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Adriana Smith Case: Setting The Record Straight · The Lila Rose Show

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Hello everyone, Welcome back to the Lila Roe Show.
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You've probably seen the media headlines about the case, the
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tragic case of Adriana Smith. Adriana Smith was a young mother
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who was pregnant with her second baby who experienced some sort
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of a blood clotting event where she ended up in the hospital and
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dying. According to media reports, she
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is now brain dead, which is dead and she is on life support.
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So she was on life support and then they declared her brain
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dead. The baby is still alive.
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And so the hospital is keeping her own life support because the
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baby is alive. The baby is growing, and now the
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baby is nearing the point of viability.
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So the baby named now Baby Chance by Adriana's grieving
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family, Baby Chance is still alive.
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And it looks like Baby Chance is going to make it now.
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This should be heralded as a wonderful silver lining, despite
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the tragic passing of the beloved Adriana, that her little
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boy, this little boy lovingly named Chance, is going to
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survive the tragic and early death of his mother.
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But instead media reports are making this about how Adriana is
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being poorly treated, or at least her dead bodies being
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poorly treated because you know, Chance is being given a chance
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to live and that Adriana's family had no choice and
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therefore this shows how big and bad pro-life laws are.
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This is all taking place in the state of Georgia, which has a
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heartbeat law prohibiting abortion after the heartbeat can
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be detected. Now, the reality is this has
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nothing to do with the heartbeat law in Georgia.
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And this has to do with another law that says that with advanced
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directives that somebody who is pregnant, who may be in a coma,
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that you can't just pull the plug on them when there's
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another life at stake because this baby, baby chance deserves
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care and deserves a shot at life.
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Unfortunately, that's not been what the media narratives have
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said in this case. And there's been a lot of
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confusion even in some pro-life circles about this case.
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And we're going to have on today Father Tad Bholchek, who is the
1:48
senior ethicist at the National Catholic and Bioethics Center.
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I think Father Tad's position on this makes the case very clear
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for any person of good conscience, certainly any
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pro-life person, as to why, of course, of course, we should
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give baby chance a chance. And of course, it's very good
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that Georgia law protects babies like baby chance.
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Father Tad, thanks so much for joining the show.
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Lila, great pleasure. Glad to be able to.
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Do it. So you and I were speaking
2:15
recently about the Adriana Smith case, which is a very tragic
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case with a a beautiful silver lining that has been making the
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media headlines over the last few weeks.
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For our listeners, can you first share what you understand to be
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the the details of the Adriana Smith case?
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Yeah. So her case is it's kind of a
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rare case, medically speaking. So it's a case that involves her
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undergoing severe damage to the brain, apparently to the point
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that this resulted actually in a full diagnosis of brain death.
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So in other words, Adriana Smith appears to be deceased.
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However, she was pregnant at the time that she had this blood
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clot that went up to her brain or perhaps multiple blood clots
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and really caused massive stroking in her brain.
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And because she's pregnant, there has arisen a huge
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controversy around whether she is entitled to continued care in
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this situation of, you know, basically attempting to shovel
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her pregnancy further and further along to the point that
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the baby would be passed viability, hopefully well past
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viability, you know, maybe several weeks, multiple weeks
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beyond viability and then be able to be delivered.
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And at that point, then the fact that Adriana is on a ventilator
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and she's presumably getting a lot of other interventions,
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blood pressure meds, you know, maybe a heating pad underneath
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to help with warming the body. You know, many of those
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functions are lost when you're when you're deceased, when
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you're brain dead and you have to be more and more aggressive
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to maintain the the kind of continuing posture of the body
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to be able to support something like a pregnancy.
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But again, after after delivery, then none of those measures
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would be continued. They would be discontinued and
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Adriana would be able to be, you know, then sent over to the
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funeral Funeral Home and, you know, prepared for burial and,
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and for last rites. Thank you, Father Chad.
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So my understanding, in addition to what you just shared about
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the details of her condition and, and the fact she's on life
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support is, you know, in terms of the media narrative on the
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case, there is a tremendous outcry from, again, media groups
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whose headlines talk about forcing women to incubate.
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You know, the word incubate is often used a baby.
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There's language about this being dehumanizing towards
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Adriana, that her family should have the ability to unplug her,
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that she should be unplugged. And there is a quote that's used
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in some of these media reports that happened, you know, close
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after she had been diagnosed as brain dead from her mother,
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indicating some sort of a desire to have a choice in the matter
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as to whether Adriana would continue to be on life support,
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her body while the baby in order to keep the baby alive versus
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let her pass. And that would end the life of
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the baby as well. And so the media is running with
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that word choice to indicate, oh, this is against the choices
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and the wishes even of her family and Adriana.
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What are your thoughts on this? Well, I think that you're right,
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the mom did say that. I have a sense that she might be
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at the point of regretting it because she subsequently
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indicated that her family does want to see the baby be born,
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and they seem to be, at this point, generally supportive.
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So I think she said that at the beginning.
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And, you know, I'm not sure sort of how the communication was
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playing out with the hospital. And you know, that's often an
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important level for the family to feel included in what's going
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on. Now the the doctors have given
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an indication that while under the law here, Georgia State law,
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we have to continue the gestation because, you know,
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there's as soon as there's a heartbeat that's detected, then
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there's an obligation to to maintain the pregnancy.
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That's that was the at least the initial claims set of claims
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that was being made in the press when this whole thing started.
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Now I think people have recognized that that law doesn't
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strictly apply, but rather the law that deals with advanced
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directives in Georgia. That's likely to be the law that
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would apply here. And I forget the exact details
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of how that specifies it, but I think it says that if an
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individual is pregnant, that they're not to be, you know,
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disconnected, that efforts are to be made so on behalf of of of
7:19
the baby, of course. And I don't know even that that
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advance directive specifies brain death, but just a
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situation involving a pregnancy. The advance directive language
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seems to afford an implied protection for the child in
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utero there. So, yeah, the narrative that
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you're, you're getting at here, the incubator narrative, you
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know, I, I think the incubator claim it's it itself, Lila is
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dehumanizing, I would say, because, you know, if you were
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to go up to a just a, a woman on the street who was pregnant and
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showing and you were to say to her, hey, you're an incubator.
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I mean, that's, that's kind of dehumanizing.
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It's failing to recognize who she is and the, the choice that
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she, she made with her husband to bring new life into the world
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and their openness and receptivity, all that, you know,
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that's implicit in in the state of being pregnant.
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She's not just an incubator. And so I think just because
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Adriana is deceased, I think the fact remains that she deserves
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to be addressed in less dehumanizing language and not be
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called an incubator. But to understand that she, when
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she was alive, she was a mom who cared, you know, deeply about
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her child. And we can safely and reasonably
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presume that she wanted to see that child continue its
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gestation and do well in the pregnancy.
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You know, a lot of moms, they will take steps to avoid
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alcohol, to avoid eating bad things, anything that would put
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their child at risk. And I think we can, again,
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imagine and assume reasonably that this was the course of
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events for her. So she wasn't just an incubator,
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she was a mom. And now, yes, she's a deceased
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mom. And we can use that language
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fairly. But I think we need ourselves to
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push back when the claim is made that that, you know, by
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supporting this child that somehow there's a dehumanization
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or a switch over to an incubator situation.
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There's not, there's still a continuity of intentions from
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when this pregnancy began and continued on.
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Now, you know, just to say a quick word about the the mom and
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the follow up. I think as I alluded to, if
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there had been better communication with the hospital,
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then the mom might not have been pressured to make the comment.
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Oh, we should have been allowed to be part of this decision
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making, you know, etcetera. And so I think this was more of
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a kind of human dynamics failure than anything else.
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Now, should it have become the the mom's decision?
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You know, it's tricky because let's say that Adriana had
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designated her mom as her healthcare proxy.
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Now, if Adriana were still alive, then her mom could make
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decisions on her behalf, you know, assuming that Adriana was
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unconscious. But now that Adriana has died,
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it kind of shifts over to a focus upon the child, the unborn
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child whom they've named Chance. So the focus is now on Chance.
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And at that point, the question becomes, well, even though the
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mom was designated as the healthcare proxy, does that
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really mean that the mom would ever have any right to step in
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and say we want to discontinue the care on behalf of this child
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and cause the child's death? I don't think so, because if you
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are providing this important service of being a healthcare
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proxy, you are acting on behalf of the individual who has
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designated you, or maybe in this case on behalf of the baby.
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And you're doing so with the best interests of that
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individual in mind. And the best interests of the
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child here are clearly not to be killed in the womb, not to be
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harmed in any way, but to be safeguarded, protected to to
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receive care from the medical system, and to be shuttled,
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hopefully to the point of viability.
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So I think this is where the Georgia law, you mentioned the 2
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Georgia laws that have been called into question and media
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reports. There's the heartbeat law
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prohibiting abortion, and then there's this law having to do
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with cases like a, a, a person on life support and, and advance
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directives that they might have that would impact their child if
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they were pregnant. And how you are not by Georgia
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law allowed to remove life support from a mother who is
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pregnant. And unless there was, you know,
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already the child was dying or, you know, was not viable, you
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know, would be dead in this point.
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So the pregnancy was not viable in the sense that the baby's
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already passed away. So I want to tease this out a
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little bit more because this is where even in I'm noticing the
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pro-life space, there's some confusion about what is the
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right step forward. Obviously, it's never correct,
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never acceptable to intentionally end an innocent
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human life. In this case, removing life
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support from the mother would end the innocent human life of
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the child, but that would not necessarily be an intended
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effect. So I've heard some
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rationalizations to say, well, removing the life support, if
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that's what the family really wanted for whatever reason,
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justifiable or not, if that's what they really wanted, they're
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not intending directly to kill the baby, even though the baby
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is going to die. So therefore somehow it is OK.
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What? What is your response to that?
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Well, I think the problem there is do you have a truly
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proportionate reason for discontinuing the interventions
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on Adriana's body? Because when you talk about
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double effect, you're going to be requiring that there be, you
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know, a sufficiently serious reason for engaging in, in this
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type of step. And so I think the type of
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argument that would likely come up from the family would be
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something like, well, we'd like to bury her or we'd like to, you
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know, be able to move to the grieving stage next.
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And those are certainly legitimate goods.
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You know, I, we can't deny that those are, are worth pursuing,
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but not perhaps in this particular set of circumstances
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right now. In other words, there are other
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goods that are competing and that actually supersede those
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goods. And that would include the good
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of the life of that child. That child is, is, you know, a
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family member factually speaking and deserving of the continued
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love and care, not just from Adriana's body, but from the
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whole family all around, you know, to the extent that they're
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involved in the decision making. So I don't think double effect
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actually applies here in in this particular scenario.
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And you know, the, the problem of having a single action that
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you're doing with two effects, it's it, you would be able to,
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you know, Marshall it under that heading.
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It's true. But I don't think you're going
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to be able to say that the good effect is proportionate to the
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bad effect. So double effect really doesn't
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doesn't apply. Doesn't work.
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And is it fair to say that the baby is a patient of the
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hospital so they have a responsibility to care for that
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patient? It certainly is.
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And I think before she was diagnosed as being brain dead,
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the hospital had two patients, presumably, you know, and as her
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brain bleed was getting more and more severe, I don't know if
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that happened in the hospital or if it happened prior to her
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arriving at the hospital. But at any rate, prior to her
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death, there were two patients. And that's always the case in a
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pregnancy. And after Adriana died, yes,
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we're left with one patient who deserves the attention of the
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medical community in that hospital.
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And, you know, my sense, my read of the Georgia law would be that
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this is a reasonable course of action that they're choosing.
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They're recognizing they have healthcare obligations here and
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they want to fulfill and carry out those duties on behalf of
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the single patient who remains under their aegis right now.
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I think there is, again, playing devil's advocate here because I
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want to allay any concerns that any person of good conscience
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has for giving baby chance, a chance, which is what's being
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done, which is beautiful. The there is another concern
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that I've heard voiced by, you know, both those that support
16:37
abortion and those that are not sure where they land.
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In this case, that the use of the mother's body to continue to
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be the conduit within with which the body of the baby receives
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the nutrients it needs in order to grow, as well as other
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support in order to grow and hopefully be born soon is
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unusual in terms of the mother being dead.
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I mean, that's a very unusual case.
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The fact that now she's on life support and that's how the
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babies can able to continue to survive.
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And I think that has raised alarm bells for some people who
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say, well, that's not that's unnatural.
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Throughout in human history, we haven't had life support in the
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same way where you could sustain a dead body long enough to
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deliver a baby alive. And so therefore, you know,
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you're entering into a space that's scary concerning.
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And, you know, perhaps this could be used, if this is
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morally acceptable to do it this way, this can be used in some
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other immoral, immoral way in the future because you're
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instrumentalizing the mother's body in this way.
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What What are your thoughts on that?
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Well, I think I would hesitate to go as far as saying that
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involves a form of instrumentalization of the body.
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I think, you know, the way I would frame this would differ
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and I would say the mom would want her body in all likelihood
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to do what it was doing prior to the point that she died.
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And one of the examples that I sometimes share is when you just
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think about motherhood more broadly, this notion of the mom
18:17
caring for the child even with her own body.
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If a mom saw that her child was slipping off of a slide at the
18:26
park and she had to kind of throw herself down quickly and
18:30
fall on the ground herself to break the fall of the baby as
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the baby, as the child came off the edge of the slide, she would
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do it. She would use her body in that
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way. Is that instrumentalization?
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Not really. Or, you know, a more extreme
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example, if if she sees a gunman with a pistol and she and he's
18:49
points at her and she's holding the baby right in her arms
18:52
facing him, I think it would be a natural instinct for her to
18:56
turn away, turn her back towards the gunman to take the bullet on
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behalf of the child. You know, that's, that's sort of
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a just, it's the maternal instinct.
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It's the maternal desire. So is it instrumentalization of
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her body? No, it's a choice.
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I think of charity. It's a manifestation of love.
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And when we look at a case like Adriana's, we can also look at
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it from a different perspective. When people die, they do a lot
19:27
of different things with their bodies.
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They have a lot of options. They may want to do a an organ
19:33
donation of part of their body to someone else.
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So you could see this as a large series of, of a set of organs
19:43
that are being temporarily donated on behalf of her child
19:48
to maintain her child. You could frame it that way when
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somebody dies, they may have may have a desire to donate their
19:58
body to science. And you know, this can involve
20:02
some pretty unusual unusual uses to use the same word that you
20:08
used earlier. For example, if you donate your
20:11
body to science, sometimes the body will be used for Ballistics
20:15
studies and they'll shoot your body full of of bullets.
20:19
And you can say, well, Gee, is that instrumentalizing the body?
20:23
Well, look, if the person wanted to do this and if everyone else
20:27
in their family, you know, was basically an agreement so that
20:30
there's an understanding that this is what you're doing,
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they're not just going off and doing it on their own without
20:36
any reference to, you know, the the web of relationships that
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they have with other people. This doesn't raise a problem
20:43
fundamentally. And certainly the church allows
20:46
people to donate their bodies to science.
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So can Adriana donate her body on behalf of the gestation of
20:55
her child? Of course she can.
20:57
And, you know, it shouldn't be turned into some kind of
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argument that this is raw instrumentalization or unjust
21:04
or, you know, otherwise inappropriate.
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I if anything, it seems to me it's again, a kind of logical
21:12
extension of the initiation of her pregnancy and the caring and
21:17
gestation of that pregnancy. This just makes a lot of sense
21:22
as the next step given the fact that there was this tragic,
21:27
really sad occurrence of the blood clots that suddenly caused
21:32
her death. I think that's a very good
21:35
analysis, Feather. Tad, just to further clarify
21:39
this, would you say that it is ever morally acceptable in any
21:44
case to remove life support from a mother who is pregnant?
21:49
And in this case, when I say pregnant, the baby is alive.
21:53
Yes, assuming the baby is alive, I think there would be some
21:57
cases, Lila, where this might work, where it might be
22:01
allowable. And those would be cases like,
22:04
you know, if the mom has a very advanced cancer that is already
22:10
metastasized all over her body And you have clear indications
22:16
that she, let's say she's at week, I don't know, 12 or
22:21
something with the pregnancy. And you have very strong grounds
22:26
for concluding that she is almost certainly not going to
22:30
make it to week 13. So it's not a question of
22:35
shuttling the pregnancy at all. And now the family is saying,
22:39
look, do we have to keep the ventilator going?
22:41
Both mom and baby are certainly going to die.
22:44
We are way ahead of viability. We don't believe this is
22:49
required in any way, shape or form.
22:51
This is a type of heroics. Everything else is in order.
22:55
She received the last sacraments.
22:57
She, you know, everyone in the family has come and said goodbye
23:01
to her at the hospital. Then I would say, okay, that's a
23:06
case where I don't think there's a problem of disconnecting and
23:10
you know, you accept the sad outcome that both of them will
23:15
be deceased after that disconnection occurs.
23:19
And so based on what you're saying, let's say theoretically
23:23
Adriana or some woman in a similar case had had an advance
23:27
directive where for whatever reason is highly unusual, she
23:30
would have said, I specifically want to remove life support even
23:33
if I was pregnant. Or if I'm pregnant, I want to
23:37
remove life support because, and they have some invented reason
23:39
like I, I don't want the baby to live without me.
23:42
You know, that there can be reasons that they would come up
23:45
with that. You know, even if that was the
23:48
choice, because we're talking about the language of what would
23:51
Adriana want? You know, she's a mother.
23:53
Mothers typically want good things for their children.
23:56
Well, there's also mothers who choose abortion or who choose
23:58
the death of their children. So what?
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How would that even with an advanced directive explicitly
24:05
stating I would want the death of this child via the removal of
24:08
life support from my body, how would that still not be a moral
24:13
action for the healthcare workers to take to make?
24:19
Yeah, yeah. So I think clearly 1 cannot act
24:24
on advanced directives that specify a path that is morally
24:31
problematic, that is morally unacceptable.
24:34
And to specify that you would in this case, where again, I'm
24:39
assuming that she would spell it all out in the advance
24:42
directive, you know, that even if it were possible to shuttle
24:45
the pregnancy beyond viability, I don't want that to be done.
24:51
I think that could not be, you know, followed in good
24:54
conscience just because it was specified.
24:57
And, you know, I remind you of another thing about advance
25:00
directives. A lot of people have this idea
25:02
that, well, once I write it down, it's sort of, you know,
25:05
becomes etched in stone, if you will.
25:09
And everybody has to follow what I've written down.
25:12
The reality here is more nuanced.
25:15
And the advance directive will many times serve as advisory to
25:23
the healthcare proxy. So I don't know who her proxy,
25:27
you know, is. Was it the the boyfriend who you
25:30
know is the father? I'm not sure.
25:34
Is it the mom who's the proxy? Whoever the proxy is, they
25:38
actually have more to say than what's written down.
25:43
The written down part can be taken into consideration by the
25:48
proxy, but is not something that is binding and necessary to be
25:54
followed. So at the end of the day,
25:57
certainly a Catholic healthcare system could never follow an
26:01
advance directive that specifies an immoral act to be carried
26:05
out. And you know, to my mind this
26:09
this approach here when you have reasonable grounds to believe
26:14
that you can shuttle the pregnancy beyond viability, that
26:18
represents, I believe, an authentic duty to attempt to do
26:22
that on behalf of the child who is the sole remaining patient.
26:29
I think that's very well, said Father Tad.
26:32
For pro-life people who are watching this story unfold,
26:36
again, the media narratives I think are very misleading.
26:40
It's almost this frenzy to urge that baby chance not survive.
26:44
They don't want baby chance to survive.
26:47
Tragically, there's no, it's like, what is the good reason
26:50
for unplugging Adriana? And they just can.
26:53
The best argument I've seen is some sort of choice or some sort
26:56
of autonomy that, you know, again, if she's dead, she
26:59
doesn't have anyways. But it's, it's, it's a tragic
27:02
thing, in my view, to see the media response here.
27:05
What would your encouragement be to those who are pro-life about
27:08
the importance of understanding these distinctions between
27:14
extraordinary and ordinary care? I'd like you to speak to that
27:18
briefly if you could, and about understanding how to speak about
27:22
cases like the Adriana Smith case to help other people
27:24
understand why baby chance in this matter does.
27:27
It is good that he's getting the continued support.
27:29
And it is the right thing for both Georgia law to have that
27:33
statute as well As for the healthcare professionals to
27:36
behave as they are. Yeah, I mean, your mention about
27:39
how the pro abortion forces are sort of wanting to twist and
27:43
torque this in such a fashion that baby chance doesn't make it
27:47
to the end. You know, I just like to think
27:50
about it from another angle, which is what happens if baby
27:53
chance is born successfully here, grows up and then becomes
27:59
a powerful witness. Look what my mom did.
28:02
Look how her you know, the generosity of my mom, even after
28:06
she had passed on, allowed me to live and to come into the world
28:11
and to have the life that I now have, you know, which may be a
28:14
long life for all we know. So that's AI think a very
28:18
beautiful, very pro-life vision that should be undergirding what
28:23
what it is that we're always attempting to do here.
28:26
Now about the ordinary and extraordinary means.
28:30
And so I want to say a little bit about those.
28:34
When you have a situation like with Adriana, the use of
28:41
ordinary or extraordinary as a distinction will apply only
28:47
while she is living. Once she is deceased, you don't
28:51
speak about that because ordinary and extraordinary means
28:56
rely on an assessment of the burdensomeness of particular
29:02
treatments or interventions that you would be using.
29:05
And if you're a corpse, if you're deceased, if you have
29:08
died, even if you have some instruments still hooked up to
29:12
you or some machinery, you're not experiencing any burden.
29:17
You know, there's just no pain. There's nothing that you can
29:20
call upon as a direct burden to that individual.
29:25
So the question then would shift a little bit laterally and you'd
29:29
say, what about the baby? Is the baby experiencing
29:34
significant burdens here by this unusual arrangement that we've
29:40
been talking about? And I would be inclined to say,
29:43
well, there may be some burdens because her mom, I mean, his
29:49
mom's body is not functioning at 100%.
29:54
It's clearly got deficits. Doctors are doing their best to
29:58
compensate for those deficits, so the baby may be indeed in
30:04
some distress. But the question becomes, can
30:09
can we accept a measure of some physiological distress as this
30:15
pregnancy is being shuttled in the hopes, then, what appear to
30:20
be reasonable hopes, that they may be able to reach the point
30:23
of viability? Is that something you know?
30:25
Do the benefits outweigh the burdens?
30:28
The benefits are extremely high here that if the baby is born
30:32
and then continues on and lives, those are great benefits and the
30:36
burdens of some distress that the baby in the pregnancy may be
30:41
under. I think it is likely in many
30:45
cases to be able to be tolerated and is not an unreasonable
30:50
burden. So we would say by an ordinary
30:52
extraordinary means analysis that we should again be
30:57
continuing to care for baby chance in the best ways that we
31:01
can. Thank you so much, Father Todd.
31:04
I'm so grateful for your work. It's so important and I
31:07
encourage everybody to check out NCBC, NCBC or ncbcenter.org and
31:14
it's also Father tad.com where they can find you.
31:18
Any other resources that you recommend people make use of
31:22
when they're learning about stories like this and and
31:25
headlines and they're wondering what's the correct way to think
31:27
about this from a a pro-life bio ethical point of view?
31:31
Yeah, I think our website if they look up especially some of
31:34
my old columns making sense of bioethics, they can find a a
31:40
wealth of material there. And for those who kind of prefer
31:43
the the video world, they can check out.
31:45
I have a YouTube channel as well with I believe it's 8 full
31:50
length videos on a range of topics.
31:53
This specific one that we're talking about, I don't deal
31:55
with, but I do deal with another complex set of circumstances in
32:01
pregnancy and the question of when you can intervene and
32:05
validly apply double effect. So it definitely overlaps with
32:10
some of what you and I have been speaking about during this
32:12
interview. And so that's on my YouTube
32:15
channel if people are interested in that as well.
32:18
Wonderful. Thank you so much, Father Tad.
32:20
Keep up the great work. Well, same to you, Lila.
32:23
Thank you so much. I really appreciate all your
32:26
work as well. Thank you.
32:28
Thanks so much for listening to this episode of the Lila Rose
32:30
Show. I hope this was helpful and
32:31
illuminating to hear from Father Tad.
32:33
Definitely go check out the ncbcentre.org and Father Tad's
32:37
work. Thanks so much for listening and
32:39
we'll see you guys next time.