Answer Happy

An elderly female patient was scheduled for back surgery.
Medical history included: HOH (hard of hearing) and
impaired vision (needed glasses for reading). This
patient was alert and oriented, cooperative, and able to make her
own decisions.
Morning of Surgery:
Surgeon was in to see patient and discuss back surgery.
Patient was agreeable to having the procedure done a day early
since there was time in operating room schedule due to a
cancellation. The patient asked for her daughter to be called
regarding the change. The nurse was asked to come into
the patient's room to witness the informed consent. The
nurse knew the patient needed to have her glasses on in order to
read the document. The patient's daughter was to bring in
her mother's glasses later in the day. The consent was
placed in front of the patient after the procedure was discussed by
the surgeon. The patient denied any questions and was asked
(by the surgeon) to sign the consent form. The patient was
hesitant but wanted to be compliant with the surgeon's
wishes. The nurse intervened by stating the
patient could not read the consent form without her
glasses. The patient confirmed this was
true. The surgeon then assertively stated the procedure
would have to be postponed.
Thoughts that come to mind:
1. What are the legal ramifications surrounding an
informed consent signature knowing the patient could not read the
material?
2. How often does this happen when the patient does not
have an advocate immediately available? After all, this
patient wanted to continue to be compliant with the surgeon's
directive.
3. What ethical principles were theoretically violated in
this case?