Handbook for rural health care ethics : a practical guide for professionals /
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| Format: | Book |
| Language: | English |
| Published: |
Hanover, NH : Lebanon, NH :
Dartmouth College Press ; University Press of New England,
2009.
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Table of Contents:
- Sect. I. Rural health care ethics. 1. Introduction / William A. Nelson
- 2. A landscape view of life and health care in rural settings / Angeline Bushy
- 3. The ethical life of rural health care professionals / Ruth B. Purtilo
- 4. "Doing" ethics in rural health care institutions / Jacqueline J. Glover
- Sect. II. Common ethics issues in rural communities. 5. Ethics conflicts in rural communities: patient-provider relationships / Rachel Davis, Laura Weiss Roberts
- 6. Ethics conflicts in rural communities: overlapping roles / Andrew Pomerantz
- 7. Ethics conflicts in rural communities: privacy and confidentiality / Tom Townsend
- 8. Ethics conflicts in rural communities: shared decision-making / Denise Niemira
- 9. Ethics conflicts in rural communities: allocation of scarce resources / Paul B. Gardent, Susan A. Reeves
- 10. Ethics conflicts in rural communities: stigma and illness / Aruna Tummala, Laura Weiss Roberts
- 11. Ethics conflicts in rural communities: end-of-life decision-making / Denise Niemira, Tom Townsend
- 12.Ethics conflicts in rural communities: recognizing and disclosing medical errors / Ann Reeman Cook, Helena Hoas
- 13. Ethics conflicts in rural communities: reproductive health care / Barbara Elliott, Ruth Westra
- 14. Ethics conflicts in rural communities: health information technology / David A. Fleming
- Sect. III. Rural ethcis resources. 15. Practical strategies for addressing and preventing ethics issues in rural settings / William A. Nelson, Karen E. Schifferdecker
- 16. Developing rural ethics networks / Lisa Anderson-Shaw, Jacqueline J. Glover
- 17. Rural health care ethics: a selected bibliography and web sites / Mary Ann Greene
- Case studies. 5. Ethics conflicts in rural communities: patient-provider relationships. Provider stress and burnout. A long-time rural physician becomes depressed after experiencing increasing social awkardness and isolation
- Confidentiality in the context of dual relationships. A nurse is conflicted about defending her reputation after a patient spreads negative rumors about her
- 6. Ethics conflicts in rural communities: overlapping roles. A physician's family gaining an unfair advantage. A physician benefits from his relationship with a patient at the expense of others
- Choosing between loyalty to the hospital or loyalty to the patient. A doctor, patient, and nurse question whether the patient should receive a complicated procedure at the local hospital or a large tertiary care center
- Breaching patient confidentiality to prevent possible harm. A nurse obtains information about a patient that could be important to the safety of children
- 7. Ethics conflicts in rural communities: privacy and confidentiality. A patient refusing needed care. A patient without insurance refuses testing and treatment for cancer and will not tell his family
- Disclosing health care information to family. When an underage patient is diagnosed with herpes, she becomes depressed and her family wants to know why
- 8. Ethics conflicts in rural communities: shared decision-making. The extent of information provided in the consent process. A doctor is unsure how much information to share with a patinet about a procedure that could be done at the local hospital but might be more successful at a facility with more experienced surgeons
- A patient's refusal of needed diagnostic evaluation. An elderly patient declines additional testing after a suspected malignancy is found, likely for financial reasons, and refuses to share the information with her family
- 9. Ethics conflicts in rural communities: allocation of scarce resources. Granite Hospital budget restrictions. A rural hospital is faced with closing a distant primary care practice due to budget restrictions
- Moving procedures from hospital to office. A physician considers moving some procedures from the small hospital to his office in order to improve reimbursement, though this would be financially detrimental to the hospital
- 10. Ethics conflicts in rural communities: stigma and illness. Confidentiality, overlapping relationships,a nd unwillingness to seek care. A young woman fears going for treatment for an STD because she knows the health care staff and thinks her diagnosis will not be kept confidential
- Limited access to health care resources in rural communities. A prominent community member is unwilling to seek treatment for PTSD from his primary physician, and the nearest psychiatrist is 100 miles away
- 11. Ethics conflicts in rural communities: end-of-life decision-making. Surrogate wishes run counter to advance directives. The wife of a patient hesitates to follow through with her husband's advance directive
- Colleagues disagree with end-of-life decisions. A family tries to determine how much treatment ot allow for their elderly father, in the midst of profesional disagreement
- 12. Ethics conflicts in rural communities: recognizing and disclosing medical errors. Addressing questionable quality of care. A small hospital struggles to correct a physician for poor performance while fearing he will leave the hospital
- The use of a wrong clinical management care plan. A patient was given an improper management care plan and required additional treatment as a result
- 13. Ethics conflicts in rural communities: reproductive health care. Birth control for a minor. A minor, who is a family friend of the physician, requests birth control but does not want to discuss the topic with her parents
- Managing and treating sexually transmitted infections. A pregnant patient is diagnosed with an STD that she got during an extra-marital relationship. She declines to share the information with her husband
- 14. Ethics conflicts in rural communities: health information technology. Privacy and consent issues when using telehealth in rural areas. A patient is ill-informed about the process of using telehealth for treatment of a skin ailment
- Availability of, and access to, electronic medical records (EMR). A physician has restricted access to electronic medical records that are critical to a patient's treatment
- Using electronic clinical decision support systems. A physician uses electronic clinical support systems that aid in a diagnosis of a coronary blockage
- Addressing patient use of online treatment and prescribing services. A hypertension patient living in a rural area seeks treatment and prescribing services from an online doctor, which results in a negative drug interaction.