Informed Consent in Emergency and Surgical Settings
This paper examines the process of obtaining informed consent across three successive surgical procedures performed on an emergency department patient following a traumatic motorcycle accident. Drawing on clinical guidelines and ethical theory, the paper evaluates whether consent was obtained appropriately at each stage. The first procedure is analyzed through the lens of utilitarianism and implied consent in emergency conditions; the second through the adequacy of oral versus written consent; and the third through deontological duties and the requirement for witnessed, written consent. The paper illustrates how procedural lapses in consent-gathering carry both ethical and legal implications in complex surgical cases.
- Introduction and Case Overview: Patient background, coma, and power of attorney
- First Surgery: Emergency Conditions and Implied Consent: Emergency consent waived; utilitarianism applied
- Second Surgery: Oral Consent and Its Limitations: Oral consent deemed insufficient for major surgery
- Third Surgery: Inadequate Written Consent and Deontological Failures: Written consent lacked witness; deontological duties violated
- References: APA citations for sources used
✍️ How to write this paper — guide, tools & examples ▾
What makes this paper effective
- Each surgical procedure is analyzed as a discrete case, allowing the reader to follow a clear progression of consent issues with corresponding ethical and legal standards.
- The paper correctly applies distinct ethical frameworks — utilitarianism for the emergency case and deontology for the witnessed-consent failure — rather than applying a single theory uniformly.
- Citations are used precisely to support specific procedural claims (e.g., the requirement for witnessed written consent in major surgery), which grounds the ethical argument in clinical guidelines.
Key academic technique demonstrated
The paper demonstrates applied ethical analysis: taking a real clinical scenario and mapping each decision onto a recognized ethical framework. Rather than merely describing what happened, the author evaluates whether each action was morally and procedurally justified, which is the core skill in healthcare ethics writing.
Structure breakdown
The paper opens with a brief case narrative establishing the patient's situation and the role of the healthcare power of attorney. It then moves chronologically through the three surgeries, dedicating one paragraph to each and applying a relevant ethical or legal standard. The paper concludes implicitly through the third surgery's deontological critique. A references section follows standard APA formatting.
Introduction and Case Overview
A patient was admitted to the hospital Emergency Department (ED) following traumatic injuries caused by a motorcycle accident. Since admission, he underwent three surgical procedures. While the first two surgeries were successful, the third was unsuccessful despite being performed accurately. As a result, he relapsed into a coma, and his long-term girlfriend — who holds the healthcare power of attorney — appeared at the hospital. The patient has a living will in which he stipulates his desire not to undergo heroic intervention.
Informed consent is a central legal and ethical requirement when carrying out surgical procedures on a patient (Rao, 2008). The circumstances surrounding each of the three surgeries raised distinct consent issues, which are examined in turn below.
First Surgery: Emergency Conditions and Implied Consent
For the first surgical procedure, the physician obtained neither implied nor expressed consent, as there was no time to do so given 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, proceeding without consent in this instance was a legally approved course of action, because the patient's admission to the ED required immediate medical examination and treatment.
The physician's actions at this stage are grounded in utilitarianism, an ethical theory in which an act is deemed right if it generates more pleasure than pain (Rodger & Blackshaw, 2017). Because the surgical procedure was successful and produced a beneficial outcome, it was morally justified despite the absence of formal informed consent.
Second Surgery: Oral Consent and Its Limitations
Prior to the second surgical procedure, the patient's nurse obtained expressed consent from the patient's only child. The nurse explained all risks, benefits, and alternatives to obtain expressed informed consent for the patient's treatment. Because this discussion took place over a telephone call, the nurse obtained oral informed consent using what was considered an appropriate procedure for that format.
However, oral consent was not sufficient for a procedure of this complexity, which required written informed consent. Krishnan & Kasthuri (2007) state that a written and witnessed consent is required for major diagnostic and surgical procedures. Since this qualified as a major surgical procedure, written and witnessed consent was necessary and should have been obtained rather than relying solely on an oral agreement.
Create your account
Always verify citation format against your institution’s current style guide requirements.