Question

A patient is admitted to your surgical center for a breast biopsy under local anesthesia. The surgeon has previously informed the patient of the procedure, risks, alternatives, desired outcomes, and possible complications. You give the surgery permit form to the patient for her signature. She readily states that she knows about the procedure and has no additional questions; she signs the form with no hesitation. Her husband, who is visiting with her, says he is worried that something may be said during the procedure to alarm his wife. What do you do at this point? Do you alert the surgeon that informed consent has not been obtained? Do you request that the surgeon revisit the patient and reinstruct her about the surgery? Since the patient has already signed the form, is there anything more you should do?

Now consider the ethical issues that such a scenario raises. Which ethical principles is the husband in this example most portraying? Which ethical principles should guide the nurse in working with this patient and family member?

Answer 1

A a healthcare professional my responsibility will be here to consider the principle of patient autonomy. From the information provided here it appears that the patient was informed about the procedure previously about the procesure, its complication and desired outcome and also the patient did not have additional question. I my responsibility here will be to tell her husband politely that the patient is well informed about the produdure and informed consent was taken accordingly. However if the patient want re-instruction for the same it will be provided. I would request the surgeon to re-instruct the patient if the patient insist for the same. Although the patient has signed the form it will be my sresponsibility to assess the need for re-instruction and provide the patient with adequate information and educate the patient with the realities and let her take the decision accordingly if required. The ethical principle involved here the patient autonomy and basic human right. Patient should be given the freedom to take decision of what should or should not be happened to her. The husband in this example portraying the ethical principle of beneficence. Beneficence obligate everyone to ensure the well being of the patient. The nurse working here should be guided by all the principles patient autonomy, beneficence, justice.