In this critical situation, the primary ethical principle of beneficence demands prioritizing the patient's immediate survival, as delaying the surgery guarantees death, while proceeding offers a chance at life despite lacking explicit consent. Upholding protocols strictly would violate non-maleficence by allowing preventable harm, and negotiation could introduce further delays in a time-sensitive emergency, potentially rendering it ineffective. Stakeholders include the patient whose life is at stake, the doctor unable to act, protesters whose concerns are noted but secondary to urgent medical needs, and the clinic's reputation, with trade-offs involving potential legal repercussions for bypassing protocols but justified by the life-or-death urgency.