A 52-year-old Spanish-speaking woman has arrived for the first day of a clinical trial of chemotherapy for breast cancer. You suddenly remember the need for signing a consent form. You ask a medical student to 'get the consent.' He walks up to the patient and says in English, 'Sign this,' and she signs. She completes the trial but her hair falls out and she files suit against you for an improper informed consent. Why will this lawsuit be successful?

A 52-year-old Spanish-speaking woman has arrived for the first day of a clinical trial of chemotherapy for breast cancer. You suddenly remember the need for signing a consent form. You ask a medical student to 'get the consent.' He walks up to the patient and says in English, 'Sign this,' and she signs. She completes the trial but her hair falls out and she files suit against you for an improper informed consent. Why will this lawsuit be successful?

A 72 year old woman was admitted to the Neurological Intensive Care Unit following a cerebral hemorrhage which left her with severe brain damage and ventilator dependent. One year before this event, the patient and her husband had drawn up living wills with an attorney. The patient's living will specified that the patient did not want ventilator support, or other artificial life supports, in the event of a terminal condition or a permanent vegetative state. The patient's husband is her legal next of kin and the person with surrogate decision-making authority. When the living will was discussed with him, he insisted that the patient had not intended for the document to be used in a situation like the present one. By this, the husband apparently meant that although the patient would not be able to recover any meaningful brain function, her condition was not imminently terminal. The husband did not consider his wife to be in a permanent vegetative state. The treatment team allowed a week to pass, with the goal of providing the husband more time to be supported in his grief and to see how ill his wife was. Nevertheless, at the end of this time, the husband was unwilling to withdraw life support measures consistent with the patient's wishes as expressed in her living will. Should the hospital follow the patient's wishes in the living will despite the husband's unwillingness to withdraw life support measures?

Mrs. Hanes is a 62-year-old woman with metastatic breast cancer. She was admitted with dehydration and weakness. Her cancer treatments have failed, as she now has a recurrence. The oncologists are contemplating some new palliative chemotherapy. The nutrition team is concerned about her cachexia and recommends total parenteral nutrition (TPN). Should the patient be started on TPN?

A 36-year-old man has been hospitalized for the past 3 days for alcoholic hepatitis. His condition is slowly improving and his prognosis is favorable. However, this is his third absence from his job in the past 6 months due to health-related issues. The patient notified his employer that he is presently hospitalized and was informed that he needs to provide the employer with proof of hospitalization or he could lose his job. In accordance with hospital policy, the patient provides verbal consent for the physician to speak with his employer and disclose his health status. The employer proceeds to contact the physician directly by phone, requesting an update on the patient and his likelihood of returning to work. Which of the following is the most appropriate response by the physician to the employer?

A 16-year-old girl is brought to the emergency department by her 18-year-old boyfriend due to nausea, vomiting, and severe pain in her lower right quadrant. She also complains of some anorexia. The patient has had these symptoms for almost 12 hours. Her last menstrual period was 2 weeks ago, and she has not been sexually active in the past 2 weeks. Her temperature is $38.1°C (100.6°F), blood pressure is $110 / 70 \mathrm{~mm} \mathrm{Hg}$, pulse is $88 / \mathrm{min}$, and respirations are $12 / \mathrm{min}$. Examination shows diffuse discomfort in her abdomen that is increased in the right lower quadrant without guarding or rebound tenderness. Pregnancy test, workup for sexually transmitted diseases, and pelvic examination are negative. Abdominal and pelvic computed tomography scans show nonspecific inflammation in the area of the appendix but are not definitive for appendicitis. The patient's condition remains stable with improved pain control. However, it is recommended that she be admitted to the hospital for further observation, with consideration for possible exploratory laparotomy in the next 24 hours if she worsens. This is discussed with the patient and her boyfriend. The physician inquires about obtaining consent for further medical care. The patient says that she lives with her parents but does not want them called as 'they would find out I've been spending time with my boyfriend, and they don't approve of him.' Who is the appropriate person to sign the consent form for admission and further medical care?