If a patient cannot provide informed consent due to cognitive impairment, what is the appropriate course of action?

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Respecting patient autonomy and the need for informed consent is the guiding principle. When a patient cannot provide consent because of cognitive impairment, you must obtain consent from a legally authorized representative before performing imaging. If no surrogate can be reached promptly and the imaging is not urgent, the safest and most appropriate course is to pause and wait for formal consent rather than proceeding without authorization. This protects the patient’s rights and aligns with legal and ethical obligations.

Choices that suggest proceeding without consent or ignoring the issue are not appropriate, because performing imaging without consent risks violating autonomy and legal protections. While involving a supervisor and attempting to obtain consent from a surrogate is part of proper process, the immediate action when consent cannot be obtained in a timely non-emergent situation is to cancel the imaging until consent is given.