Cancer

A patient suffering from cancer is scheduled for surgery in the morning.

While instructing the patient not to eat or drink after a certain hour, you realize that the patient is unaware of the risks involved in having the surgery and of those involved in not having the surgery. In talking further, you see clearly that the option of not having surgery was never presented and that the patient has only a vague idea of what the surgery will entail. She also appears to be unaware of her diagnosis. The patient has signed the informed consent. Should you proceed in preparing the patient for surgery?

1. What are the obligations of nurses in example such as this?
2. To what extent must nurses pursue questioning when, in their view, the patient’s right of self-determination is being violated? Unless we are willing to say that a patient upon entering a hospital surrenders the right of self-determination, it seems clear that the physician orders, explicit and implied, should be questioned in all of the above examples.