In the screenplay for the film, In America written by Jim Sheridan. There are several moral and ethical dilemmas throughout the film. However, there's one ethical dilemma that captured my interest as a registered nurse and for personal reasons. The ethical dilemma is whether Johnny and Sarah should allow their premature infant to receive a blood transfusion to save her life that could be potentially infected with a bloodborne disease such HIV.

The scene, where the ethical dilemma occurs, is after Sarah delivers the baby prematurely following a complicated pregnancy. The premature infant requires a blood transfusion to survive. Unfortunately, Johnny was not a blood match and Sarah was too sick and weak to donate blood. Sarah adamantly refused to allow the hospital to give the baby "bad blood." Mateo who is family friend contracted HIV from a blood transfusion. Mateo's health had deteriorated before the family's eyes over time. He was in the intensive care unit at the same hospital as Sarah. Mateo was unresponsive at the time of Sarah delivering the baby and expected not to survive. Sarah could not bring herself to expose her premature baby to that deadly risk of HIV. Christy who is the oldest daughter of Johnny and Sarah's bravely donates blood to her little sister to save her life.

My response to the ethical dilemma is a difficult one as a registered nurse. While I truly understand the fear of the mother not wanting to endanger the life of her newborn with potentially infected blood products. Allowing the baby to die because of her fears is not ethical. As a registered nurse, I've dealt with patients who made choices out of fear which lead to their demise. When this happens, I have the sense of failure as a nurse maybe there a different way I've could have connected with the patient. After a couple of days, I remember a patient has a right to choose their choice of treatment after knowing all the potential outcomes. It's one of their rights as a patient in the Patient Bill of Rights. I'm sure for Sarah watching Mateo die from AIDS was difficult and traumatizing. She could not fathom having her child suffer the same fate, so for that, I sympathized with her.

There was a patient who was a frequent flyer to a hospital where I used to be a staff nurse. He would consistently go on alcohol binges until he ran out of money. The patient would go through alcohol withdrawal requiring hospital admissions. I felt very sorry for his brother who took responsibly for bringing him to the hospital for treatment. His brother would go searching for him when he was missing basically trying to keep him alive. The last time I saw him alive, he was admitted to the hospital for ingesting rubbing alcohol. He was receiving five hundred milliliters per hour of normal saline to detox his system. While changing his IV bags we had a very sober discussion about his life. I attempted to convey to him that he was going to die from alcohol if he doesn't allow us to help him. His response was totally shocking to me as a new nurse he said, "I'm okay with dying." The patient was found dead in his apartment from a seizure a couple months later. It was his choice not to seek treatment for his alcohol dependence despite the fact he knew the death was a potential outcome.

My personal response does not differ from my professional response one. Once Sarah decided to continue the pregnancy after being advised to terminate it. She should continue doing everything to save the baby's life now since she has arrived. I would pray to God for the best possible outcome but attempt to save my baby's life. This would not be an ethical dilemma for me this is my responsibility as a parent.