A 58 -year-old man is out of town on business in New York....

A 58 -year-old man is out of town on business in New York. He has a myocardial infarction and deteriorates despite thrombolytics and angioplasty. He is intubated and is disoriented and unable to understand his condition. He needs a coronary bypass. His wife is the health-care proxy but she is in another city. You would like her consent in order to perform the surgery because she is the designated surrogate. Which of the following is true in this case? a. She must come to the hospital to sign consent in person. b. The wife must designate a local guardian until her arrival. c. You must repeat the angioplasty instead. d. Telephone consent is only valid for minor procedures. e. Take consent for the bypass over the phone and have a second person witness the telephone consent.

A 58 -year-old man is out of town on business in New York. He has a myocardial infarction and deteriorates despite thrombolytics and angioplasty. He is intubated and is disoriented and unable to understand his condition. He needs a coronary bypass. His wife is the health-care proxy but she is in another city. You would like her consent in order to perform the surgery because she is the designated surrogate.
Which of the following is true in this case?
a. She must come to the hospital to sign consent in person.
b. The wife must designate a local guardian until her arrival.
c. You must repeat the angioplasty instead.
d. Telephone consent is only valid for minor procedures.
e. Take consent for the bypass over the phone and have a second person witness the telephone consent.

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Key Concepts

Surrogate Decision-Making

Surrogate decision-making occurs when a patient is unable to make decisions for themselves and a designated individual, often a family member or legally appointed representative, is authorized to make healthcare decisions that reflect the patient’s presumed wishes and best interests.

Health-Care Proxy

A health-care proxy is an individual legally designated by a patient to make medical decisions on their behalf when they are incapacitated or unable to communicate their own healthcare preferences, ensuring that the patient’s autonomy is maintained even in difficult situations.

Informed Consent

Informed consent is the process in which a patient or their authorized surrogate is provided with all necessary information regarding a medical procedure, including its risks, benefits, and alternatives, to make a knowledgeable decision about whether to proceed with the treatment.

Telephone Consent

Telephone consent involves obtaining a patient's or surrogate's authorization for medical procedures through a telephonic conversation. When appropriately documented and witnessed, it is considered legally valid, even for significant procedures, if timely decision-making is critical and the circumstances prevent in-person consent.

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