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 fetal personhood and abortion laws.

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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 anti-abortion 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 v. Wade in 2022, restricts abortion once cardiac activity is detected and gives personhood rights to a fetus.

Smith’s mother says it 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 they 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 v. Wade 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 Emory may therefore consider Smith and the fetus as two patients and that once Smith was on life support, they had a legal obligation to keep the fetus alive, even after she died.

“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.

Personhood divide within anti-abortion movement

Anti-abortion 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 those already born. This personhood concept seeks to give them rights under the 14th Amendment to the U.S. 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 anti-abortion 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 complain 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 health care decisions.”

“Like so many Black women, Adriana spoke up for herself. She expressed what she felt in her body, and as a health care 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 Hispanic and Asian women.

What is Smith’s current situation?

While Smith is on a ventilator and likely 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.

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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.”

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 it aims to raise $275,000.

Associated Press writer Jeff Amy in Atlanta contributed reporting.

By MATT BROWN and MATT O’BRIEN

WASHINGTON (AP) — House Republicans surprised tech industry watchers and outraged state governments when they added a clause to Republicans’ signature “ big, beautiful ” tax bill that would ban states and localities from regulating artificial intelligence for a decade.

The brief but consequential provision, tucked into the House Energy and Commerce Committee’s sweeping markup, would be a major boon to the AI industry, which has lobbied for uniform and light touch regulation as tech firms develop a technology they promise will transform society.

However, while the clause would be far-reaching if enacted, it faces long odds in the U.S. Senate, where procedural rules may doom its inclusion in the GOP legislation.

“I don’t know whether it will pass the Byrd Rule,” said Sen. John Cornyn, R-Texas, referring to a provision that requires that all parts of a budget reconciliation bill, like the GOP plan, focus mainly on the budgetary matters rather than general policy aims.

“That sounds to me like a policy change. I’m not going to speculate what the parliamentarian is going to do but I think it is unlikely to make it,” Cornyn said.

Senators in both parties have expressed an interest in artificial intelligence and believe that Congress should take the lead in regulating the technology. But while lawmakers have introduced scores of bills, including some bipartisan efforts, that would impact artificial intelligence, few have seen any meaningful advancement in the deeply divided Congress.

An exception is a bipartisan bill expected to be signed into law by President Donald Trump next week that would enact stricter penalties on the distribution of intimate “revenge porn” images, both real and AI-generated, without a person’s consent.

“AI doesn’t understand state borders, so it is extraordinarily important for the federal government to be the one that sets interstate commerce. It’s in our Constitution. You can’t have a patchwork of 50 states,” said Sen. Bernie Moreno, an Ohio Republican. But Moreno said he was unsure if the House’s proposed ban could make it through Senate procedure.

The AI provision in the bill states that “no state or political subdivision may enforce any law or regulation regulating artificial intelligence models, artificial intelligence systems, or automated decision systems.” The language could bar regulations on systems ranging from popular commercial models like ChatGPT to those that help make decisions about who gets hired or finds housing.

State regulations on AI’s usage in business, research, public utilities, educational settings and government would be banned.

The congressional pushback against state-led AI regulation is part of a broader move led by the Trump administration to do away with policies and business approaches that have sought to limit AI’s harms and pervasive bias.

Half of all U.S. states so far have enacted legislation regulating AI deepfakes in political campaigns, according to a tracker from the watchdog organization Public Citizen.

Most of those laws were passed within the last year, as incidents in democratic elections around the globe in 2024 highlighted the threat of lifelike AI audio clips, videos and images to deceive voters.

California state Sen. Scott Wiener called the Republican proposal “truly gross” in a social media post. Wiener, a San Francisco Democrat, authored landmark legislation last year that would have created first-in-the-nation safety measures for advanced artificial intelligence models. The bill was vetoed by California Gov. Gavin Newsom, a fellow San Francisco Democrat.

“Congress is incapable of meaningful AI regulation to protect the public. It is, however, quite capable of failing to act while also banning states from acting,” Wiener wrote.

A bipartisan group of dozens of state attorneys general also sent a letter to Congress on Friday opposing the bill.

“AI brings real promise, but also real danger, and South Carolina has been doing the hard work to protect our citizens,” said South Carolina Attorney General Alan Wilson, a Republican, in a statement. “Now, instead of stepping up with real solutions, Congress wants to tie our hands and push a one-size-fits-all mandate from Washington without a clear direction. That’s not leadership, that’s federal overreach.”

As the debate unfolds, AI industry leaders are pressing ahead on research while competing with rivals to develop the best — and most widely used —AI systems. They have pushed federal lawmakers for uniform and unintrusive rules on the technology, saying they need to move quickly on the latest models to compete with Chinese firms.

Sam Altman, the CEO of ChatGPT maker OpenAI, testified in a Senate hearing last week that a “patchwork” of AI regulations “would be quite burdensome and significantly impair our ability to do what we need to do.”

“One federal framework, that is light touch, that we can understand and that lets us move with the speed that this moment calls for seems important and fine,” Altman told Sen. Cynthia Lummis, a Wyoming Republican.

And Sen. Ted Cruz floated the idea of a 10-year “learning period” for AI at the same hearing, which included three other tech company executives.

“Would you support a 10-year learning period on states issuing comprehensive AI regulation, or some form of federal preemption to create an even playing field for AI developers and employers?” asked the Texas Republican.

Altman responded that he was “not sure what a 10-year learning period means, but I think having one federal approach focused on light touch and an even playing field sounds great to me.”

Microsoft’s president, Brad Smith, also offered measured support for “giving the country time” in the way that limited U.S. regulation enabled early internet commerce to flourish.

“There’s a lot of details that need to be hammered out, but giving the federal government the ability to lead, especially in the areas around product safety and pre-release reviews and the like, would help this industry grow,” Smith said.

It was a change, at least in tone, for some of the executives. Altman had testified to Congress two years ago on the need for AI regulation, and Smith, five years ago, praised Microsoft’s home state of Washington for its “significant breakthrough” in passing first-in-the-nation guardrails on the use of facial recognition, a form of AI.

Ten GOP senators said they were sympathetic to the idea of creating a national framework for AI. But whether the majority can work with Democrats to find a filibuster-proof solution is unclear.

“I am not opposed to the concept. In fact, interstate commerce would suggest that it is the responsibility of Congress to regulate these types of activities and not the states,” said Sen. Mike Rounds, a South Dakota Republican.

“If we’re going to do it state by state we’re going to have a real mess on our hands,” Rounds said.

O’Brien reported from Providence, Rhode Island. AP writers Ali Swenson in New York, Jesse Bedayn in Denver, Jeffrey Collins in Columbia, South Carolina, and Trân Nguyễn in Sacramento, California contributed to this report.

WASHINGTON — U.S. health officials on Friday endorsed the first blood test that can help diagnose Alzheimer’s and identify patients who may benefit from drugs that can modestly slow the memory-destroying disease.

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The test can aid doctors in determining whether a patient’s memory problems are due to Alzheimer’s or a number of other medical conditions that can cause cognitive difficulties. The Food and Drug Administration cleared it for patients 55 and older who are showing early signs of the disease.

More than 6 million people in the United States and millions more around the world have Alzheimer’s, the most common form of dementia.

The new test, from Fujirebio Diagnostics, Inc., identifies a sticky brain plaque, known as beta-amyloid, that is a key marker for Alzheimer’s. Previously, the only FDA-approved methods for detecting amyloid were invasive tests of spinal fluid or expensive PET scans.

The lower costs and convenience of a blood test could also help expand use of two new drugs, Leqembi and Kisunla, which have been shown to slightly slow the progression of Alzheimer’s by clearing amyloid from the brain. Doctors are required to test patients for the plaque before prescribing the drugs, which require regular IV infusions.

“Today’s clearance is an important step for Alzheimer’s disease diagnosis, making it easier and potentially more accessible for U.S. patients earlier in the disease,” said Dr. Michelle Tarver, of FDA’s center for devices.

A number of specialty hospitals and laboratories have already developed their own in-house tests for amyloid in recent years. But those tests aren’t reviewed by the FDA and generally aren’t covered by insurance. Doctors have also had little data to judge which tests are reliable and accurate, leading to an unregulated marketplace that some have called a “wild west.”

Several larger diagnostic and drug companies are also developing their own tests for FDA approval, including Roche, Eli Lilly and C2N Diagnostics.

The tests can only be ordered by a doctor and aren’t intended for people who don’t yet have any symptoms.

AP Medical Writer Lauran Neergaard contributed to this story

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

By CLAIRE SAVAGE

A federal judge in Texas struck down guidance from a government agency specifying protections against workplace harassment based on gender identity and sexual orientation.

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Judge Matthew J. Kacsmaryk of U.S. District Court for the Northern District of Texas on Thursday determined that the U.S. Equal Employment Opportunity Commission exceeded its statutory authority when the agency issued guidance to employers against deliberately using the wrong pronouns for an employee, refusing them access to bathrooms corresponding with their gender identity, and barring employees from wearing dress code-compliant clothing according to their gender identity because they may constitute forms of workplace harassment.

Kacsmaryk said the guidance is “inconsistent with the text, history, and tradition of Title VII and recent Supreme Court precedent.”

Title VII of the 1964 Civil Rights Act protects employees and job applicants from employment discrimination based on race, color, religion, sex and national origin.

The EEOC, which enforces workplace anti-discrimination laws, had updated its guidance on workplace harassment in April of last year under President Joe Biden for the first time in 25 years. It followed a 2020 Supreme Court ruling that gay, lesbian and transgender people are protected from employment discrimination.

Texas and the Heritage Foundation, the conservative think tank behind Project 2025, in August challenged the guidance, which the agency says serves as a tool for employers to assess compliance with anti-discrimination laws and is not legally binding. Kacsmaryk disagreed, writing that the guidance creates “mandatory standards … from which legal consequences will necessarily flow if an employer fails to comply.”

The decision marks the latest blow to workplace protections for transgender workers following President Donald Trump’s Jan. 20 executive order declaring that the government would recognize only two “immutable” sexes — male and female.

Kacsmaryk, a 2017 Trump nominee, invalidated all portions of the EEOC guidance that defines “sex” to include “sexual orientation” and “gender identity,” along with an entire section addressing the subject.

“Title VII does not require employers or courts to blind themselves to the biological differences between men and women,” he wrote in the opinion.

Heritage Foundation president Kevin Roberts commended the decision in an emailed statement: “The Biden EEOC tried to compel businesses — and the American people — to deny basic biological truth. Today, thanks to the great state of Texas and the work of my Heritage colleagues, a federal judge said: not so fast.”

He added: “This ruling is more than a legal victory. It’s a cultural one. It says no — you don’t have to surrender common sense at the altar of leftist ideology. You don’t have to pretend men are women. And you don’t have to lie to keep your job. ”

The National Women’s Law Center, which filed an amicus brief in November in support of the harassment guidance, blasted the decision in an emailed statement.

“The district court’s decision is an outrage and blatantly at odds with Supreme Court precedent,” said Liz Theran, senior director of litigation for education and workplace justice at NWLC. “The EEOC’s Harassment Guidance reminds employers and workers alike to do one simple thing that should cost no one anything: refrain from degrading others on the job based on their identity and who they love. This decision does not change the law, but it will make it harder for LGBTQIA+ workers to enforce their rights and experience a workplace free from harassment.”

The U.S. Department of Justice and the EEOC declined to comment on the outcome of the case.

The EEOC in fiscal year 2024 received more than 3,000 charges alleging discrimination based on sexual orientation or gender identity, and 3,000-plus in 2023, according to the agency’s website.

The Associated Press’ women in the workforce and state government coverage receives financial support from Pivotal Ventures. AP is solely responsible for all content. Find AP’s standards for working with philanthropies, a list of supporters and funded coverage areas at AP.org.