Georgia Republicans Are Playing Dumb About Adriana Smith

Sign up for the Slatest to get the most insightful analysis, criticism, and advice out there, delivered to your inbox daily.

The state of Georgia wants us to believe that Adriana Smith’s case is a mystery. Smith, a 30-year-old Black woman who lost brain function after a pregnancy complication, is being kept on a ventilator because she is pregnant. Her family members haven’t decided whether they would want life support turned off but resent that they don’t even have a choice. Her case—and the bad publicity it has attracted—has set off a cascade of denials from Georgia Republicans. The anti-abortion group that championed the state’s heartbeat ban, the Faith and Freedom Coalition, argues that Georgia’s six-week abortion ban doesn’t apply to Smith. The state’s attorney general likewise issued a press release last week arguing that nothing in Georgia’s law “requires medical professionals to keep a woman on life support after brain death.” How? Because removing Smith from life support would not count as “an action with the purpose to terminate a pregnancy.” But Republicans in Georgia aren’t addressing the rest of the state’s law, which is much more than an abortion ban, and how it affects this case and other state residents. Smith’s case is a predictable result of a state that has embraced not just bans on reproductive rights, but the “personhood” of a fetus.

While many states recognize fetal rights in various contexts, Georgia’s LIFE Act was unique. At the time it passed, so-called heartbeat bans were all the rage in red states. These laws criminalized abortion at six weeks. Georgia went a step much further, defining the term natural person to mean “any human being including an unborn child.” The state even spelled out changes to the laws governing the collection of child support and census measurements.

It’s true that Georgia lawmakers probably weren’t thinking of women like Adriana Smith when they passed their abortion ban. Smith, a nurse and mother, was pregnant with her second child when she began experiencing severe headaches. It turned out that she had severe blood clots in her brain that eventually left her brain-dead. Emory Healthcare, her provider, is keeping her on life support because of her pregnancy and its fears that they might run afoul of the “natural person” law. It is unclear whether Smith’s child will ever be born or would survive long thereafter. Smith’s family is fighting for the right to decide whether she should be kept on life support. They also are raising money, given that they bear the costs of raising Smith’s son if he survives (it is unclear whether Smith has insurance, or who is paying for the costs associated with her hospitalization, but it is likely her family).

If Georgia lawmakers weren’t thinking of cases like this one, they may be regretting that now. The attorney general opened a familiar playbook to deal with the blowback: He argued that Emory Healthcare wouldn’t get in trouble if they took Smith off life support because that wouldn’t count as an abortion. Since the Supreme Court reversed Roe v. Wade in 2022, anti-abortion leaders have used this strategy more than once. Physicians have sometimes withheld lifesaving care for patients suffering from complications related to miscarriage, stillbirth, or abortion because they fear prosecution. But anti-abortion politicians have insisted that these procedures actually aren’t actually lifesaving. Or, if they are medically necessary, like the management of an ectopic pregnancy or preterm premature rupture of membranes, that just doesn’t count as an abortion. Making this move allows abortion opponents to argue that the procedure is never medically necessary, and that their bans are not causing the very concrete harms that are impossible to deny.

Now, Georgia Republicans want to argue that any time voters are sympathetic, a procedure might not be an abortion either. They seem to be tapping into an idea also advanced by groups like the American Association of Pro-Life Obstetricians and Gynecologists that doctors may provide lifesaving care that terminates a pregnancy if termination isn’t the primary intent—a claim that echoes the Catholic doctrine of double effect. Taking Adriana Smith off life support would be primarily intended to honor the wishes of her family, not end her pregnancy. For that reason, the state suggests, doing so wouldn’t qualify as an abortion.

But the problem, again, is that Georgia was an early adopter of fetal personhood arguments. Fetal personhood—the idea that the Constitution recognizes rights from the moment an egg is fertilized—often serves as a rationale for abortion bans, but it’s more than that. If rights begin at fertilization, and if rights are honored with criminal punishment against anyone seen to harm the fetus, then why wouldn’t Emory Healthcare get in trouble? Why, for that matter, would it be acceptable to destroy unused embryos created through in-vitro fertilization, or even to store embryos for future use? Why would it be acceptable for a pregnant woman to refuse a cesarean section if physicians feel that procedure would improve the outcome for the fetal person? Georgia’s attorney general might have been able to finesse this situation if the state’s law were an abortion ban, but it’s not. It’s a preview of what’s to come as the push for personhood continues.

As the group Pregnancy Justice has documented, laws recognizing fetal rights aren’t unusual, even if isn’t always clear how judges, prosecutors, and doctors will understand and enforce them. But anti-abortion groups have much grander ambitions. The most absolutist groups are lobbying for laws that would authorize the criminal punishment of women in the name of protecting fetal rights. Others are taking a more incrementalist approach, writing personhood into measures on child support, or wrongful death.

But the goal isn’t to remain in the states; the desired destination is the U.S. Supreme Court, which could issue a ruling recognizing fetal rights under the federal Constitution. From a practical standpoint, that would be the silver bullet the anti-abortion movement has been searching for—a ruling that could be used to argue that any state law protecting abortion or IVF violates the federal Constitution. And from a symbolic standpoint, it would affirm something abortion foes have long believed: that the meaning of equality in America has to be overhauled to focus on the fetus.

Cases like Adriana Smith’s are no accident. Even when Roe was on the books, states like Texas passed laws prohibiting pregnant women from being taken off life support in the name of protecting fetal life.

It’s hard to believe Georgia conservatives that they didn’t see any of this coming. But regardless, the rest of us know what’s next. Adriana Smith’s case isn’t an oversight. It’s just one example of what fetal personhood means.

Sign up for Slate's evening newsletter.