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Case of Informed Consent: Mrs. Sparza

Mrs. Sparza, a 70 year old grandmother with little English skills, is scheduled for surgery of her right eye. Upon entry to the hospital, she and her son review the general admission documents and Mrs. Sparza signs them all. Mrs. Sparza also completed and executed a durable power of attorney for health care. Mrs. Sparza identified her daughter and son as her agents for decision making in the event that she became incapacitated. Mrs. Sparza also specified that she did not wish any heroic measures and that in the event she went into a coma, she wanted the life support terminated.

After changing into a patient gown and having her vital signs taken, Mrs. Sparza is taken into the pre-operative room where she is placed on a gurney. After administration of pre-operative muscle relaxant medication, she is rolled into the operating room. Upon entering the operating room, Mrs. Sparza is greeted by Nurse Johnson who asks Mrs. Sparza to sign the surgical consent form. The form is in English and identifies the procedure as surgery of both eyes. Mrs. Sparza is told that she is scheduled for surgery of both eyes and is asked to sign the consent.

When Mrs. Sparza objects and refuses, Dr. Pinnette enters in his green scrubbs and talks with Mrs. Sparza with the aid of an interpreter. After a minute of conversation, with tears in her eyes, Mrs. Sparza signs the consent form and is placed under general anesthesia. At six a.m., on the next day of her hospitalization, Mrs. Sparza suffers a heart attack and her kidneys ceased function. She subsequently went into a coma. Her children were immediately notified and arrived at the hospital at 8:30 a.m. When informed of the doctor's decision to place Mrs. Sparza on a dialysis machine, the son and daughter declined consent and asked that life-support be terminated pursuant to the patient's directive.

Mrs. Sparza's cardiologist, a world renown cardiac surgeon, refused to give the nurses the order to terminate life-support. Dr. Lox looked for every excuse to avoid the family. At the family's request, Mrs. Sparza's nurses provided comfort care until 3:30 in the afternoon of the next day. The two day ordeal was a long and emotionally traumatic experience for Mrs. Sparza's family, who received relief when Mrs. Sparza's nurse injected a fatal dose of morphine to ease and expedite her death.

Evaluate and discuss the legal implications of the actions in the foregoing scenario in light of the module materials and your own research. Please be thorough in responding in an organized paper to the following:

What are the elements of informed consent?

Was Mrs. Sparza's consent proper? Why/Why not?

What were Mrs. Sparza's rights regarding end-of-life decision making?

Discuss the nature of the act of injecting morphine. Was it legal?

Limit your response to a maximum of four pages. Be sure to properly and clearly cite your resources.

Solution Preview

What are the elements of informed consent?

Informed consent is a patient's right to be presented with sufficient information, by either the physician or their representative, to allow the patient to make an informed decision regarding whether or not to consent to a treatment or procedure. Patients have the right to refuse medical care for any reason. Their reasons may include religious grounds as well as any other personal grounds they choose, even if you as physician consider their grounds to be frivolous or in poor judgment.

Informed consent must be obtained by a health care provider who is reasonably involved with the patient's care. A medical student may not obtain consent since they can not be held responsible for patient care. The attending physician has the legal requirement to obtain informed consent. The attending physician may delegate his or her responsibility to obtain informed consent to another health care provider; however, he or she remains totally responsible to ensure it is obtained.

The patient has the right to sue for medical malpractice if informed consent is not obtained. Informed consent is necessary any time the physician is going to either touch the patient or perform an invasive procedure. Informed consent is divided into two parts; express consent and implied consent, which will not be covered in this particular discussion.

In order ...

Solution Summary

Elements of informed consent are discussed in 814 words with three references.