A 55-Year-Old Woman with Advanced Metastatic Breast Cancer Arrives at the Emergency

A 55-year-old woman with advanced metastatic breast cancer arrives at the emergency room with dyspnea and tachycardia. After evaluating the patient, the resident orders an echocardiography, which confirms the existence of a pericardial effusion. The surgical team is called in, and the surgical attending informs the patient that a pericardiocentesis is required. After receiving an urgent page, the attending surgeon instructs the resident to acquire informed permission for the treatment. Although the surgical resident has never seen or done a pericardiocentesis, he has recently read an article regarding malignant pericardial effusions. Which of the following is the best plan of action for the resident?

A) Ask an attending in the emergency department to assist with the informed consent discussion
B) Ask the attending surgeon to obtain informed consent for the procedure
C) Give the patient time to carefully read the consent form and return with a witness to obtain her signature
D) Obtain the patient's signature and assure her the surgeon can answer questions before the procedure
E) Research the procedure thoroughly and then obtain informed consent for the procedure

Correct Answer:

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