Brain Death and a Body Held Hostage
How Georgia law turned a dead woman into a vessel—and stripped her family of any say.
Adriana Smith was legally dead.
Her heart was beating because machines made it beat.
Her body was breathing because a ventilator forced it to.
But her brain—the part of her that made her a person—was gone.
She had suffered a catastrophic brain injury from untreated cerebral clots.
Doctors at Emory University Hospital declared her brain dead on February 19, 2025.
And yet… they didn’t let her go.
Instead, her body was kept on life support for almost four more months. Not for her.
But for the fetus inside her.
Her family was told they had no say.
Why? Because Georgia law said the fetus had rights of its own.
🧠 What Is Brain Death—And Why It Matters
Brain death is legal death.
It’s not a coma. Not a vegetative state. Not something people “wake up” from.
When a person is brain dead, they are dead.
No EEG activity. No brainstem reflexes. No capacity to breathe without a machine.
Under standard law and clinical ethics, once brain death is confirmed:
Life support can be withdrawn.
The body is released to the family.
End-of-life wishes (or those of next-of-kin) are followed.
That’s how it’s supposed to work.
But that’s not what happened in Georgia.
⚖️ What Georgia’s Law Says—and How It Was Used
In 2019, Georgia passed the Living Infants Fairness and Equality (LIFE) Act—also known as the “heartbeat bill.” It bans most abortions after six weeks and gives embryos and fetuses legal personhood once cardiac activity is detected.
Adriana’s fetus was roughly 8–9 weeks old when she was declared brain dead.
That meant, under Georgia law, her fetus was considered a legal person—a patient with rights.
Emory Hospital interpreted the law this way:
“We cannot remove life support. The fetus is alive. That would be ending a life.”
Her family, horrified, was told:
“You don’t have a say. Because she was pregnant.”
The hospital (Emory University Hospital Midtown) remained relatively tight-lipped, citing patient privacy, but did issue statements that they were following “Georgia’s abortion laws and all other applicable laws” and using “consensus from clinical experts, medical literature, and legal guidance” in making treatment decisions.
In other words, the hospital’s ethics committee and legal team had presumably concluded that withdrawing life support could violate state law given the fetus’s legal status.
Indeed, legal analysts pointed out that the Georgia law’s personhood provision might have put the hospital in a position of seeing two patients – and feeling a legal obligation to protect the fetus’s life once Smith’s body could be used as a life-sustaining environment.
“These are the kind of cases that law professors have been talking about for a long time when they talk about fetal personhood,” noted law professor David S. Cohen .
🧾 Could Adriana Have Stopped This Herself?
Even if Adriana had filled out an advance directive saying “Do not keep me on life support,” it wouldn’t have mattered.
Georgia—like many other states—nullifies advance directives during pregnancy.
That means:
A pregnant person’s wishes can be legally ignored.
Even brain death may not end care.
The fetus’s potential life can override the patient’s autonomy.
So unless Adriana had legal documentation specifically addressing pregnancy and brain death (which most people don’t), her prior wishes were legally void.
Her family, who knew her best, were left helpless.
🧭 What the Attorney General Said—Too Late
In May 2025, as the case drew national attention, Georgia’s Attorney General made a surprising statement:
“Nothing in the LIFE Act requires hospitals to keep a brain-dead woman on life support.”
Legally, they argued, removing life support from a deceased person was not an “abortion”—because the intent wasn’t to terminate the pregnancy, just to end futile medical intervention.
But by that point, Emory Hospital had already made its call.
They had interpreted the law conservatively.
And in the absence of clear legal protection, they chose the fetus over the family.
In a statement, the AG’s spokesperson said:
“Removing life support is not an action with the purpose to terminate a pregnancy.” 
In fact, Georgia’s abortion statute does not explicitly address the scenario of a brain-dead pregnant patient, and it includes exceptions for the life or health of the mother (which arguably could apply in a case where the mother is already deceased).
Some Georgia officials went so far as to call the law “completely irrelevant” to Smith’s case, accusing activists and media of mischaracterizing the intent of the legislation .
Nonetheless, others – including State Sen. Ed Setzler, the very author of the heartbeat law – praised the hospital’s actions as “completely appropriate” and lauded the effort to save the fetus.
Setzler said he was “thankful that the hospital recognizes the full value of the small human life living inside of this regrettably dying young mother,” hoping the child would “grow into vibrant adulthood” and calling it a silver lining that at least one life might be saved out of the tragedy .
Influential anti-abortion groups like Students for Life echoed that stance, arguing that keeping Smith on somatic support was the right thing to do under the law.
🏥 What Happens When Law and Medicine Collide
This case reveals a chilling truth about post-Roe America:
Laws written to protect fetuses are being used to override adult patients’ rights.
Hospitals, fearing liability, are deferring to legal interpretation—not ethical standards.
Families are being stripped of authority—even after their loved one is legally dead.
Adriana Smith became a vessel.
Her body was maintained for the fetus inside her.
Her humanity was secondary.
Her mother called it “torture.”
She watched her daughter turn 31—on a ventilator.
She sat by her bedside, unable to say goodbye.
This clash of interpretations highlights a profound ethical dilemma. At its core is the question: Who has the right to decide in a case where a pregnant patient can no longer speak for herself?
Before the fall of Roe v. Wade, it would have been standard for a brain-dead person’s next of kin or designated medical proxy to make decisions about continuing or discontinuing life-sustaining treatment.
In Georgia, as in many states, an individual can fill out an advance directive for healthcare – but notably, Georgia law invalidates such directives during pregnancy unless the fetus is already viable outside the womb (viability is generally ~23–24 weeks; Smith was only 9 weeks pregnant at brain death).
This “pregnancy exclusion” meant that even if Smith had documented wishes not to be kept on life support, those wishes could not be honored at the time she collapsed.
Still, absent a specific law compelling intervention, ordinarily her mother (as next of kin) would have been able to decide to remove life support given the futility of Smith’s condition.
Post-Roe abortion bans introduced a new wildcard: fear among providers and hospitals that withdrawing support (and thus losing the fetus) might expose them to legal liability under strict fetal-protective laws.
As legal experts noted, these laws have “removed patient autonomy when they are pregnant,” creating scenarios where it’s “not clear who we are making decisions for anymore”.
In Smith’s case, the hospital essentially made the decision on behalf of the fetus, effectively using Smith’s body as an incubator against her prior wishes or her family’s wishes. Reproductive rights advocates found this deeply troubling, arguing that the state’s intervention had “denied the family the ability to even make a decision about their loved one”.
An ethicist from Compassion & Choices described Smith as “being used as a means to an end in a really, really heartbreaking way,” with the woman’s own dignity and humanity sidelined for the sake of the pregnancy.
The nationwide debate spurred by Smith’s story touched on other cases and concerns as well. Medical experts noted that maintaining a brain-dead woman on support from such an early point in pregnancy (only 9 weeks along) with hopes of a healthy baby at the end is virtually uncharted territory – most reported cases of prolonged somatic support in pregnancy have occurred later in gestation (late second or third trimester).
The toll on the mother’s body and the resources required are enormous: in one published case in Florida, a brain-dead woman at 22 weeks was kept on ICU support until 33 weeks, requiring continuous monitoring, hormone treatments, infection control with multiple antibiotics, and a large team of specialists; even then the intervention was considered costly and extraordinary.
Smith’s case pushed these boundaries further, raising questions of how far medical systems should go, and at what cost, to potentially save a fetus.
Notably, Smith’s mother had launched a GoFundMe campaign to help with expenses, indicating that the baby “could have significant disabilities” and setting a goal of $275,000 for care. Thus, the practical and financial implications of such mandated life support were also part of the conversation.
Ethics in a Post-Roe World — Who Gets to Decide?
In the wake of Dobbs, advance directives are suddenly full of loopholes for pregnant patients.
Many standard forms explicitly exclude any “extraordinary measures” that might prolong death—but then carve out an exception for pregnancy.
That means your documented end-of-life wishes disappear the moment you test positive.
Hospital ethics boards now shoulder decisions in these legal grey zones.
— When no clear directive exists, ethics committees convene: OB, ICU, legal, chaplaincy.
— They wrestle with questions like, “Are we honoring the patient, or the fetus?”
— As one ethicist put it, “It’s not clear who we are making decisions for anymore.”
Fetal personhood statutes complicate things further.
— In many states, laws grant the fetus independent rights—even after maternal brain death.
— Doctors become proxy parents to a legal “person” whose interests may conflict with the patient’s prior wishes.
— Removing life support can be deemed “feticide,” exposing providers to criminal liability.
These dynamics play out very differently across socioeconomic lines.
— Poor families, lacking access to high-powered legal counsel, rarely see their advance directives honored.
— Families of color report feeling sidelined by committees that implicitly assign lesser weight to their voices.
— One community advocate observed, “When money and race intersect, it’s the patient’s autonomy that vanishes first.”
In this post-Roe reality, the most vulnerable pregnant patients find themselves stripped of choice—subject to a patchwork of statutes, hospital policies, and committee judgments.
And the question remains:
Who truly gets to decide when there is no clear patient left to speak for?
Medical experimentation disguised under an antiabortion veneer.
I want to be crystal clear about something — however carefully the hospital sought to redefine the narrative, the core facts remain unchanged. A brain‑dead mother and a pre‑viable fetus were maintained on full life‑support in circumstances for which no protocol exists and no ethical consensus has been reached. In one jurisdiction those machines would have been disconnected; in another, they would have remained. That interstate variability is not the mark of settled science—it is the hallmark of improvised practice. Trial. Error. And in the middle of it all, a family forced to watch as their loved ones became the variables.
It is impossible to divorce this reality from medicine’s long, well‑documented history of experimenting on Black bodies—J. Marion Sims’s unanesthetized gynecologic surgeries on enslaved women, the non‑consensual harvesting of Henrietta Lacks’s cells, the forced sterilizations of Black, Brown, and Indigenous women throughout the 20th century. Whenever the profession edges up against its ethical limits, it too often tests those limits on us.
This case is no exception.
We must therefore ask: Had this patient been white, affluent, or legally represented from day one, would her death have been considered final rather than provisional? Would the hospital have hesitated before venturing into ethically uncharted territory?
Because what transpired was not an inevitable tragedy—it was a series of conscious choices. Choices that treated a Black woman’s body as an instrument even in death, that privileged a speculative fetal outcome over a moral reckoning, and that echoed centuries of reproductive violence wrapped in the language of care.
💡 What You Need to Know
If you’re pregnant—or could become pregnant—you deserve to understand what these laws mean for you.
📝 Check your state’s laws on pregnancy exclusions.
Some states invalidate advance directives during pregnancy. Others limit decision-making power if a fetus is viable.
📜 Update your Advance Care Directive (ACD).
Make sure it includes pregnancy-specific language. If you don’t want to be kept on life support while brain dead, say so—clearly, explicitly, and legally.
⚖️ Know that “personhood” laws don’t just affect abortion—they can affect life, death, and everything in between.
In a post-Roe world, fetal rights are expanding. But maternal rights? Often shrinking.
🧩 What This Means for All of Us
This wasn’t just a medical tragedy.
It was a legal failure. An ethical failure. A policy failure.
Adriana Smith was denied her voice.
Her family was denied their role.
And her death became a prolonged spectacle of state control.
Her body deserved peace.
Her family deserved dignity.
And we all deserve laws that don’t turn dead women into incubators.
Next: The Baby She Carried—and the Risks He Faces
In Part 5, we’ll follow the birth of Baby Chance—Adriana’s premature son—delivered by C-section at 25 weeks.
We’ll explore what it means to survive as a micro-preemie, the medical challenges he faces, and the quiet burdens families carry after the public headlines fade.
Because this story didn’t end with life support.
It continued in an incubator.
And that, too, deserves to be understood.