Delaying the operation guarantees Sarah Jenkins’s death, and attempting to negotiate would introduce additional delay with a high likelihood of fatal outcome. Emergency ethics recognizes implied consent when a patient is incapacitated and immediate treatment is necessary to prevent death, so beneficence and nonmaleficence favor proceeding. While bypassing protocols risks legal and trust implications, these are proportionate and mitigable (e.g., full audit logging, immediate notification of oversight, and restoration of standard controls) compared to the irreversible harm of death. Prioritizing the patient’s life best serves the core duty to the patient and the broader stakeholders, including family, clinicians, and the institution’s mission to preserve life.