? Nearly 62 million Americans live in rural areas, and they experience considerable health care disparities in comparison with urban people. Rural clinicians are challenged in providing services for their seriously ill patients, including the 15 million Americans with stigmatizing disorders such as drug addiction, HIV, STDs, Hepatitis C, mental illnesses, and co-occurring disorders. It is increasingly recognized that rural clinicians also encounter distinct, frequent, and heightened ethical conflicts; this represents a significant barrier to fulfilling an appropriate standard of care in small communities. As yet, little attention has focused on helping rural health care professionals recognize and respond to ethical issues, placing disadvantaged rural Americans at risk for ethically disparate care. The traditional health care ethics literature tends to ignore the rural context. Preliminary research on health care professionals in the rural setting has indicated there is a great need to develop a useful and practical ethics resource specifically for rural clinicians and administrators. ? ? To meet this need, an information resource - a Handbook for Rural Health Care Ethics - will be created. ? ? The Handbook will be ecologically sound, evidence-informed, and culturally-attuned. It will specifically ? address the most salient ethical issues encountered by clinicians, administrators, and policy-makers working in American rural communities. Some of those unique ethical challenges include confidentiality, boundary issues, provider-patient relationships, limited resources, and access to quality care to a population that is typically older, sicker and poorer than its urban counterpart. The Handbook will be disseminated online in order to maximize access and minimize cost to individuals and institutions. The edited Handbook will be written primarily by members of the newly formed Rural Health Care Ethics Coalition. The Coalition consists of a unique, multidisciplinary team of professionals with extensive experience and recognized scholarship in rural ethics issues. ? ? Relevance ? ? This Handbook is essential because there are a dramatically limited number of ethics resources ? ? specifically written by and for rural health care professionals. Because ethics is an essential component to quality care, an unfortunate result of not writing and distributing this Handbook is the potential concern that rural Americans may be exposed to a lesser standard of care, ethically as well as clinically. It is suggested that the development of evidence-informed and culturally attuned ethics resources will demonstrably help efforts to assure that rural people receive an equitable and sound standard of health care. ? ? ?
| Jackson, Christopher M; Kochel, Christina M; Nirschl, Christopher J et al. (2016) Systemic Tolerance Mediated by Melanoma Brain Tumors Is Reversible by Radiotherapy and Vaccination. Clin Cancer Res 22:1161-72 |
