Then document the issues of the case as you would document in the medical record.

Decide how you will proceed. Then document the issues of the case as you would document in the medical record. Your documentation needs to 1) include the issue, 2) decision you made to resolve the issues, 3) what actions you took and 4) the reasoning for you decisions and actions. 

Sandra, an exceptionally bright and articulate 13 year old, is found to have a cancerous tumor in one eye. The tumor is growing rapidly. Surgery is required and the surgeons believe it is likely that a blood transfusion will be required during the operation. Sandra’s parents make it clear to you that they are unwilling to give their consent to any procedure which involves giving her blood products. Initially, Sandra agrees with them, even though you explain to her the risks involved. However, later on, when you and your colleagues are alone with Sandra, she tells you that she’s really very scared of dying and would like you to do whatever you think is best. What should you do?

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