Question

A 32-year-old female is brought to the hospital following a severe automobile accident. She is unconscious and does not have any identification on her. She is suffering from head trauma, a compound fracture of the femur, a simple fracture of the ulna, and numerous cuts and abrasions. The neurologist is concerned about the head injury and following a CT scan wants to immediately do surgery to reduce brain swelling; with an orthopedist stabilizing the fractures. The ER nurse is concerned because stat blood work indicates the patient is 10 weeks pregnant and there are risks to the pregnancy and the unborn baby with surgery. She is urging the surgical team to wait until the patient is identified and consent can be given prior to starting the procedures. Can the surgery be performed? Under what legal theory would this decision be made?

Answer 1

In this complex medical scenario, the decision to perform surgery without the patient's consent revolves around the legal theory of implied or presumed consent, typically applicable in emergency situations where an unconscious patient faces a life-threatening condition. However, the added complexity of the patient's pregnancy introduces additional ethical and legal considerations. The medical team must carefully balance the urgency of life-saving intervention with potential risks to both the patient and the unborn child. To navigate this situation, consultation with legal and ethical experts is crucial, as well as making earnest efforts to locate the patient's family or next of kin to obtain informed consent or make decisions that prioritize the well-being of both the patient and the unborn child. The decision should ultimately align with established legal and ethical principles and medical guidelines.