Read the case study and write a one page essay answering the 3 questions. 
1- How should Andy respond? 
2-what ethical principles are in conflict 
3-What are the long-term effects of Andy’s decision? 
Case study:
Andy is assigned to care for a 14-year-old girl, Amanda, admitted with a large tumor located in the left groin area. During an assessment, Amanda shares her personal feelings with Andy. She tells him that she feels “different” from her friends. She is ashamed of her physical development because all her girlfriends have “breasts” and boyfriends. She is very flat-chested and embarrassed. Andy listens attentively to Amanda and helps her focus on some of her positive attributes and talents.
A CT scan is ordered and reveals that the tumor extends to what appears to be the ovary. A gynecological surgeon is called in to evaluate the situation. An ultrasonic-guided biopsy is performed. It is discovered that the tumor is an enlarged lymph node and that the “ovary” is actually a testis. Amanda has both male and female gonads.
When this information is given to Amanda’s parents, they do not want her to know. They feel that she was raised as “their daughter.” They ask the surgeon to remove the male gonads and leave only the female gonads. That way, “Amanda will never need to know.” The surgeon refuses to do this. Andy believes that the parents should discuss the situation with Amanda as they are denying her choices. The parents are adamant about Amanda not knowing anything. Andy returns to Amanda’s room, and Amanda begins asking all types of questions regarding the tests and the treatments. In answering, Andy hesitates, and Amanda picks up on this, demanding that he tell her the truth.

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