• Read the case study presented at the end of Chapter 8 (Guido, p. 150)
  • Isthe patient correct in asserting that he has a right to know the namesand status of individuals who will be performing this procedure?
  • Does the manner in which the student introduced herself and the two other team members have relevance in this case?
  • Was the informed consent deficient to the degree that there was a lack of informed consent by the patient?
  • How would you decide this case?
• Apatient is admitted to your surgical center for a breast biopsy underlocal anesthesia. The surgeon has previously informed the patient of theprocedure, risks, alternatives, desired outcomes, and possiblecomplications. You give the surgery permit form to the patient for hersignature. She readily states that she knows about the procedure and hasno additional questions; she signs the form with no hesitation. Herhusband, who is visiting with her, says he is worried that something maybe said during the procedure to alarm his wife. What do you do at thispoint? Do you alert the surgeon that informed consent has not beenobtained? Do you request that the surgeon revisit the patient andreinstruct her about the surgery? Since the patient has already signedthe form, is there anything more you should do?

Nowconsider the ethical issues that such a scenario raises. Which ethicalprinciples is the husband in this example most portraying? Which ethicalprinciples should guide the nurse in working with this patient andfamily member?

• Jimmy Chang, a 20- year- oldcollege student, is admitted to your institution for additionalchemotherapy. Jimmy was diagnosed with leukemia 5 years earlier and hashad several courses of chemotherapy. He is currently in an acute activephase of the disease, though he had enjoyed a 14- month remission phaseprior to this admission. His parents, who accompany him to the hospital,are divided as to the benefits of additional chemotherapy. His motheris adamant that she will sign the informed consent form for this courseof therapy, and his father is equally adamant that he will refuse tosign the informed consent form because "Jimmy has suffered enough."

You

are his primary nurse and must assist in somehow resolving this

impasse. What do you do about the informed consent form? Who signs and

why? Using the MORAL model, decide the best course of action for Jimmy

from an ethical perspective rather than a legal perspective. Did you

come to the same conclusion using both an ethical and a legal approach?