Judy and Richard live in a rural community where the closest hospital is a four hour drive away in good weather. Travelling to the hospital for specialist appointments often entails an overnight stay and additional time away from work for both Judy and Richard. In discussing the recent trips to the hospital with their family doctor, Judy indicates that she is not sure how much longer she can keep doing this and asks about options for care closer to their community. The family doctor is aware that this is an issue for several of her patients, and is advocating for a different approach to some forms of specialist care, such as making more use of telehealth and other technological options as well as the possibility of travel subsidies for some patients. Richard asks about whether arranging for some specialists to come to the community once a month might be another option…
What ethics issues do you identify in this case?
What are some of the different perspectives around issues of access to care that may impact whether and how we provide health care in a variety of urban, urban-rural, rural and remote settings?
What values are involved in this case (e.g., equity, fairness, trust, good care…)?
How should Canada, with its large rural and remote areas, address issues of access to care?
Browne, A. Issues Affecting Access to Health Services in Northern, Rural and Remote Regions of Canada. http://www.unbc.ca/assets/northern_studies/northern/issues_affecting_access_to_health_services_in_northern.pdf
Laurent, S. 2002. Rural Canada: Access to health care. http://publications.gc.ca/Collection-R/LoPBdP/BP/prb0245-e.htm
Rural Health Services Review Committee. 2015. Rural health services review: final report. Edmonton: Government of Alberta. http://www.health.alberta.ca/documents/Rural-Health-Services-Review-2015.pdf