The Tragedy of Adriana Smith
A brief feminist analysis of the case of Adriana Smith, the brain-dead Georgia woman whose body was kept on life support to gestate her fetus
I wanted to write a quick post on the Adriana Smith case and why it deeply disturbs so many feminists.
For those who haven’t heard about the case, Smith was a young Black woman in Georgia who began suffering excruciating headaches when around 9 weeks pregnant. Smith’s boyfriend took her to the hospital, where she was declared brain dead after blood clots were found in her brain.
Rather than consult with the family about what Smith would have wanted in this scenario, the hospital, citing Georgia’s abortion law, elected to keep Smith’s brain dead body on life support to gestate the fetus. As Smith’s body began to decay and issues with the health of the fetus began to mount, such as increasing fluid levels in the fetal brain, the hospital elected to deliver the extremely preterm fetus at 24 weeks. The current health of the baby is unclear. Smith’s body has been taken off life support.
Some pro-lifers and ethicists have expressed puzzlement as to why many women find this so disturbing. Smith was brain dead, so, they claim, there can be no violation of her consent in keeping her decaying corpse alive simply to gestate the fetus; Smith’s mind didn’t exist any more to object. Why, they ask, should anyone be so bothered by this?
I first have to note the irony and hypocrisy of the pro-life position here. Pro-life groups claim that Smith’s 9 week fetus was a person with dignity and “rights”, despite the fact this fetus had no more desires or other mental states than Smith’s brain dead body.
Yet the pro-life groups also claim that it’s perfectly acceptable to treat Smith’s body as, essentially, a biological gestation machine without rights or dignity of its own, and without concern for what Smith might have wanted, because Smith’s brain had ceased to produce any thoughts or desires of its own.
Either both Smith and her fetus were, at this point, non-persons, or both of them were persons with rights and dignity on the grounds both were “living human organisms”, despite both having no brain activity that corresponds to thoughts, desires, and the other mental states associated with personhood.
But one can’t coherently hold that Smith was a non-person without meaningful rights because she had no mental states, yet her fetus was such a person with rights despite also having no mental states!
Of course, pro-life groups might for the sake of argument grant that both were non-persons and then still ask what the problem is with keeping Smith’s body alive as a gestation machine.
I would offer a simple thought experiment to elucidate why women might find Smith’s case so disturbing. Imagine a woman suddenly experiences brain death. Rather than allow her body to die, a group of male nurses decide it would be more fun to keep her body on life support as a sex toy. They justify this on the grounds the woman never specifically asked that her body not be used in this way; the woman’s mind is gone and can’t experience anything; and so there is no problem with treating her body as a means to their sexual pleasure as long as they see fit. What, they ask, is the problem here?
I suspect most people, even pro-lifers, would feel visceral revulsion at the thought of this and find this to be immoral. But why?
Most feminists might point out that such an act treats the woman’s body as a commodity. That it is degrading - if not to the brain dead woman, then to women as a group - for a woman’s body to be callously used simply as a means to such an end, especially when she never gave express permission for her body to be used in such a way. They might point out that such a thing both leads to and springs from a culture in which women’s bodies are not seen as fully belonging to women themselves, but are seen instead as tools that can, at potentially any moment, be appropriated to meet some stranger’s needs. In a state like Georgia, where women’s autonomy is already strongly limited, the cultural and political implications of such an act would be even more strongly felt.
These objections apply just as strongly to Adriana Smith’s case as to the imaginary scenario presented above. But there are even more issues that feminists might object to in Smith’s case.
At 9 weeks, there is no scientific basis for considering Smith’s fetus to have the psychological features required for personhood. By gestating this fetus and then cutting it out of Adriana Smith’s body, the state of Georgia effectively worked to create a little boy with unknown physical and mental health issues, one who will never know his mother.
If you could snap your fingers and create from thin air a motherless infant with unclear, possibly lifelong and severe disabilities, would it be right to do so, if you had no intention or plan for the care of this child yourself? I would argue that, without knowing with great certainty that this child could have a secure and happy life, such an act would be wrong. Creating a little person with such a high potential for deep unhappiness and without a chance for the full spectrum of childhood joy seems at best a terrible moral risk and at worst a truly evil act. If we are to create a child, we should try as much as we can for that child to have at least the basics for childhood happiness - loving parents, a healthy body, and a healthy place to grow up. The state of Georgia was unconcerned with any of this when it decided to run what was essentially a grotesque scientific experiment on Smith’s body.
It’s certainly possible Smith’s child will grow up happy and loved. I hope, if this baby survives, he experiences as much love and joy as every child deserves. But I can hold that while believing what the state did was deeply wrong, a reflection of a deeply morally broken society that cares little about actual women or their children.
In case it isn’t clear, this is no contradiction. I believe that rape is a deeply immoral act, and I hope for a future in which no children are conceived as a result of rape. Yet I also hope that any current children who exist as a result of rape grow up happy and well. In the same way, I hope the best for Smith’s child, should he survive. Yet I hope for a future in which women like Smith can be laid to rest, without being transformed into gestation machines by a cold and uncaring state apparatus.
> But one can’t coherently hold that Smith was a non-person without meaningful rights because she had no mental states, yet her fetus was such a person with rights despite also having no mental states!
I agree with Silas that one could (foolishly) believe that personhood has nothing to do with mental states, but I have a different nitpick here: even if neither was a person *yet*, the fetus had much greater potential to become one than the mother. Potential-life should clearly be a moral consideration, though admittedly a small one—small enough that, in normal cases, women should have the right to abort non-person fetuses, but not so small that it should be totally ignored when there's no woman left to make that decision.
Which brings me to your thought experiment, about which you write:
> Most feminists might point out that such an act treats the woman’s body as a commodity. That it is degrading - if not to the brain dead woman, then to women as a group - for a woman’s body to be callously used simply as a means to such an end, especially when she never gave express permission for her body to be used in such a way. They might point out that such a thing both leads to and springs from a culture in which women’s bodies are not seen as fully belonging to women themselves, but are seen instead as tools that can, at potentially any moment, be appropriated to meet some stranger’s needs.
I really don't think this goes through at all! More likely, our instinctual revulsion toward the men's behavior springs from our usually faulty sexual ethics (cf. zoophilia [https://journalofcontroversialideas.org/article/3/2/255], non-offending pedophiles [https://philpapers.org/rec/KERPAA-7], Louis C.K.'s dead-kid-in-a-field bit [https://youtu.be/96ImL9SZDkg?si=F8XE6PQXni5Yi9Vg&t=331], etc.). Because what we're talking about isn't really a "woman's body" it's just a woman-looking thing which can't feel pain nor be harmed. And though the act still feels icky, it doesn't really bear on whether or not a woman's body "belongs to the woman herself"—because there's no woman left for it to belong to! Of course everyone has a natural right to ownership over their body, but "you" can't have a natural right without "you" existing.
I still think your conclusions are mostly right, though, for two reasons:
1. On the potential-person thing: the quality of their potential-life definitely matters. "If you could snap your fingers and create from thin air a motherless infant with unclear, possibly lifelong and severe disabilities, would it be right to do so, if you had no intention or plan for the care of this child yourself?" is a good question, the answer is no, and so the Smith case has in fact been a real debacle.
2. The fact that so many women and activists saw this as a symbol of autonomy and rights means something, maybe. If it really feels like an affront, like a claim that women don't have ownership of their bodies, then maybe it really was *meant* to be that, and we should oppose it on those grounds. I'm a bit more skeptical of this, though: when I wrote about the Smith case a month ago [https://mistakesweremade.substack.com/p/brain-dead-women-do-not-have-a-right], I mostly made the case that framing this as a battle about abortion is really silly and counterproductive. If anything, the feministy "take her off life support" position was *way* less intuitively sympathetic than the usual pro-choice position, because it just looked like pure downside: in essence, it means killing a fetus just to make a point. So I think feminists would be better off saying something like: "Boy, this is a really ugly situation in a thousand different ways, and as we mourn Smith's family's loss and wish for the wellbeing of all involved, it's important to remember that when women *aren't* braindead they should have full autonomy over their reproductive choices."
I more or less agree with your conclusions, and agree that it is a disturbing case. But being a pedant, I can't help nitpick a few things.
You claim that it is incoherent to hold that Smith was no longer a person, while the fetus was a person at the time. That just looks straightforwardly false! You seem to be assuming that one *has* to believe that personhood requires a certain sort of brain activity, or that it comes down to biological organism-ness. Consider the position: Personhood begins at conception, and ends at brain death... Contradiction? What, no! This looks like a perfectly coherent (if not contrived and strange) view, and in fact I think many pro-lifers will hold something along these lines. So it won't be particularly convincing to someone not already convinced.
Second, you say that it would be bad to bring a person into existence with the prospects of the fetus, and that is supposed to show that they shouldn't have tried to save the fetus here. But for this you again seem to be assuming that the fetus is not a person, which very few not already convinced will grant. You yourself state that once a person exists (even one with a bad life), one should make them have good lives (instead of killing them or letting them die, I assume). A better comparison seems to be: A person who will likely have a bad life in the future is about to die, but you can snap your fingers to save them. Here the case is less obvious, and I think a doctor's ethics of always trying to save lives (even though that's stupid), would commit them to saving the baby, as they did. So it seems to me like you assume what's controversial off the bat to make the case, which will be unconvincing.