Along with his work at the Divinity School, Smith is the director of the bioethics program for the Trent Center for Bioethics, Humanities, and History of Medicine and associate professor in population health sciences, Department of Health Sciences, Duke University Medical School. 

He has served as a member of the board of directors and the executive committee for the American Society of Bioethics and Humanities. His current research and writing are in the areas of moral philosophy, bioethics, theological ethics, end-of-life care, and religious social ethics. Professor Smith was named a 2016-17 Henry Luce III Fellow in Theology, was the recipient of the 2019 Paul Ramsey Award for Excellence in Bioethics, and in 2022 received the Edmund Pellegrino Medalist Award in health care ethics.  

Professor Smith served as a lecturer at Harvard Medical School in the Department of Global Health and Social Medicine. He served as core faculty for the Master of Bioethics program offered through Harvard’s Center for Bioethics. He also was a principal faculty member for the Initiative on Health, Religion, and Spirituality, an interfaculty initiative across Harvard University that aims to be a research catalyst for an integrated model of spirituality, public health, and patient care in dialogue with spiritual communities.