The Adriana Smith Case Was an Ethical Disaster

June 25, 2025

(The Atlantic) – To be clear, Smith, as a brain-dead patient, was legally and medically deceased, so precepts about doing good and avoiding harm would not have applied to her, at least clinically speaking. But the ethical principle of autonomy applies even after a patient’s death. (Consider the United States’ strict consent laws around organ donation.) In the difficult cases when a patient—including a pregnant patient—is in such dire condition that she cannot speak for herself, a proxy decision maker, typically the next of kin, must be the one to make decisions about withdrawing care based on knowledge of the patient’s wishes or values. Some people might argue that a fetus, unable to speak for itself, should also be regarded as having some degree of autonomy; still, in Smith’s case, the fetus’s next of kin, not doctors, should have acted as a proxy decision maker.

Yet Newkirk told reporters that prior to Chance’s birth, she was given no say in what happened to her daughter’s body, nor to the fetus inside her. Emory doctors simply followed what they believed the law prescribed. (Read More)