A patient is admitted to your surgical center for a breast biopsy under local anesthesia.

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?

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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?