A pregnant nurse, declared brain-dead, remains on life support in order to save her child’s life. The case raises profound bioethical questions about respect for human dignity, the absolute value of unborn life, and the limits of medical intervention. How far can and should medicine go?

Adriana Smith, a 30-year-old nurse nine weeks pregnant with her second child, remains brain-dead after suffering a thromboembolic event in February 2025. She was diagnosed with brain death and is being kept on life support, both respiratory and circulatory, to continue the pregnancy until the fetus reaches the necessary maturity for birth.

Adriana Smith (SPECIAL)

It all began when Adriana experienced severe headaches. After going to the hospital, she was sent home, where she died hours later from a cerebral thrombosis that caused brain death. Once the total absence of brain activity was confirmed, doctors at Emory University Hospital opted to maintain her on life support to preserve the life of the fetus.

The goal is to prolong the pregnancy until 32 weeks, at which point the baby would have a high chance of survival outside the womb. Currently, there are still 11 weeks to reach that point.

Georgia’s state law, one of the most restrictive in the country following the overturning of Roe v. Wade, prohibits abortion from the moment fetal cardiac activity is detected, which occurs approximately six weeks into pregnancy. This law significantly influenced the medical decision to proceed with the abortion.

Adriana’s family has expressed concern about the lack of participation in clinical decisions. Her mother reports that the family has not received clear information about the condition of the fetus or the possible consequences it could suffer. Furthermore, they face a considerable financial burden due to high hospital costs, which is why they have launched a fundraising campaign.

Bioethical Assessment

On previous occasions, we have addressed this topic in our Observatory, analyzing the significant ethical challenges underlying these cases.

One of the main dilemmas is the viability of the fetus in a pregnancy maintained artificially after the mother’s brain death. Although the medical literature, as reported in the Journal of Medical Ethics, documents successful cases of prolonged gestations in these circumstances, these are exceptional and clinically complex situations.

Despite the risks, the life of the nasciturus—the human being in gestation—has absolute value and must be protected. In this case, the fetus is at an advanced stage of development, which increases its chances of survival. Therefore, the effort to maintain the pregnancy until viability is achieved is ethically justifiable.

Based on the premise that the dignity of the mother, even if deceased, must also be respected, avoiding any exploitation of her body, the priority in the case at hand is the defense of the life of the unborn child, the most vulnerable in this situation. Every effort aimed at guaranteeing its birth deserves to be valued as a concrete expression of respect for human life.

In this case, it does not seem appropriate to support the requests for abortion made by her family, based on fear of the appearance of after-effects in the baby. Nor does the cost of the process justify allowing her child to die.

The principle of the defense of physical life in personalist bioethics recognizes the inalienable value of human life at all stages of development and in any circumstance of disability or dependency, placing this value above others such as the will of the mother, the family, the risk of disability, or the cost of life support.

Julio Tudela – Cristina Castillo – Bioethics Observatory – Life Sciences Institute – Catholic University of Valencia