A 32-Year-Old Woman at 37 Weeks Gestation Is Brought to the Hospital

A 32-year-old woman at 37 weeks gestation is brought to the hospital by her husband.  They have recently immigrated to the United States.  The patient has not received prior prenatal care but reports no problems during the pregnancy.  She has been having regular uterine contractions for the past 4 hours.  Examination reveals that she is in active labor.  The patient agrees to be admitted for delivery.  The physician explains the possible methods of delivery and the complications that can arise from each.  The patient and her husband appear to understand everything that has been reviewed.  They are given the opportunity to ask questions and the patient agrees to proceed.  When the patient is asked to sign the consent form for treatment, she becomes reluctant and explains that women in their culture are not allowed to sign official papers.  She asks that her husband sign the consent form for her treatment instead.  Which of the following is the most appropriate response to this patient's request?

A) Ask the husband to make an exception and allow his wife to sign the consent form
B) Document the patient's verbal agreement and begin treatment
C) Explain that the patient cannot be treated unless she signs consent
D) Have the husband sign the consent form as a surrogate decision maker
E) Treat the patient without obtaining written consent as this is an emergency