A 50-year-old male presents for an urgent laparoscopic cholecystectomy. The patient has been incarcerated and arrives with the guards from the local correctional facility. While speaking with the patient, the physician anesthesiologist determines that the patient does not have decision-making capacity. The guard suggests to you that you can obtain consent from the warden of the patient’s correctional facility.

From whom should the anesthesiologist obtain informed consent for this patient’s laparoscopic cholecystectomy?

It is a patient’s right to be informed about his or her medical treatment. Because our society highly values autonomy (one of the four principles of biomedical ethics: beneficence, non-maleficence, autonomy and justice), a patient has the right to begin, continue, refuse or withdraw medical treatment. Adults of sound mind are assumed to be legally competent (i.e., able to make decisions regarding their own affairs)....

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