# A nurse is caring for a 16-year-old patient who was brought to the emergency department by friends after a motor vehicle accident. The patient is conscious and alert but has sustained multiple injuries requiring immediate surgical intervention. The patient's parents cannot be reached, and no legal guardian is present. What is the most appropriate nursing action in this situation?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=543609  
> language: ko  
> subject: Critical Care

## 문제

A nurse is caring for a 16-year-old patient who was brought to the emergency department by friends after a motor vehicle accident. The patient is conscious and alert but has sustained multiple injuries requiring immediate surgical intervention. The patient's parents cannot be reached, and no legal guardian is present. What is the most appropriate nursing action in this situation?

## 보기

1. Wait for parental consent before proceeding with any treatment
2. Proceed with emergency treatment under implied consent doctrine **✔ 정답**
3. Have the patient sign their own consent forms as they are alert and oriented
4. Ask the accompanying friends to provide consent for treatment

**정답: 2**

## 해설

In emergencies with minors when parents cannot be reached, implied consent allows life-saving treatment to proceed. Other options cause harmful delays or involve unauthorized consent.

## 심화 해설

Clinical Judgment
The core of this question is applying the legal and ethical principles of Consent in Emergencies and Minor Treatment. The patient is alert and oriented, but is in a life-threatening condition requiring immediate surgery, such as suspected internal bleeding. In a situation where the parents cannot be reached, the nurse's priority judgment is to protect the patient's life and health. The principle of "Implied Consent" allows life-saving treatment to proceed without delay, assuming that a reasonable person (or parent) would consent to emergency treatment. This is a legal safeguard for situations where consent cannot be obtained, not a refusal of treatment.

Memory Tip:
Remember it as **E**mergency + **M**inor + **U**nreachable guardian = **I**mplied Consent (EMUI). In an emergency (E) situation involving a minor (M) when the guardian is unreachable (U), implied consent (I) applies.

KR vs US:
In Korea, under the *Medical Service Act*, emergency treatment for a minor (under 19) also generally requires parental consent, but exceptions are recognized in cases of imminent life-threatening danger. In the US, state laws may more clearly define provisions for "Mature Minor" or "Emancipated Minor" status. For the NGN, you must apply the universal US legal principle of 'Implied Consent'.

## 임상 시나리오

Clinical Practice Guide
Consent procedure in emergency situations:
1.  Determine if the patient's condition poses an immediate threat to life or major bodily functions.
2.  Continuously attempt to contact parents/guardians and be sure to document the process.
3.  Collaborate with the medical team (attending physician, surgical team) to confirm the necessity of emergency treatment.
4.  It is often standard procedure to notify the hospital's legal team or administrator of the situation.

Caution:
If this appears as a SATA (Select All That Apply) question, the action of "continuing to attempt to contact the parents" is a correct action that should be performed concurrently with proceeding with treatment under implied consent. Be careful of traps that ask you to choose only one. The key point is "do not stop attempting to contact the guardian while proceeding with treatment."

## 핵심 개념

- **Implied Consent (묵시적 동의)** — Legal principle that allows necessary treatment to protect life or health in an emergency when the patient is unconscious or lacks decision-making capacity and no guardian can be reached, based on the presumption that a reasonable person would consent to the treatment.
- **Informed Consent (사전동의)** — A process in which a healthcare provider fully explains the purpose, methods, expected outcomes, risks, and alternatives of a treatment to a patient or their representative, ensures understanding, and then obtains voluntary consent. It is a prerequisite for non-emergency, routine medical care.
- **Minor (미성년자)** — A person who has not reached the legal age of adulthood. In most U.S. states, this means under 18 years old, and their legal capacity for actions like giving medical consent is limited.
- **Emergency Doctrine (응급 원칙)** — A legal and ethical standard that allows for the omission of the consent process and the immediate provision of necessary treatment in emergency situations where there is a serious risk to life or health. It forms the basis of Implied Consent.
- **Documentation (문서화)** — An essential part of medical practice. In this scenario, it is very important to document in detail the time, method, and outcome of attempts to contact the parent/guardian, as this serves as the basis for applying implied consent.

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