Informed Consent for Surgical Procedures

Obtaining Informed Consent

Mr. Roberts is a patient that was admitted to the hospital Emergency Department (ED) following traumatic injuries caused by a motorcycle accident. Since admission, Mr. Roberts has undergone three surgical procedures. While the first two surgeries were successful, the third one was unsuccessful despite being performed accurately. As a result, he relapsed into a coma and his long-term girlfriend has appeared and holds the healthcare power of attorney since the patient has a living will in which he stipulates his desire not to undergo heroic intervention.

The process of administering the surgical procedures to the patient has involved obtaining informed consent at different points. An informed consent is an important document when carrying out aesthetic or surgical procedures on a patient (Rao, 2008). For the first surgical procedure, the physician neither obtained implied nor expressed consent as there was no time to obtain consent because of the emergency conditions. Implied consent refers to consent to clinical examination in a general sense whereas expressed consent is stated in explicit and distinct language (Arora, 2013). However, this is a legally approved step because the patient’s admission at the ED required medical examination and treatment in a general sense. The physician’s actions in this stage are based on utilitarianism, which is an ethical theory in which an act is deemed right if it generates more pleasure than pain (Rodger & Blackshaw, 2017). Since the surgical procedure was successful and generated more pleasure, it was morally justified despite the lack of informed consent.

The patient’s nurse obtained expressed consent from his only child, Mary, prior to the second surgical procedure. The nurse explained all risks, benefits, and alternatives to Mary to obtain expressed informed consent for her dad’s treatment. Since this discussion was carried out on a telephone call, the nurse obtained oral informed consent using the appropriate procedure. However, oral consent was not appropriate since the procedure was complex and required written informed consent. Krishnan & Kasthuri (2007) state that a written and witnessed consent is required for major diagnostic and surgical procedures. Since this was a major surgical procedure, a written and witnessed consent was necessary and should have been obtained.