Clinical Ethics Concerns of Rural Healthcare Providers

Purpose: This project aimed to identify ethical concerns in rural hospitals and elicit ideas for establishing clinical ethics services to meet needs. Methods: Two-hundred-fifty-six rural physicians were sent an email requesting participation in an electronic survey. Data were entered into Microsoft excel.  Findings: Seventy-four (29%) physicians responded; 59% have an ethics committee available to them. Of these ethics committees, 43% are available 24/7. Ethical dilemmas were categorized into themes, with end-of-life care and vulnerable adult concerns identified most commonly. Online group-learning is the preferred training method for ethics education. Thirty-eight percent would likely use a tele-ethics service if available. Conclusions: Providers in rural health systems face unique and complex ethical dilemmas and would likely utilize remote support for complex bioethical situations. Given these findings, the next step is to develop and pilot an ethics service that would include the three traditional roles for a clinical ethics service: policy development, education, and clinical ethics consultation services.