What is meant by high-risk informed consent?

Dr S.C. Alpel is a renowned complex aneurysm surgeon, accepting difficult cases from around the world. He has an English-speaking patient from the Middle East who has a very large life-threatening aneurysm. The patient is in the mid-70s, is frail with multiple comorbidities, and needs extensive open surgery. How does the standard Informed consent process need to be altered? A. An interpreter should be present B. The surrogate should be present and participate C. All possible serious complications, including prolonged life support, should be detailed D. The patient must be questioned about his end-of-life wishes E. All of the above should be included