conservative state

WASHINGTON — The Supreme Court term that ended Friday will not be remembered for blockbuster rulings like those recent years that struck down the right to abortion and college affirmative action.

The justices scaled back their docket this year and spent much of their energy focused on deciding fast-track appeals from President Trump. His administration’s lawyers complained too many judges were standing in the way of Trump’s agenda.

On Friday, the court’s conservatives agreed to rein in district judges, a procedural victory for Trump.

What’s been missing so far, however, is a clear ruling on whether the president has abided by the law or overstepped his authority under the U.S. Constitution.

On the final two days of the term, the court’s conservative majority provided big wins for Republican-leaning states, religious parents and Trump.

The justices gave states more authority to prohibit medical treatments for transgender teens, to deny Medicaid funds to Planned Parenthood clinics and to enforce age-verification laws for online porn sites.

Each came with the familiar 6-3 split, with the Republican appointees siding with the GOP-led states, while the Democratic appointees dissented.

These rulings, while significant, were something short of nationwide landmark decisions — celebrated victories for the Republican half of the nation but having no direct or immediate effect on Democratic-led states.

California lawmakers are not likely to pass measures to restrict gender-affirming care or to prohibit women on Medicaid from obtaining birth control, pregnancy testing or medical screenings at a Planned Parenthood clinic.

The new decisions echoed the Dobbs ruling three years ago that struck down Roe vs. Wade and the constitutional right to abortion.

As the conservative justices noted, the decision in Dobbs vs. Jackson Women’s Health did not outlaw abortion nationwide. However, it did allow conservative states to do so. Since then, 17 Republican-led states in the South and Midwest have adopted new laws to prohibit most or all abortions.

On this front, the court’s decisions reflect a “federalism,” or states-rights style of conservatism, that was dominant in decades past under President Reagan and two of the court’s conservative leaders, Chief Justice William Rehnquist and Justice Sandra Day O’Connor.

Both were Arizona Republicans (and in O’Connor’s case, a former state legislator) who came to the court with that view that Washington holds too much power and wields too much control over states and local governments.

With the nation sharply divided along partisan lines, today’s conservative court could be praised or defended for freeing states to make different choices on the “culture wars.”

The other big winner so far this year has been Trump and his broad claims of executive power.

Since returning to the White House in January, Trump has asserted he has total authority to run federal agencies, cut their spending and fire most of their employees, all without the approval of Congress, which created and funded the agencies.

He has also claimed the authority to impose tariffs of any amount on any country and also change his mind a few days later.

He has dispatched National Guard troops and Marines to Los Angeles against the wishes of the governor and the mayor.

He has asserted he can punish universities and law firms.

He has claimed he can revise by executive order the 14th Amendment and its birthright citizenship clause.

So far, the Supreme Court has not ruled squarely on Trump’s broad assertions of power. But the justices have granted a series of emergency appeals from Trump’s lawyers and set aside lower court orders that blocked his initiatives from taking effect.

The theme has been that judges are out of line, not the president.

Friday’s ruling limiting nationwide injunctions set out that view in a 26-page opinion. The conservatives agreed that some judges have overstepped their authority by ruling broadly based on a single lawsuit.

The justices have yet to rule on whether the president has overstepped his power.

Justice Amy Coney Barrett summed up the dispute in a revealing comment responding to a dissent from Justice Ketanji Brown Jackson. “Justice Jackson decries an imperial Executive while embracing an imperial Judiciary,” she wrote.

Missing from all this is the earlier strain of conservatism that opposed concentrated power in Washington — and in this instance, in one person.

Last year offered a hint of what was to come. A year ago, the court ended its term by declaring the president is immune from being prosecuted for his official acts while in the White House.

That decision, in Trump vs. United States, shielded the former and soon-to-be president from the criminal law.

The Constitution does not mention any such immunity for ex-presidents charged with crimes, but Chief Justice John G. Roberts Jr. said a shield of immunity was necessary to “enable the the President to carry out his constitutional duties without undue caution.”

Since returning to the White House, Trump has not been accused of exercising “undue caution.”

Instead, he appears to have viewed the court’s opinion as confirming his unchecked power as the nation’s chief executive. Trump advisors say that because the president was elected, he has a mandate and the authority to put his priorities and policies into effect.

But the Supreme Court’s conservatives did not take that view when President Biden took office promising to take action on climate change and to reduce the burden of student loan debt.

In both areas, the Roberts court ruled that the Biden administration had exceeded its authority under the laws passed by Congress.

Away from Washington, the most significant decision from this term may be Friday’s ruling empowering parents.

The six justices on the right ruled parents have a right to remove their children from certain public school classes that offend their religious beliefs. They objected to new storybooks and lessons for young children with LGBTQ+ themes.

In recent years, the court, led by Roberts, has championed the “free exercise” of religion that is protected by the 1st Amendment. In a series of decisions, the court has exempted Catholic schools and charities from laws or regulations on, for example, providing contraceptives to employees.

Friday’s ruling in a Maryland case extended that religious liberty right into the schools and ruled for Muslim and Catholic parents who objected to new LGBTQ+-themed storybooks.

At first, the school board said parents could have their young children “opt out” of those classes. But when too many parents took the offer, the school board rescinded it.

The clash between progressive educators and conservative parents reached the court when the Becket Fund for Religious Liberty appealed on behalf of the parents.

Justice Samuel A. Alito Jr. said the parents believed the books and stories offended their religious beliefs, and he ordered school authorities to “to notify them in advance whenever one of the books in question is to be used … and allow them to have their children excused from that instruction.”

This decision may have a broader impact than any from this term because it empowers parents nationwide. But it too has limits. It does not require the schools to change their curriculum and their lessons or remove any books from the shelves.

The conservatives fell one vote short in a case that could have brought about a far-reaching change in American schools. Split 4 to 4, the justices could not rule to uphold the nation’s first publicly funded, church-run charter school.

In the past, Roberts had voted to allow students to use state tuition grants in religious schools, but he appeared uncertain about using tax money to operate a church-run school.

But that question is almost certain to return to the court. Barrett stepped aside from the Oklahoma case heard in April because friends and former colleagues at the Notre Dame Law School had filed the appeal. But in a future case, she could participate and cast a deciding vote.

ATLANTA — The case of a pregnant woman in Georgia who was declared brain-dead and has been kept on life support for three months has given rise to complicated questions about abortion law and differing views about whether a fetus is a person.

Adriana Smith, a 30-year-old nurse and mother, was about two months pregnant on Feb. 19 when she was declared brain-dead, according to an online fundraising page started by her mother. Doctors said Georgia’s strict antiabortion law requires that she remain on life support until the fetus has developed enough to be delivered, her mother wrote.

The law, one of a wave of measures enacted in conservative states after the Supreme Court overturned Roe vs. Wade in 2022, restricts abortion once cardiac activity is detected and gives personhood rights to a fetus.

Smith’s mother says the law has left her family without a say in a difficult situation, and with her due date still months away, the family is left wondering whether the baby will be born with disabilities or can even survive. Some activists, many of them Black women like Smith, say it raises issues of racial equity.

What does the law say?

Emory Healthcare, which runs the hospital, has not explained how doctors decided to keep Smith on life support except to say in a statement that it considered “Georgia’s abortion laws and all other applicable laws.”

The state adopted a law in 2019 to ban abortion after cardiac activity can be detected, about six weeks into pregnancy, that came into effect after Roe was overturned.

That law does not explicitly address Smith’s situation, but allows abortion to preserve the life or physical health of the pregnant woman. Three other states have similar bans that kick in around the six-week mark, and 12 bar abortion at all stages of pregnancy.

David S. Cohen, a professor at Drexel University’s Thomas R. Kline School of Law in Philadelphia, said the hospital might be most concerned about part of the law that gives fetuses legal rights as “members of the species Homo sapiens.”

Cohen said that Emory may therefore consider Smith and the fetus as two patients and that once Smith was on life support, the hospital had a legal obligation to keep the fetus alive, even after Smith was considered brain-dead.

“These are the kind of cases that law professors have been talking about for a long time when they talk about fetal personhood,” he said.

State Rep. Nabilah Islam Parkes, an Atlanta-area Democrat, said Friday that she sent a letter to state Atty. Gen. Chris Carr asking for a legal opinion on how Georgia’s abortion law applies when a pregnant woman is brain-dead.

Divide within antiabortion movement

Antiabortion groups are divided over whether they should support personhood provisions, which are on the books in at least 17 states, according to the advocacy group Pregnancy Justice.

Some argue that fertilized eggs, embryos and fetuses should be considered people with the same rights as babies after birth. This personhood concept seeks to give them rights under the 14th Amendment to the Constitution, which says a state can’t “deprive any person of life, liberty, or property, without due process or law; nor deny any person within its jurisdiction the equal protection of the laws.”

Some saw personhood as politically impractical, especially after personhood amendments to state constitutions were rejected by voters in Colorado, Mississippi and North Dakota between 2008 and 2014. Those who steered away sought laws and restrictions on abortion that stopped short of personhood, although they were often informed by the concept.

Personhood proponents argue this lacks moral clarity. Some personhood proponents have been sidelined in national antiabortion groups; the National Right to Life Committee cut ties with its Georgia Right to Life affiliate in 2014 after the state wing opposed bills that restricted abortion but allowed exceptions for rape and incest.

Unequal access to care for Black women

The Associated Press has not been able to reach Smith’s mother, April Newkirk. But Newkirk told Atlanta TV station WXIA that her daughter went to a hospital complaining of headaches and was given medication and released. Then, her boyfriend awoke to her gasping for air and called 911. Emory University Hospital determined she had blood clots in her brain and she was declared brain-dead.

It’s not clear what Smith said when she went to the hospital or whether the care she was given was standard for her symptoms. But Black women often report that their pain isn’t taken seriously, and an Associated Press investigation found that health outcomes for Black women are worse because of circumstances linked to racism and unequal access to care.

Monica Simpson, executive director of SisterSong, the lead plaintiff in a lawsuit challenging Georgia’s abortion law, said: “Black women must be trusted when it comes to our healthcare decisions.”

“Like so many Black women, Adriana spoke up for herself. She expressed what she felt in her body, and as a healthcare provider, she knew how to navigate the medical system,” Simpson said, noting that by the time Smith was diagnosed “it was already too late.”

It’s unclear whether the clots in Smith’s brain were related to her pregnancy.

But her situation is undoubtedly alarming for those seeking solutions to disparities in the maternal mortality rate among Black women. According to the Centers for Disease Control and Prevention, Black women had a mortality rate of 50.3 deaths per 100,000 live births in 2023. That’s more than three times the rate for white women, and it is higher than the rates for Latino and Asian women.

What is Smith’s current situation?

While Smith is on a ventilator and probably other life-support devices, being declared brain-dead means she is dead.

Some experts refer to “life support” as “maintenance measures,” “organ support” or “somatic support,” which relates to the body as distinct from the mind.

Emory has not made public what is being done to allow Smith’s fetus to continue to develop.

In another case in Florida, doctors successfully delivered the baby of a 31-year-old woman who was declared brain-dead while 22 weeks pregnant, but not without weeks of sustained monitoring, testing and medical care. The woman’s family wanted to keep the fetus, physicians with the University of Florida College of Medicine said in a 2023 paper.

On her first day of admission, doctors administered hormones to raise her blood pressure and placed a feeding tube. After she was transferred to an intensive care unit, an obstetric nurse stayed by her bedside continuously to monitor the fetus’ heart rate and movements.

She was on a ventilator, regularly received steroids and hormones, and needed multiple antibiotics to treat pneumonia. Her medical team encompassed multiple specialties: obstetrics, neonatology, radiology and endocrinology.

Doctors performed surgery to remove the fetus at 33 weeks when its heart rate fell, and the baby appeared to be in good health at birth.

“We don’t have great science to guide clinical decision-making in these cases,” said Dr. Kavita Arora, an obstetrician and gynecologist in North Carolina who raised concerns about the effect of prolonged ventilator use on a fetus. “There simply aren’t a lot of cases like this.”

The 2023 paper warned that “costs should not be underestimated.”

It is not clear whether Smith, whose mother said she was a nurse at Emory University Hospital, had health insurance. But JoAnn Volk, a professor, founder and co-director of the Center on Health Insurance Reforms at Georgetown University, said that for people with health insurance, it’s generally up to the insurer to determine whether care is medically necessary and covered under the plan.

While it is unclear how much it will cost to keep Smith on life support until the fetus can be delivered, or who will be responsible for that cost, her mother’s GoFundMe page mentions Smith’s 7-year-old son and notes that the baby could have significant disabilities as the effort aims to raise $275,000.

Associated Press writers Brumback and Thanawala reported from Atlanta and Mulvihill from Cherry Hill, N.J. AP writer Jeff Amy in Atlanta contributed to this report.