What should have happened in the tragic case of Adriana Smith, the two-months-pregnant woman who was declared brain dead but has been on life support since February at Emory Hospital in Atlanta, so that her baby might eventually be delivered by C-section? The hospital refused to let her die, concerned it would violate Georgia’s abortion ban, so her family wasn’t given a choice to let her die.
Ms. Smith should have been allowed to die because she, or her body, was no longer a person. Understanding why she wasn’t a person helps us see why her beginning fetus was not a person either and why her being newly pregnant was not a good moral reason to not let her body die. This helps us even better understand why abortion bans like Georgia’s—which were a partial root of this tragedy, due to not specifying what’s legally allowed in cases like these—are unjust laws.
To begin, since Ms. Smith was brain dead, her body remaining alive was of no benefit to her anymore, and allowing her body to die might have been what her family would have chosen: at least, they wanted to be able to make the choice. Their wishes should have been honored: that’s standard, that’s what’s respectful, that’s what’s right. So, given what the family has said, it’s likely that Ms. Smith, or her body, would have been allowed to die many months ago, were it not for her being pregnant.
Should her being around two months pregnant when this tragedy began have made any difference to this? Morally and ethically, no, because neither she nor the fetus were persons. A number of strands of reasoning can be given to support this judgment.
First, people are familiar with brain death and similar conditions and their ethical and legal significance to “end of life” issues. But there are lesser-known counterpart “beginning of life” concepts—being “brain birthed,” “brain born,” and “brain alive”—that are also ethically relevant, insofar as having not just a physical brain, but a consciousness-producing brain, is necessary for our existence as a person, to begin. Indeed, the concepts of brain death and “brain birth” form a kind of symmetry: if brain death marks the end of a person’s existence—as many people believe, then brain birth—or the emergence of a functioning, consciousness-producing brain—marks the beginning: our existence as persons is more than the existence of a living body. That symmetry helps clarify why early fetuses, which have not yet developed such brains, are not yet persons.
We can also better understand why Ms. Smith, the person, is gone, even though her body is still alive, and why her beginning fetus was not a person, by reflecting on a wide range of examples where the concept of “person” applies. Consider these questions:
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What is it to personify something?
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There are fictional persons who are not human: why do they fit the concept of “person”?
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Some people believe there are spiritual persons—God, angels, demons, etc.—who are not human and don’t even have physical bodies: why are they persons, or why do they fit the concept of “person”?
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Some argue that certain non-human animals are persons—or are at least person-like—because they possess at least some characteristics typically associated with being a person. Why is that?
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Many are concerned about Artificial Intelligences (AIs) eventually being persons: what are they thinking AIs might eventually be?
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What makes human beings or human persons persons?
It is plausible that the most initial and obvious answers here will appeal to the general proposal that persons are conscious beings—beings with minds of some type. Why think this? Think about how many people would answer the questions above:
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When something is personified, or presented as having the traits of a person, it is presented something as having a mind—with perception, beliefs, desires, and the like;
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Fictional or possible non-human persons (e.g., from science fiction) are understood to have minds of certain types—mentally and emotionally, they are often similar to human beings, yet they are not biologically human;
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Spiritual persons are often thought of or conceptualized as having beliefs, intentions, plans, hopes, knowledge, and emotions—all of which involve having a mind;
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Some non-human animals are argued to be persons or at least person-like on the grounds that they have beliefs, desires, memories, knowledge, emotions, and sociability—this requires a mind of some type;
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The concern about AI is whether it will ever have genuine experiences—a mind, a point of view—or whether it will always be just a tool doing tasks without awareness, like a fancy calculator: that’s the difference between it being someone, not a mindless something;
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What makes human beings like us persons? Well, we are persons because we have—we are—what Ms. Smith tragically lost: a conscious mind.
These reflections on persons and the concept of “person” helps justify the judgment that Ms. Smith was no longer a person—or that there was no longer a person in her body, so to speak—and that beginning fetuses are not persons either, since they don’t have minds and have never had them. We do not have moral obligations to beings that are not persons or are even person-like; and beings that are not persons or are even person-like do not have moral rights to anyone else’s body for survival and nobody is morally obligated to sustain their biological existence; therefore, letting Ms. Smith’s body die would not have been wrong, despite the fetus dying.
Furthermore, this supports the thinking that early abortions are generally not wrong either: causing the death of a beginning fetus, whether by letting it die or by actively ending its life, is not inherently morally wrong since the beginning fetus is not a person. This means that abortion bans like Georgia’s are unjust because they prohibit and criminalize many actions that are not morally wrong. And their injustice doesn’t always just stop there—they can also lead to further wrongs, such as, in this case, the violation of Ms. Smith’s family’s wishes.
To conclude, what ultimately happens to the fetus will determine the final evaluation of this case. If he dies before birth, these months of anguish and intervention will have served no purpose. If he survives but suffers major medical problems due to his atypical, essentially experimental, gestation, the tragedy will be compounded. Or perhaps he will be basically fine—an outcome that, while fortunate, came at the unjust cost of disregarding the family’s rights.
Nathan Nobis, PhD is a Professor of Philosophy at Morehouse College.