The theme editor introduces a special issue focusing on the challenges of patient access to health care.

A rural physician who is faced with treating patients outside of his area of specialization should confer with the necessary specialists and make every effort to help patients get the specific care that they need.

A rural physician who is faced with treating patients outside of his area of specialization should confer with the necessary specialists and make every effort to help patients get the specific care that they need.

Physicians should understand the ethical issues surrounding assisting patients who receive Medicare- and Medicaid-funded health care.

Physicians should understand the ethical issues surrounding assisting patients who receive Medicare- and Medicaid-funded health care.

In a case where a physician is treating two related patients, he should weigh the harm done by breaking one patient's confidentiality against the harm that patient may inflict on another if that confidentiality is preserved.

When a dual relationship exists between a physician and a patient, the physician has an obligation to put the patient's health first even at the risk of ending the personal relationship.

Physicians who encounter a patient who is suffering from depression may find it necessary to breach confidentiality and patient autonomy in order to act in the best interest of the patient.

A physician outlines the concept of the family covenant, an agreement between consenting family members that defines exactly how and when medical information is divulged to other family members.

Physicians need to carefully explain the difficult medical realities of carrying a fetus with severe congenital abnormalities to term but then follow the wishes of a religious family who ask for reasonable medical care.