For many people living in the rural U.S., emergency medical services (EMS) are often the most immediate point of contact when they are confronted with urgent health needs. But the low call volume inherent in rural areas limits responders’ exposure to real-life procedures. It also limits payment for services rendered, pushing EMS programs to increasingly rely on volunteers. That, in turn, can exacerbate access inequities.
The July issue of AMA Journal of Ethics® (@JournalofEthics) examines rural EMS as a source of clinical and legal questions often neglected in health care ethics, policy and equity discussions.
The AMA Journal of Ethics is an editorially independent, peer-reviewed journal devoted to helping students and clinicians navigate ethical decisions in service to patients and communities. The July issue of the journal includes the following articles.
“When Is It Acceptable to Terminate Resuscitation in Prehospital Settings?”
- Ethics and science inform emergency medical technicians’ and paramedics’ decisions to initiate, continue or terminate resuscitation.
“When Is It Justifiable for an Inexperienced but Licensed Clinician to Perform a High-Risk but Low-Frequency Procedure on a Patient in a Prehospital Setting?”
- In prehospital settings, clinicians make difficult decisions that need to be made quickly and be within their scope of practice and skill set.
“How Should We Fund and Reimagine EMS to Support Sustainable Rural Health Infrastructure?”
- EMS care in rural areas of the U.S. has suffered from being chronically underfunded and understaffed.
“What Might the Past Suggest About Rural Emergency Services Amidst Critical Access Hospitals’ Decline?”
- Recent rural hospital closures influence clinical and ethical dimensions of emergency care.
Listen and learn
The journal’s July “Ethics Talk” podcast features a conversation with Eric Emery, a paramedic and emergency medical services director for the Rosebud Indian Reservation, as well as a representative in the South Dakota House of Representatives, about how rural EMS workers manage time as a critical resource and how legislative policy can help direct resources toward improving rural EMS service.
The July issue also features three author-interview podcasts and one editorial-fellow-interview podcast. Listen to previous episodes of the “Ethics Talk” podcast or subscribe in iTunes or other services.
Also, CME modules drawn from this month’s issue are collected at the AMA Ed Hub™ AMA Journal of Ethics webpage.
The next issue of the journal will focus on existential health care ethics. Apply to be an AMA Journal of Ethics editorial fellow or senior editorial fellow and design a theme issue with us.
Subscribe to free AMA email newsletters
Get the latest news from the AMA on the topics that matter to you—delivered to your inbox.
