Andy is a nurse caring for a 14-year-old girl, Amanda, admitted…

Question Answered step-by-step Andy is a nurse caring for a 14-year-old girl, Amanda, admitted… Andy is a nurse caring for a 14-year-old girl, Amanda, admitted with a large tumor located in the left groin area. During an assessment, Amanda shares with Andy her personal feelings. She tells Andy that she feels “different” from her other 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 the 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.How would you respond if you were Andy?If I were Andy, I would answer as many of Amanda’s questions as possible without disclosing the information that the parents specifically requested be withheld. I would ensure that I did not lie to Amanda and if she somehow managed to ask a question that was going to force me reveal exactly what was happening I would respond by saying, that’s a great question but it’s one that the doctor needs to address, I would then excuse myself and make contact with the provider.What are the ethical principles and values that are in conflict here?There is a lot of potential conflict being created in this situation. Looking at the principle of Autonomy, Amanda’s right to self-determination is in danger with her parents attempting to make decisions in secret that will have lifelong consequences. Her parents are attempting exclude her from participating in deciding how she will be able to live for the rest of her life.The principle of Beneficence is also at risk. If the health care team helps in a cover up that will one day be exposed, it is not acting for the good or overall welfare of the patient.Justice also plays a large role here. Removing Amanda’s gonads while purposefully keeping it a secret is not fair to her, and treats her differently than others making determinations about their sexual health.Finally, by going along with the parents the care team would be directly violating the principle of nonmaleficence. This care team would be doing irreversible harm to Amanda without her knowledge or consent. What are your legal responsibilities, or obligations if any?In this situation Amanda is a minor and her parents would be in charge of her care, however, the law allows for teenagers to see their provider in regards to their sexual health without the consent of their parents. Since Amanda expressed body imagine issues and specially mentioned frustration regarding breast development I think Andy should report this information to her provider who could then address Amanda’s concerns legally and tell her exactly what is going on wither body without her parent’s consent.Do you agree with the surgeon?I agree with the surgeon’s decision not to perform the procedure without including Amanda in the process. As I mentioned above, the law allows teenagers the right to make decisions regarding the sexual health independently of their parents, keeping that in mind I think the surgeon was correct to refuse.What process can be used to sort through this conflict?I feel case management, social work, mental health providers, and the existing care team should all come together to try and help this family navigate this very difficult issue. If that fails and Amanda’s parents continue to try to exclude her from the process and make life altering decisions that may not be in her best interest, child protective services should then be involved to protect Amanda’s interests.What is moral distress among care-givers and what can you do to alleviate it?Moral distress occurs when you know the ethically correct action to take but you are constrained from taking it.  Managing this distress can involve several processes such as supporting the nursing code of ethics, continuing to educate staff members on what moral distress is, how to recognize it, and how to respond to it. Facilities should create a space where staff feel safe to share their concerns and feelings and speak up. Do you agree with the student answers?What do you feel about it?Please use college level English and grammar in your comments, and write from a professional point of view. Health Science Science Nursing NURS 101 Share QuestionEmailCopy link Comments (0)