Because any delay guarantees Sarah Jenkins’s death, the duty to rescue and beneficence—together with the norm of implied consent in life‑threatening emergencies—override strict protocol adherence in this moment. Proceeding prevents imminent, irreversible harm to the primary stakeholder (the patient), whereas the harms of a protocol breach (legal, procedural, reputational) are secondary and remediable post‑event with full auditing and disclosure. Negotiation is unlikely to be timely, and upholding protocols would constitute a knowing failure to prevent avoidable death, conflicting with nonmaleficence. I would initiate surgery immediately while simultaneously alerting security, preserving complete logs, and preparing for transparent review afterward.