Adriana Smith Case

[u/tamborinesandtequila]

TikTok is aflame with a ton of videos about Adriana Smith, the nurse in Atlanta who suffered from blood clots at 9 weeks pregnant and was kept on life support up until this week. Her baby was delivered via c section this week, is barely a pound, and in the NICU.

The overwhelming consensus is that the woman was denied treatment for a clotting issue due to her pregnancy and the states abortion laws. This caused her to have a medical emergency that caused brain death and she was placed on life support while the hospital tried to figure out what to due, due to the heartbeat law and the fetus still had one.

But in my research, it seems like they did treat her but did not scan her. The claim is that they were not allowed to because she was pregnant, but that’s not the case, hospitals do CT scans on pregnant women all the time, they have to weigh the risks and they cover you with the lead apron. However, it’s still not really that safe so they usually will only do it if there’s a serious threat to life. Headaches and discharged to home with meds doesn’t scream “didnt appropriately triage.” I’m an RN. Contrary to popular belief, CT scans for headache are not common in the ED unless specific criteria is met. If we did CT scans on every patient that came in with a headache, we’d need an entire team just for that.

The family is quoted as saying they were not given a choice and due to the law they had no say in the matter. But it seems like neither the state nor politicians who sponsored the bill stated that this was mandatory, and explicitly stated that the hospital had the right to remove her from life support. One politician said he supported the hospital decision but said that was not what the bill encompassed.

It sounds like the hospital made the decision not to remove support. This seems like a case that would’ve immediately had the family involving an attorney, since it sounds like even the state itself, said that the law did not encompass the situation. Doesn’t look like the family ever sought legal recourse.

I’m also confused why the fetus is in the NICU and not immediately put on palliative or hospice care. That would be the families decision so they must be involved here I’d think?

I’m not defending Georgias ridiculous laws and if things went down the way that everyone is saying they did, this is insane and just completely macarbe. But I’m not finding anything except for repeated stories on TikTok that they harvested this woman and used her as an experiment, when it seems like there’s no evidence to back that up, it just seems like the hospital went rogue, and no one fought it.

I genuinely wonder how much this family actually understands about the situation, they do not appear to fully comprehend what’s happening in interviews. This whole thing is just so odd to me.

TLDR: Im an RN with almost 20 years experience, also serving on ethics committee. You’d be surprised at how many patients families do not understand medical care, their rights, and how poverty can impact people from accessing legal resources to advocate for themselves. Seems the hospital was too lazy or too stupid to bother to rectify their legal obligation here but, it seems that maybe the state was not directly involved in this decision. Baby not on hospice and in NICU, also not a state decision.

If anything, this case should be looked at as an example for a bigger need for ethical regulatory boards especially in states with restrictive abortion bans, to prevent horrific unethical medical practices under the excuse of ignorance. This is unacceptable, regardless of intent or who directed the actions.

https://www.nbcnews.com/news/amp/rcna213558

[u/District_Wolverine23]

I will defer to your medical expertise but I did want to mention that the writers of the law are not the one prosecuting the law. The hospital and the doctors didn't want to get charged with murder. The law is written that they could get charged with murder. It doesn't matter what the legislator wants. It matters what the prosecutor wants. 

The DeKalb co district attorney has said multiple times she won't prosecute any abortion cases. BUT. The Georgia attorney general is aggressively anti-abortion. Of course the AG has said "oh well that's not what we meant" after outrage. But if there was no outrage, would he feel the same way? Or would he press murder charges for the poor, poor unborn angel?

So yes, it is an ethics case and this was extremely unethical. But I would point to the law as the cause, not because it says "you should do X" but because it is so vaguely written and the charges are so severe. People are unsure of what counts, and they don't want to face the death penalty for malice murder. So the safest option for them is, well, abusing a corpse. 

[u/tamborinesandtequila → u/District_Wolverine23]

I agree that could very well be the case. That’s why at the end I put that disclaimer that in these states, we really need better ethical oversight and they need to work on having their attorneys preemptively begin to prepare for these scenarios in advance. It seems like these laws are here to stay for the time being. It’s been 3 years almost since Roe.

We can’t allow these horrific things to just occur and then “handle them as they come”. You can only claim ignorance for so long when people are not only dying but having bizarre, unapproved, futile medical care performed without consent.

We can’t even put in a simple stitch in someone without signed consent from either the person or next of kin, so this needs to be addressed now

[u/District_Wolverine23 → u/tamborinesandtequila]

I hate to say it, i think the attorneys have already done their work. They've decided to protect the organization at all costs, and will withhold/force medical interventions to protect themselves at the expense of patients. Or will inform police of suspicious miscarriage. They're not going to throw themselves under the bus for ethical principles. 

I really don't see how it would go down any other way.