An Incubator: What are the Rights of a Brain-Dead Woman?

For decades, Americans have trusted that our voices — captured in advanced care directives, or spoken by loved ones — would guide end-of-life medical decisions when we were no longer able. But, in Georgia, a woman’s body has been used to serve the interests of a fetus she will never get to hold.

Adriana Smith was a 30-year-old nurse in Atlanta. In February, just nine weeks into her pregnancy, she suffered a massive stroke that left her brain dead. She was taken to Emory University Hospital, where doctors confirmed that there was no hope of recovery. Her body — by all medical standards — had died.

But because of Georgia’s “heartbeat law,” which bans abortion after fetal cardiac activity is detected — typically around six weeks — Ms. Smith’s body had been kept on life support. Not to save her, but to serve as an incubator for the fetus. It was the Supreme Court’s Dobbs decision that directly enabled Georgia’s current abortion law to take effect. Before Dobbs, states were prevented from enforcing bans on abortion before fetal viability. But now, under Georgia law, a fetus with a detectable heartbeat is considered a full legal person. Yet in this case, even though there are serious medical concerns about the fetus’s viability, Ms. Smith’s body was sustained for four months through machines and medication against what her family says would have been her wishes.

Doctors and the legal team at Emory University Hospital adopted a more conservative approach. They declined to honor the family’s request to withdraw life support. This issue placed those who advocate for protecting a fetus at all costs against those who believe in respecting the mother’s wishes.

The stakes were enormous, both ethically and legally. This situation echoes the 1990 U.S. Supreme Court’s Cruzan case, which established the right of patients — or their designated surrogates — to make end-of-life decisions. Since then, more than 40 states have passed laws allowing people to document their medical preferences in advance, or name someone — a surrogate — to speak on their behalf.

But these documents only work if people complete them — and many don’t. In Ms. Smith’s case, her family says she was clear about not wanting to be kept alive under such circumstances. They believe continuing life support violates her dignity, her autonomy, and her rights — not just as a patient, but as a human being.

At its core, this case forces us to ask: Who gets to decide what happens to our bodies when we can no longer speak for ourselves?

This case demands a deeper reckoning: Should a state have the power to override a woman’s wishes, silence her family, and keep her body functioning — not for her benefit, but for someone else’s?

The baby was delivered on Friday, June 13th by C-section, weighing 1 pound 13 ounces. Assuming it survives, the baby called “Chance” will be in the ICU for some time. Adriana Smith was removed from life support Tuesday, June 17th.

– Dr. Michael Wilkes with a Second Opinion