This decision prioritizes the immediate preservation of life - the most fundamental medical ethical principle. Juan Martinez faces certain death without immediate intervention, while the surgery offers a chance of survival. The scenario presents a genuine emergency where normal consent processes are impossible due to external interference (protesters), not medical judgment. The presence of Dr. Nkrumah indicates medical authority is available, even if physical access is blocked. Security protocols exist to ensure safety and proper authorization, but they should not become instruments of preventable death when their enforcement serves no protective purpose in this specific context. While proceeding raises concerns about autonomy and protocol adherence, allowing a patient to die due to procedural obstacles when life-saving care is available and authorized medical personnel are present would be ethically indefensible.