July 2025: Rural US Emergency Medical Services

Despite geographic isolation, technological and infrastructure barriers, restricted funding, and limited worker recruitment and retention resources. Emergency Medical Services (EMS) are the most immediate health care resource for many US residents living in rural areas. We all rely on EMS to coordinate networks of transporters, first-responders, basic and intermediate Emergency Medical Technicians (EMTs), paramedics, and medical directors to bring professional skill sets and scopes of practice to their crews when our health needs are urgent. Yet, low call volume in rural areas hinder responders’ exposure to real-life procedures and undermine reimbursement for services rendered, so many rural EMS programs must depend—and perhaps over rely—on volunteers. Air transport and telehealth help some rural US residents overcome some proximity demands but are imperfect workarounds for meeting critical vulnerabilities and do not substantially mitigate rural/urban emergent health care access inequity. This theme issue explores rural EMS as a source of clinical, legal, and policy-level questions neglected in bioethics and health equity discussions.

We invite manuscripts for the July 2025 issue of the AMA Journal of Ethics® that consider a cross-disciplinary approach to these and kindred topics. Manuscripts submitted for peer review consideration and inclusion in this issue must follow Instructions for Authors and be submitted by 30 August 2024.