Alive and kicking

Several months ago, Adriana Smith began having a series of mysteriously intense headaches. When she went to the hospital in Atlanta, Ga., doctors prescribed some medicine and sent her home. The following morning, she woke up unable to breathe, gasping and choking. Her boyfriend called 911, but it was too late. The blood clots building in her brain undetected had robbed her of consciousness. She was declared brain-dead. This would be tragedy enough, but to compound the tragedy, she was pregnant.

As I write, Smith is now 22 weeks pregnant. By Georgia law, her body has been kept on life support, including breathing tubes, to allow the baby to grow. If you read major reports from outlets like NBC News or the Associated Press, you would think this is some “radical” red-state legislation downstream of the Dobbs decision. In fact, the relevant state law well pre-dates Dobbs and is separate from the state’s abortion ban, although it bears specifically on tragic cases like Smith’s. According to Georgia Code § 31-32-9, doctors aren’t permitted to withdraw life support from a comatose pregnant woman unless the fetus isn’t viable and the patient has an advanced directive stating she didn’t want to be kept on support. In Smith’s case, neither condition applies. 

As for her family, we haven’t been told what Smith’s boyfriend would want, but her mother is unhappy that they weren’t given a choice, especially since the baby might turn out to be disabled.

The leftist reaction to this story is predictable, painting pro-lifers as macabre and ghoulish for approving of the state’s decision to give Adriana’s baby a chance to live. One tweet hysterically compares the story to The Handmaid’s Tale, as if Adriana is being enslaved by insane right-wingers. Meanwhile, as Robin Atkins points out, nobody is asking the questions that actually need to be asked around this story, such as why the doctors sent Adriana home without catching her life-threatening brain condition.

Surprisingly, though, it is not just leftists who have argued that Adriana Smith’s life support should be removed. Most recently, Abby Johnson has argued that Smith should for all ethical purposes be considered dead, and thus it is immoral to continue sustaining her body for her child’s gestation. Jennifer Lahl has made the same argument, in disagreement with National Review’s Wesley Smith (no relation). “Sustaining a dead body to incubate a child is no different than gestating a baby in an artificial womb, or pod,” she writes. This wrongs both the child and the woman whose body “should be honored with a prompt and decent burial.” Keeping Adriana’s organs going now constitutes “harvesting the dead.”

Protestant ethicist Matthew Lee Anderson agrees with both of them and fleshes out his own similar argument in a Substack. He believes that most pro-lifers lack and need “a more expansive moral framework” beyond the question of whether Smith’s baby lives or dies. In his mind, by judging that the doctors should keep Smith on life support, they’re betraying a too-narrow theology of the body that doesn’t consider how we should properly handle human corpses. 

Several points need to be made here. First, it shouldn’t be treated as a given that Smith is actually dead. The process of gestation is marvelously complicated. Is it really possible for a corpse to undergo it purely by machine assistance? That hasn’t been established. Anderson’s article accuses pro-lifers of “reduc[ing] the mother to a cipher,” but one could just as well say he “reduces” her to a cadaver by referring to the case as a “post-mortem pregnancy.” (Though, confusingly, he’s also said on Twitter that he thinks she’s alive.)

Further, it is of course true that Christians should approach the bodies of the dead with an appropriate reverence, and that we should be able to explain easily why it would be wrong for a mad scientist to “harvest” corpses for gestation experiments. In a similar vein, both Lahl and Anderson have done good work developing strong arguments against surrogacy and in vitro fertilization. More evangelicals should develop ethical intuitions around such issues. Anderson also makes the correct isolated point that consent is not all, and we should not ground our ethics in thin liberalism. 

Unfortunately, Lahl and Anderson have taken their good intuitions around IVF and surrogacy and seriously misapplied them to Smith’s case. There is a great ethical gulf fixed between their dystopian hypotheticals and the choice not to snuff out the life of a mother’s already naturally gestating child. Even if someone uncovered a macabre gestation experiment mid-flight, it would still be wrong to end the new lives it had created. The blame would lie squarely on the unethical experimenters who had created the scenario, not on those trying to salvage life from it. This view is not incommensurate with a robust theology of the body that gives the living and the dead the respect they are due.

We should stand with the state of Georgia and the doctors caring for Adriana and her child, and we should encourage all pro-lifers to support them with a unified voice. May God bring life from death and beauty from ashes.