Physicians must obtain informed consent before performing treatments on their patients. This critical process requires a complete understanding of the risks and benefits of the proposed treatment options. These are delicate and complex discussions that are difficult to do well, but they are imperative to making the right choice for each individual.

Our community is currently in the process of making a decision concerning whether or not to approve the development of the largest coal exporting facility in North America in our own front yard. Due to the magnitude and longevity of the project, this requires a level of informed consent that is as complicated as the decisions we make with our patients each day. Simply stated, we need to understand how this proposal will make our lives better or worse.

More than 200 physicians who live and care for patients in Whatcom County feel strongly that we need to have a full understanding of the risks and benefits of developing this coal exporting facility in our area. We're told that the benefits will include more jobs and bigger paychecks and increased tax revenues for our county. But this is no small proposal. It means a quantum leap in quantity of both rail and ship traffic. We want to know the risks to our health and well-being.

We want to know how the diesel emissions from 18 additional trains each day will affect the respiratory and cardiovascular function of our friends and neighbors and patients who are exposed to the resulting increase in toxic airborne particulate matter. We want to know how long and how often our emergency medical services will be delayed at rail crossings and how many lives will be lost or diminished because of increased delays getting both the ambulance to the patient, and our patients to the hospital. We want to know how trains blowing their horns throughout the night will affect the sleep quality and cognitive performance of our children. And we want to know how carcinogens in the coal dust dispersed from these rail cars will accumulate in our ecosystem and affect our health.

Sometimes in the practice of medicine the proposed treatment is more toxic and risky to the patient than the alternative of no intervention. Because a project of this magnitude would have direct and foreseeable impacts not only on its own citizens but also that of our neighbors, Whatcom County needs a rigorous health study that quantifies the risk to human health. Our community needs to have facts based upon the best science to make an intelligent and informed decision.

Gib Morrow is a physican and resident of Bellingham.