Unpacking the Adriana Smith case: A Modern Dilemma in Medical Ethics

When a woman cannot speak for herself, who decides: her family, her doctors, or the law? Adriana Smith’s case exposes the painful clash between autonomy, ethics, and state control.

By Crystal Kong and Chloe Cherng

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Adriana Smith, a 30-year-old mother and nurse who was also 9 weeks pregnant, was admitted to Emory University Hospital after suffering from a severe stroke. She was later pronounced dead by neurological criteria (“brain dead”) by doctors. Legally, this should have marked the end of life, but because her fetus still had a detectable heartbeat, the hospital refused to remove her from life support.

The heartbeat bill, also known as the Georgia LIFE Act, grants fetal constitutional rights after there is a detectable fetal heartbeat (usually at six weeks). The Emory Hospital claimed this case had to comply with the LIFE Act, though it previously only applied to abortions. Doctors were legally obligated to have her remain connected to machines that sustain her heartbeat and blood circulation until her baby was delivered.

Ethical Issues: Conflicting Perspectives

The Adriana Smith case extends far beyond medicine–it highlights the complexities that arise when the law, medicine, and autonomy intersect. 

Due to Georgia’s law, numerous ethical violations took place. An important aspect of receiving care, especially during end-of-life care, is informed consent, which is essentially autonomy. Adriana Smith was unable to consent, so it was not possible to know if she had wanted to stay on life support to save her baby. Physicians faced the reality of Georgia’s restrictive law: Smith was kept alive to preserve the life of her unborn child, despite her not having given consent.

For the Smith family, the situation was heartbreaking to watch. Her family’s wishes were completely disregarded. Her mother, April Newkirk, emphasized how the decision should’ve been left to the family rather than the state, “And I'm not saying that we would have chose to terminate her pregnancy, but what I'm saying is we should have had a choice." In addition, they were not only losing their daughter, but they had to watch her be used as a human incubator for a baby, without ever knowing if Adriana herself would have wanted to choose this path. In addition, saving this baby without a mother meant the Smiths would be tasked to care for a baby who might have lifelong medical challenges.

Physicians, on the other hand, found themselves trapped between ethics and the law. Their duty to provide the best treatment to their patients conflicted with their legal obligation to follow state restrictions. “These laws create an environment of fear and attempt to coerce us as providers to align with the state, as opposed to aligning with our patients that we work so hard to serve," said Dr. Lucier-Julian.

Though supporters of the law argue that the hospital acted appropriately. Setzler states, "I think it is completely appropriate that the hospital do what they can to save the life of the child. I think this is an unusual circumstance, but I think it highlights the value of innocent human life."

Conclusion

Adriana’s story isn’t unique; it highlights a recurring conflict in medicine. Legal obligations continue to obstruct the rights of pregnant/postpartum individuals for the pursuit of fetal personhood–the belief that fetuses have the legal rights of a person. 

Her story underscores how medicine is more than just simple treatment; it involves addressing numerous factors, such as respecting ethics/values versus the law. Without advocacy and reform, this bioethics crisis will prevail, with patients lacking autonomy and experiencing avoidable distress.

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Works Cited

Cox, J., & Bajada, A. (2025, May 30). Adriana Smith is far from the first incubator. Journal of Medical Ethics blog. https://blogs.bmj.com/medical-ethics/2025/05/30/adriana-smith-is-far-from-the-first-incubator/

Mador, J. (2025, June 7). Does Georgia’s fetal “personhood” law mean a pregnant woman must stay on life support? NPR. https://www.npr.org/sections/shots-health-news/2025/06/07/nx-s1-5425384/georgia-anti-abortion-fetal-personhood-law-pregnant-woman-life-support

Schott, S., Fletcher, F., Horner, C., & Brown, V. (2025, June 4). Pregnancy, brain death, and the right to choose: Lessons from the adriana smith case. The Hastings Center for Bioethics. https://www.thehastingscenter.org/pregnancy-brain-death-and-the-right-to-choose-lessons-from-the-adriana-smith-case/