Who, What, and Whose Decision: Informed Consent for Procedures, Surgery, and a Teenager's Chemotherapy
Student Name
Master of Science in Nursing Program, Aspen University
N520: Legal and Ethical Issues in Health Care
Instructor Name
Month Day, Year
Who, What, and Whose Decision: Informed Consent for Procedures, Surgery, and a Teenager's Chemotherapy
Informed consent is both a legal requirement and an ethical expression of respect for autonomy. Valid consent requires that a patient with decision-making capacity receive adequate information about the nature of the procedure, its risks, benefits, and alternatives, understand it, and agree voluntarily (Guido, 2020). This paper answers the Module 5 prompts through three composite cases.
Case 1: The Right to Know Who Is Performing the Procedure
Composite facts: Mrs. L., 66, consented to placement of a central venous catheter. The attending physician's name appeared on the consent form. At the bedside, a second-year resident introduced herself only as "one of the doctors," and a medical student performed part of the procedure under supervision. Mrs. L. later developed a pneumothorax and learned from a nurse that a student had been involved. She asked whether she had a right to know.
She did. Patients have a right to know the identity and professional status of those who will perform a procedure, because the experience of the operator can be material to the decision; a reasonable patient might want to know that a trainee will perform part of an invasive procedure (Guido, 2020). The manner of introduction is relevant: introducing a resident as "one of the doctors" and not mentioning the student's role conceals information the patient could have weighed. Teaching hospitals meet this obligation by explaining the team structure and the level of supervision during the consent discussion. Mrs. L.'s consent was therefore deficient, not because trainees participated, which is lawful and necessary for education, but because she was not told.
Was the Consent Deficient Beyond Disclosure of Roles?
The signed form does not by itself prove consent. It is evidence that a discussion occurred, but the substance of the discussion determines validity. If Mrs. L. was not told that pneumothorax is a recognized risk of central line placement, the consent also failed to disclose a material risk. The nurse's role is to witness the signature, confirm that the patient appears to understand, and notify the physician if the patient has questions or seems unsure; the nurse does not obtain consent for the physician's procedure (Guido, 2020). If the nurse had noticed that Mrs. L. seemed confused about who would perform the procedure, the appropriate step would have been to pause and ask the physician to clarify before the procedure began. Nurses who witness a signature while doubting that the patient understands take on part of the risk that the consent will later be found invalid, and they also miss the chance to protect the patient's right to decide.
Case 2: The Patient's Knowledge Versus the Family's Concerns
Composite facts: Mr. H., 58, is scheduled for outpatient surgery to remove a suspicious thyroid nodule. He is fully alert and asks the surgeon directly about the chance of cancer and the risk of voice changes. His wife, in the waiting area, asks the nurse to make sure the surgeon "doesn't scare him" with statistics because he is anxious.
Mr. H. is an adult with capacity, and the right to information belongs to him. The family's concern is understandable but does not override his request. Withholding requested information to reduce anxiety would undermine the voluntariness and understanding that consent requires, and the narrow therapeutic privilege recognized in some jurisdictions does not apply to a patient who asks direct questions and is capable of understanding the answers (Beauchamp & Childress, 2019). The nurse can acknowledge the wife's concern, explain that the surgeon will answer her husband's questions honestly and compassionately, and, with Mr. H.'s permission, invite her into the discussion so she can support him.
Case 3: A Teenager's Chemotherapy and Divided Parents
Composite facts: Jordan, 15, has been diagnosed with Hodgkin lymphoma, which has a high cure rate with chemotherapy. His mother supports treatment. His father, influenced by online testimonials, wants to delay chemotherapy and pursue a dietary and herbal regimen. Jordan says he is scared of losing his hair and feeling sick but does not want to die. The prompt asks for an ethical rather than legal resolution, using the MORAL model.
Massage the Dilemma and Outline the Options
The dilemma sets parental authority and family unity against Jordan's welfare and his developing autonomy. In pediatrics, parents give permission rather than consent, and children should give assent to the extent of their ability; decisions are guided by the child's best interest (Katz et al., 2016). The options are to proceed with chemotherapy with the mother's permission; to delay treatment for the father's alternative regimen; to pursue a mediated family discussion aiming for agreement; or, if agreement fails and delay threatens Jordan's life, to seek outside review.
Resolve, Act, and Look Back
Ethically, the strongest option is a mediated discussion that aims for both parents' support for chemotherapy while taking the father's fears and Jordan's concerns seriously. The benefit of treatment is high and the harm of delay may be irreversible, which weighs heavily against the alternative regimen. Jordan's assent matters ethically even where the law gives the decision to his parents: a 15-year-old who understands his illness should help shape how treatment happens. Acting on the choice, the team would meet with the family, explain the evidence plainly, offer to integrate safe complementary measures such as nutrition support alongside chemotherapy, and address Jordan's fears about side effects with specific plans for nausea and hair loss. If agreement cannot be reached and delay would seriously endanger him, ethics consultation and, as a last resort, legal intervention would be justified to protect him (Katz et al., 2016). Looking back, the team would ask whether Jordan felt heard and whether earlier engagement with the father could have prevented the conflict.
Conclusion
Across the three cases, informed consent turns on the same questions: whether the person entitled to decide received the information that matters, understood it, and chose freely. Patients have a right to know who will perform their procedures, a signature does not replace a discussion, families cannot override a capable adult's right to information, and in pediatrics the child's best interest and assent guide decisions when parents disagree.
References
Beauchamp, T. L., & Childress, J. F. (2019). Principles of biomedical ethics (8th ed.). Oxford University Press.
Guido, G. W. (2020). Legal and ethical issues in nursing (7th ed.). Pearson.
Katz, A. L., Webb, S. A., & Committee on Bioethics. (2016). Informed consent in decision-making in pediatric practice. Pediatrics, 138(2), Article e20161485. https://doi.org/10.1542/peds.2016-1485
How this N 520 Module 5 example is structured
N520 Module 5 typically asks for one Word document on the textbook's informed consent chapter: whether a patient has the right to know who performs a procedure and their status, whether consent was deficient, a surgical center scenario weighing the patient's knowledge against family concerns and a pediatric chemotherapy case with divided parents resolved with the MORAL model from an ethical perspective. The textbook cases are not reproduced here; the composites raise the same questions. Aspen revises courses, so follow your classroom's prompt.
N520 Module 5 questions, answered
What does N520 Module 5 usually ask for?
A Word document on informed consent cases: the patient's right to know who performs a procedure, whether consent was deficient, a scenario weighing the patient's knowledge against family concerns and a pediatric chemotherapy case with divided parents resolved with the MORAL model.
Does a signed consent form prove informed consent?
No. The form is evidence that a discussion took place, but valid consent depends on the patient receiving material information about risks, benefits and alternatives, understanding it and agreeing voluntarily.
Who consents for a minor's treatment?
Parents or guardians give permission, and the child should give assent to the extent of their ability, with decisions guided by the child's best interest. When parents refuse highly effective treatment for a serious condition, outside review may be justified.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Aspen University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.