Ghost surgery — the unauthorised performance of a surgical procedure by a substitute operator while the consented patient remains anaesthetised and unaware — constitutes one of the most serious violations of patient autonomy in modern healthcare [1]. While sustained protests in South Korea have brought this practice to international attention, its dimensions in Indian private hospitals remain inadequately studied and dangerously under-regulated. As a nursing professional, I write to highlight the ethical responsibilities of theatre nurses who witness such substitutions, the moral distress this imposes, and the urgent need for institutional policy reform.