Various aspects of consent

Assess the various aspects of consent, including informed consent, capacity to consent, adequacy of consent,
proof of consent, authorization for consent, implied consent, and statutory consent
Describe means for obtaining informed consent, including expressed, implied, oral, written, complete, and
partial
Outline four exceptions to informed consent
Analyze the influence of medical literacy as it pertains to informed consent
Describe advanced directives, including living wills, natural death acts, and durable power of attorney for health
care and do-not-resuscitate directives.
Assess risk factors, and physical and behavioral findings associated with patient abuse
Describe reporting requirements for abuse

f. Nurses
must understand and use measures that ensure one’s right to control his or her destiny. This module
concluded with a discussion of patient abuse, focusing specifically on pediatric and geriatric populations. Risk
factors, as well as behavioral and physical signs of abuse were discussed. Legal reporting requirements for
abuse were outlined.
Assignment:
Professional Development Exercises :
Read the case study presented at the end of Chapter 8 (Guido, p. 150)
Is the patient correct in asserting that he has a right to know the names and 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?
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?
Jimmy Chang, a 20- year- old college student, is admitted to your institution for additional chemotherapy.
Jimmy was diagnosed with leukemia 5 years earlier and has had several courses of chemotherapy. He is
currently in an acute active phase of the disease, though he had enjoyed a 14- month remission phase prior to
this admission. His parents, who accompany him to the hospital, are divided as to the benefits of additional
chemotherapy. His mother is adamant that she will sign the informed consent form for this course of therapy,
and his father is equally adamant that he will refuse to sign 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?

Sample Solution

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