The Case of the Gestating Brain-Dead Mother: When In Doubt, Choose Life

What a tragedy. A Georgia woman named Adriana Smith was two months pregnant when she suffered blood clots to the brain and was later declared deceased by neurological criteria, i.e., “brain dead.” Under the law, that means Adriana’s body is a cadaver.

The medical team has kept her body functioning so that her baby can continue to gestate. The baby is now at 21-weeks gestation, which is close to viability. (Whether a true corpse can gestate for months is a different question that I won’t address here.) From the AP story:

Smith’s family says Emory doctors have told them they are not allowed to stop or remove the devices that are keeping her breathing because state law bans abortion after cardiac activity can be detected — generally around six weeks into pregnancy.

The law was adopted in 2019 but not enforced until after Roe v. Wade was overturned in the 2022 Dobbs v. Jackson Women’s Health Organization ruling, opening the door to state abortion bans. Twelve states are enforcing bans on abortion at all stages of pregnancy and three others have bans like Georgia’s that kick in after about six weeks.

Like the others, Georgia’s ban includes an exception if an abortion is necessary to maintain the woman’s life. Those exceptions have been at the heart of legal and political questions, including a major Texas Supreme Court ruling last year that found the ban there applies even when there are major pregnancy complications.

Smith’s family, including her five-year-old son, still visit her in the hospital.

Newkirk told WXIA that doctors told the family that the fetus has fluid on the brain and that they’re concerned about his health.

“She’s pregnant with my grandson. But he may be blind, may not be able to walk, may not survive once he’s born,” Newkirk said. She has not said whether the family wants Smith removed from life support.

Let’s analyze this tragic circumstance.

• Abortion is outlawed in Georgia after the fetal heartbeat can be detected, with a health or life-of-the-mother exception. Neither apply here as she is legally dead.
• Removing medical technology would not be an abortion because nothing would be administered to end the pregnancy, nor would the pregnancy be terminated surgically. If Adrianna’s body ceased functioning, the baby would die naturally.
• The baby is considered a “natural person” under the law. I am not sure if that is relevant here.
• Apparently, there is no law in Georgia requiring mechanical body support to continue when a brain-dead woman is pregnant, as exists in a few states. (I generally support such statutes to save unborn babies’ lives.)
• Thus, I agree with lawyer/bioethicist Thaddeus Mason Pope’s assessment — with whom I disagree about almost everything — that the hospital is not legally required to maintain Adriana’s body.

The “law” is one thing. Doing what is “right” is another. Consider:

• Adriana is not being harmed.
• Her baby’s life is precious.
• The baby will be viable in the next several weeks.
• Potential disability does not make the baby’s life less important.
• We allow the bodies of people declared dead by neurological criteria to be maintained for organ donation, so why not gestation? Both are gifts of life.
• The crucial question is consent.
• Would Adriana have wanted her death to kill her child? There is nothing to indicate in the story that she would.
• In this regard, note that the family has not decided whether to remove life support, so the media’s huffing and puffing about Georgia’s abortion ban is misplaced.
• The story doesn’t mention the father. When the baby is born, he should be required to help support or, perhaps, be awarded custody depending on that is in the best interests of the child.

I hope Adriana’s family allows the baby to gestate to viability. I urge those so inclined to pray for the family, the baby, and Adriana’s soul.

When in doubt, choose life.