Since health is a crucial feature of persons’ well-being, we have good reasons to consider all present and future persons as members of a “league of patients.” 

Ethics and science inform EMTs’ and paramedics’ decisions to initiate, continue, or terminate resuscitation.

EMS responses are critical functions of local governments, yet, in rural areas, many EMS systems are staffed by licensed volunteers.

EMS care in rural areas of the United States has suffered from being chronically under-resourced and understaffed.

Situational awareness means that good care might not only be about the patient.

Assessing and adequately documenting a patient’s decision-making capacity is a responsibility and skill required of all EMS personnel.

Cultural humility, cost-effectiveness, equity, and tribal sovereignty are key to improving EMS responsiveness in AI/NA rural communities.

Despite their essential functions, rural EMS systems are often underfunded and understaffed to the point at which health equity is severely compromised.

Barriers to maintaining EMS in rural areas include personnel shortages, long travel times, and austere settings.

In prehospital settings, clinicians make difficult decisions that need to be made quickly and be within their scope of practice and skill set.