Sung, Hooten and Villanueva join forces to convince Trisha Miller, a 13-year-old girl with an advanced brain stem glioma, to try surgery one last time before giving up. Shaken from losing a patient, Ty turns to Dr. Tina Ridgeway for support. Meanwhile, Dr. Buck Tierney tries to bully resident Michelle Robideux into pronouncing a potential organ donor brain dead. And Sydney enlists Villanueva's help diagnosing a patient under the care of internist Dr. John Lieberman.

Sung is forced to meet with Risk Management's Fran Horowitz after refusing to apologize to the wife of a patient who died on his table. Ty and Michelle face a moral dilemma when a seemingly schizophrenic homeless man cannot provide the informed consent needed for life-saving surgery. Sydney and Lieberman can't leave work behind during their date. And Buck is forced to evaluate his callous behavior after being named in a lawsuit by malpractice attorney Mitch Tompkins.

Tina's proposal to use an unorthodox procedure to treat a young man with extreme O.C.D. divides the surgeons at the 311 conference. At the same time, Villanueva must find a way to treat a girl with critical internal bleeding who refuses care because of her religious beliefs. Sung discovers that no good deed goes unpunished when a former patient sues him after her successful surgery creates an unforeseen side effect – abnormally increased sexual appetite.

During Monday's 311 conference, Hooten calls Dr. Stewart Delany to explain how a careless mistake killed Delany's young patient. But the outcome of the conference leaves the hospital's surgeons conflicted. Sydney and Villanueva operate on Keith Harriman, a young man with extensive injuries from an apparent suicide attempt. Sydney and Buck wonder about the resources wasted on those who cannot or do not want to be saved. And Mark Ridgeway returns, determined to make Ty and Tina pay for their adultery.

In the season finale, Hooten and Buck find themselves facing off in court against attorney Mitch Tompkins after a grieving son refuses to comply with his mother's final wishes. Sydney's outrage over the health of a morbidly obese 16-year-old boy further strains her relationship with Lieberman. And a seemingly harmless patient puts one of Chelsea General's own in grave danger.