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Book and Media Reviews
May 27, 2009

Ethical Issues in Rural Health Care

JAMA. 2009;301(20):2162-2166. doi:10.1001/jama.2009.730

Are ethics different in rural areas than in the big city? This collection of 12 essays provides a careful look at how ethical issues are perceived, noticed, ignored, or dealt with in rural health care. The contributors make clear that perceptions of ethics that come from urban and academic health care centers may need to be adjusted in dealing with the rural environment.

The book is divided into 3 sections. The first provides an overview of what is meant by rural and general ethical issues in rural health care. The second section consists of 3 essays by rural health practitioners. The third and final section examines specific ethical issues in the rural setting. The book provides an illuminating look at questions of culture, character, regulation, social justice, and organizational response. As a reader who has predominantly practiced medicine and taught ethics in urban medical environments, I found the book fascinating in the insights it provides on the challenges and the rewards of delivering health care in areas far removed from the big city. The book also encourages reflective readers to consider some of the hidden issues in their own clinical settings.

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