A patient requires emergent surgery; the client's next of kin is not available immediately. Which action is appropriate?

A patient requires emergent surgery; the client's next of kin is not available immediately. Which action is appropriate?

• A. Obtain consent from the client for the surgery.
• B. Perform the surgery since it is emergent, consent is not necessary.
• C. Delay the surgery until the client's granddaughter can be contacted.
• D. Obtain a consult from mental health to ensure the client's competence.

Answer: (A)

In emergencies, a competent patient’s autonomy means you must obtain informed consent directly from the patient if they are able to understand the procedure, its risks, and alternatives. If the patient can consent, you explain and document consent before proceeding, even when time is critical and family isn’t immediately reachable. Here, the appropriate action is to obtain consent from the patient for the surgery because the patient is capable of making that decision. Delaying to contact a relative would unnecessarily risk the patient, and proceeding without consent would violate the patient’s rights. A mental health consult to assess competence is only needed if there’s doubt about the patient’s decision-making ability, not by default. If the patient were incapacitated and no surrogate available, that would raise the issue of implied consent, but that situation isn’t described here.

In emergencies, a competent patient’s autonomy means you must obtain informed consent directly from the patient if they are able to understand the procedure, its risks, and alternatives. If the patient can consent, you explain and document consent before proceeding, even when time is critical and family isn’t immediately reachable.

Here, the appropriate action is to obtain consent from the patient for the surgery because the patient is capable of making that decision. Delaying to contact a relative would unnecessarily risk the patient, and proceeding without consent would violate the patient’s rights. A mental health consult to assess competence is only needed if there’s doubt about the patient’s decision-making ability, not by default. If the patient were incapacitated and no surrogate available, that would raise the issue of implied consent, but that situation isn’t described here.