Hastings Center Research Scholar Virginia Brown will be on a panel with colleagues at the 2026 annual ASBH Conference.

Location: JW Grand Ballroom 4 (Third Floor)

Panelists: Virginia Brown, Carolyn Neuhaus, Laura Specker-Sullivan, Faith Fletcher Abstract: Brain death during pregnancy presents complex ethical and legal questions regarding whether-and under what circumstances-any fetal interests or rights take precedence over those of a pregnant person. As pregnancy complications may result in end of life decision-making, bioethicists have a duty to articulate how pregnancy might alter whether and how a patient’s end-of-life preferences are applied. In this interactive panel, we discuss the urgent need for updated guidance on advance care planning and pregnancy. Our panelists bring perspectives from clinical medicine, ethics and health law, advance directive implementation, and reproductive justice-informed maternal health research.

Of the 31 states that disregard pregnant patients’ stated end-of-life preferences, only 2 states disclose these restrictions in their advance directive forms. Obscuring pregnancy restrictions in state advance directive forms offers patients false assurances that their wishes will be honored should they become incapacitated. A lack of transparency around advance care plans prevents patients and their families from making informed decisions about future care and undermines trust between patients and physicians at a critical moment in their relationship.

As revealed by the case of Adriana Smith, the medical system is unprepared for the ethical tensions generated by laws that limit birthing people’s rights to say what will and will not be done to their bodies should they become incapacitated. How ought physicians proceed when the law demands that they disregard the end-of-life preferences of a pregnant patient? And how ought clinical teams counsel patients on how pregnancy might alter the implementation of their advance directives?

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