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Ethical Issues in Rural Health Care

This volume initiates a much-needed conversation about the ethical and policy concerns facing health care providers in the rural United States. Although 21 percent of the population lives in rural areas, only 11 percent of physicians practice there. What challenges do health care workers face in remote locations? What are the differences between rural and urban health care practices? What particular ethical issues arise in treating residents of small communities? Craig M. Klugman and Pamela M. Dalinis gather philosophers, lawyers, physicians, nurses, and researchers to discuss these and other questions, offering a multidisciplinary overview of rural health care in the United States.

Rural practitioners often practice within small, tight-knit communities, socializing with their patients outside the examination room. The residents are more likely to have limited finances and to lack health insurance. Physicians may have insufficient resources to treat their patients, who often have to travel great distances to see a doctor.

The first part of the book analyzes the differences between rural and urban cultures and discusses the difficulties in treating patients in rural settings. The second part features the personal narratives of rural health care providers, who share their experiences and insights. The last part introduces unique ethical challenges facing rural health care providers and proposes innovative solutions to those problems.

This volume is a useful resource for bioethicists, members of rural bioethics committees and networks, policy makers, teachers of health care providers, and rural practitioners themselves.

About the Authors

Craig M. Klugman is the Stewart & Marianne Reuter Professor of Medical Humanities and assistant director for ethics education at the Center for Medical Humanities and Ethics at the University of Texas Health Science Center, San Antonio. Pamela M. Dalinis is senior associate director, DIVACO Education, The Joint Commission, Oakbrook Terrace, Illinois.

Reviews

"Of obvious value for those active in rural health care. It may be even more useful, however, for nonrural practitioners, ethicists, and members of ethics committees. Reading the essays in this volume is like acquiring a new set of glasses. It made me better able to perceive differences in how ethics can be considered based on culture, population, geographic challenges, and personal connections . . . An even bigger service may be the tools it provides to look differently at problems commonly thought to be understood."—Myles N. Sheehan, SJ, MD, JAMA

"An excellent scholarly examination of what rural people face in the world of health care."—Midwest Book Review

"A welcome addition to this oft-neglected area of ethics. The collection is broad-ranging and well-designed."—Robert Macauley , Journal of Bioethical Inquiry

"The common thread among the essays is a bioethical perspective. Their common goal is to raise awareness among rural practitioners and other interested parties about the particular challenges that the rural environment presents."—Health Affairs

"This volume elucidates a wide range of ethical issues and the authors provide helpful strategies for practice and policy."—Ruth B. Purtilo, Massachusetts General Hospital Institute of Health Professions

The Johns Hopkins University Press

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