She prepares the necessary airway equipment for general endotracheal anesthesia and pulls her induction medications from the pyxis. The neuroteam is a tightly knit group. The nurse, Carol Wright RN, is a regular. The surgical tech, Lorie Floyd, is a permanent fixture. The team works well with each other and always supports each other in times of crisis. Marin has been a practicing CRNA for over 20 years and is highly respected by the staff. After preparing the room Marin and Carol walk over to pre-op together since the neurosurgeon, Dr. Ian Mellow has just been announced. The patient, Joann Stoic, is seated cross-legged on the stretcher apparently unfazed by the hubbub of the morning chaos. She is talking with Dr. A. Sleep, anesthesiologist, for the case. As the nurses approach Dr. Sleep asks Marin if they can have a word together. Marin and Dr. Sleep walk away from the patients bedside. Dr. Sleep confides to Marin that he is worried about the case since the patient is 13 weeks pregnant. The patient has a letter from her obstetrician that states that the surgery may have a deleterious effect on the fetus. When the patient is asked whether she understands the ramifications of fluoroscopy on a 14-week fetus she calmly states she understands. She tells everyone that although this is her first pregnancy she just cant take the pain anymore and must have the surgery regardless of the damage it may cause the fetus. Her significant other remains stoically by her side. He is an odd looking man with wide set eyes and a low set ears. The team acknowledges her statement and Dr. Sleep asks Marin to text Dr. Mellow to discuss the patients affect and to ask him if the surgery is truly necessary. Dr. Sleep is not convinced that the patient understands what the risks are and wants advice from the chief of anesthesia, Dr. Noel Way. Carol is uneasy about the case and seeks advice from her superiors. Marin has some ideas and is preparing them when she talks to the chief of anesthesia. Describe the ethical and legal issues that are involved in this case. If you were Marin what would you do and why? What party in this case do you feel responsible to? Remember to cite your references and support your answers. Remember quality not quantity.
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