Pitfalls and potential improvements in reporting are evaluated to raise the question of future standards.

Results: The ethical recommendation to respect indigenous healing practices can be conceptualized as being based on a) empirical assumptions and b) value judgments. In deriving recommendations from these premises, the so-called is-ought gap must be bridged. Explanations as to how this gap is bridged are essential. The concept of bridge principles can be used as a simple way to aid these explanations. However, unreported implicit bridge principles are a major weakness in the reviewed debate. They, first, bear the risk of unproven, implicit and even dubious assumptions entering the recommendations. Secondly, scientific debate is hampered due to missing transparency.

Conclusion: Planetary health is an emerging field that has not yet fully agreed on reporting standards for research under this name. In case of ethical recommendations, reporting of bridge principles can inform readers and support them in understanding the relationship between empirical and normative claims in a specific recommendation. It may pave new ways for the rigorous reporting of research that has moral implications. It should be an essential part of future reporting guidelines to ensure transparency and validity of results.

Competing interests: The authors declare to have no conflict of interest.