Rural Health Care
Handbooks and Manuals
Handbook for Rural Health Care Ethics: A Practical Guide for Professionals
Health care delivered in a rural context—in closely-knit, tightly interdependent small community settings—poses unique ethics considerations for clinical practitioners. A provider in a resource-poor rural setting may be faced with treating a family member, friend, business associate or neighbor, since the role separation between clinician and patient that predominates in the urban setting is less likely to occur in a small town. It is difficult for a provider to protect patients' privacy when their care occurs in clinics where neighbors, friends, and relatives may work. Similarly, it is difficult to establish a professional clinician-patient relationship when the patient is the doctor's former grade school teacher, or a member of the nurse's local parish. Ethical aspects of care are especially relevant and sensitive when the patient's health problem is stigmatizing, such as mental illnesses or infectious diseases. Because of the unique rural context, the solutions that health care providers develop to resolve complex ethics dilemmas may differ from solutions derived in urban areas.
The Handbook For Rural Health Care Ethics is designed to fulfill that purpose, and contains a case-based approach to analyzing, solving and anticipating health care ethics dilemmas. The Handbook is authored by physicians, nurses, health-care ethicists, and hospital administrators who all had scholarship or expertise in rural ethics, and was funded by a grant from the National Institutes of Health (NIH) National Library of Medicine.