Read the case study at the end of Chapter 8. (Guido, p. 150)
Is the patient correct in claiming that he has a right to know the names and status of those who will perform this procedure?
Is the way the student introduced herself and the two other team members relevant in this case?

Was the informed consent inadequate to the point where the patient refused to consent?

How would you rule in this situation?

A patient is admitted to your surgical center under local anesthesia for a breast biopsy. The surgeon has already informed the patient about the procedure, its risks, alternatives, desired outcomes, and potential complications. You give the patient the surgery permit form for her signature. She confidently states that she understands the procedure and has no further questions; she signs the form without hesitation. Her husband, who is visiting her, expresses concern that something may be said during the procedure that will frighten his wife. What are you going to do at this point? Do you notify the surgeon that you have not obtained informed consent? Do you want the surgeon to come back and re-instruct the patient on the surgery? Is there anything else you should do now that the patient has signed the form?

Consider the ethical implications of such a scenario. Which of the following ethical principles is most exemplified by the husband in this example? Which ethical principles should the nurse follow when dealing with this patient and family member?

Jimmy Chang, a 20-year-old college student, has been admitted to your facility for further chemotherapy. Jimmy was diagnosed with leukemia five years ago and has undergone several rounds of chemotherapy. He is currently in an acute active phase of the disease, despite having been in remission for 14 months prior to this admission. His parents, who accompany him to the hospital, are split on whether additional chemotherapy is beneficial. His mother is adamant about signing the informed consent form for this course of therapy, and his father is equally adamant about refusing to sign the informed consent form because “Jimmy has suffered enough.”

You are his primary caregiver and must help him find a way out of this bind. What are your plans for the informed consent form? Who, and why, signs? Using the MORAL model, determine the best course of action for Jimmy from an ethical rather than a legal standpoint. Did you reach the same conclusion using both an ethical and legal framework?

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