Nikki Sapiro Vinckier: We sued the State of Michigan. And we won.
By Nikki Sapiro Vinckier, PA-C
We watched a travesty play out in real time when Adriana Smith was kept on life support after being declared brain dead, her body used to sustain a nine-week pregnancy in a decision driven not by her wishes, but by state law.
That was not just a story out of Georgia. Until this week, Michigan law carried the same underlying logic.
So I sued the state. And we won.
Under Michigan law, a person’s advance directive could be set aside if they were pregnant. Meaning, people who were incapacitated and pregnant didn’t have the same right to refuse life sustaining treatment as all other Michiganders. The state could step in even when a patient had already made their wishes clear. It created a separate standard of care that applied only to people capable of pregnancy, one where autonomy could be overridden at the most vulnerable moment of a person’s life.
Not because of medical necessity. Not because of patient values. But because of pregnancy alone.
That is what this case challenged. And the court was clear in its response.
It found that the law interfered with a person’s ability to make their own medical decisions, that it did not meaningfully protect patient health, and that it conflicted with accepted medical standards grounded in informed consent, the foundation of ethical care.
It also recognized something even more fundamental: Michigan’s constitutional right to reproductive freedom includes the ability to make and carry out medical decisions during pregnancy. That includes decisions about life-sustaining care. That includes determining who gets to speak for you. That includes the right to say no.
But this win did not happen in isolation. And that is the takeaway so many of us need to hear right now.
This was the result of years of organizing, advocacy, and people showing up when it mattered. In 2022, Michiganders gathered signatures, knocked doors, and made the case to one another that reproductive freedom belonged in our state constitution. We got it on the ballot, and we passed it with resounding approval.
Proposal 3 created a legal foundation. And this case was built on it.
We did not just challenge a law. We used the constitutional amendment that people fought for to dismantle it. That is what organizing power looks like. It is not abstract. It is structural. It creates tools that can be used later, in moments like this one.
The ruling affirms that reproductive freedom is not limited to a single decision. It extends to how a person is treated throughout pregnancy, including in moments of crisis and incapacity. It affirms that a pregnant person remains the decision-maker, and that their previously stated wishes do not become optional simply because they are pregnant.
Just as importantly, it shows that laws built on the erosion of autonomy are not inevitable. They can be challenged. And when the groundwork has been laid, they can be defeated. That is the part we cannot afford to overlook.
In a moment where so much feels uncertain or out of reach, it is easy to believe that our individual actions do not matter. That organizing does not matter. That signing a petition, having a conversation, or showing up to vote will not actually change outcomes.
This case is proof that it does.
The constitutional amendment that made this ruling possible did not appear on its own. It was built by people who decided to act. And now it is being used to protect people in real, tangible ways.
That is not theoretical. That is power. Collective power. And it is a reminder, especially right now, not to take for granted that what you are doing matters. Because it does.
Nikki Sapiro Vinckier, PA-C, is an OB/GYN Physician Assistant, Author of the upcoming book We Deserve More, a reproductive health content creator, and a plaintiff in Koskenoja v. Whitmer. She is the founder of Take Back Trust, a digital platform helping people navigate reproductive healthcare in this changing landscape. You can find her on social media @nikkivinck.
