Case Title: People ex rel. Sherman v. Cryns

Citation: 

Docket Number: 93412

State: illinois

Court: Illinois Supreme Court

Date: 2003-02-21T00:00:00Z

Document:
Docket No. 93412-Agenda 13-November 2002.
THE PEOPLE OF THE STATE OF ILLINOIS ex rel. LEONARD 
A. SHERMAN, Director of Professional Regulation, Appellee, v.
YVONNE CRYNS, Appellant.
Opinion filed February 21, 2003.
	CHIEF JUSTICE McMORROW delivered the opinion of the
court:
	At issue in this case is the narrow question of whether
plaintiff, the People of the State of Illinois ex rel. Leonard
Sherman, Director of the Illinois Department of Professional
Regulation (Department), established a prima facie case that
defendant, Yvonne Cryns, a lay midwife, violated provisions of
the Nursing and Advanced Practice Nursing Act (Act) (225 ILCS
65/20-75(a) (West 2000)) when she participated in the August 19,
2000, birth of Spencer Verzi. Plaintiff filed a petition for a
preliminary injunction against defendant, pursuant to section
20-75(a) of the Act (225 ILCS 65/20-75(a) (West 2000)), arguing
that injunctive relief was warranted because defendant's actions
during the Verzi birth constituted the practice of professional
nursing and advanced practice nursing without a license. During
a hearing on plaintiff's petition, the circuit court of McHenry
County granted defendant's motion for directed finding at the
close of plaintiff's case in chief. The circuit court found that
plaintiff had presented no evidence showing that any acts engaged
in by defendant at the Verzi home constituted acts of nursing or
advanced practice nursing. The appellate court reversed, holding
that plaintiff had presented prima facie evidence that during the
birth of Spencer Verzi, defendant had practiced professional
nursing and advanced practice nursing without a license in
violation of the Act. The appellate court accordingly remanded this
cause to the circuit court for further proceedings. 327 Ill. App. 3d
753. For the reasons that follow, we affirm the judgment of the
appellate court.

BACKGROUND
	On January 18, 2000, Leonard Sherman, the Director of
Professional Regulation (Director), issued a rule to show cause
against defendant, who is a lay midwife. The rule to show cause
alleged that, in practicing midwifery, defendant engaged in
conduct that constituted the practice of professional nursing and
advanced practice nursing, as defined within sections 5-10(l) and
15-5 of the Act (225 ILCS 65/5-10(l), 15-5 (West 2000)). The
rule to show cause provided defendant with seven days in which
to show why an order to cease and desist the unlicenced practice
of nursing and midwifery should not be entered against her.
Defendant responded by filing a special and limited appearance
objecting to the Department's jurisdiction over her as a nonnurse
midwife. Defendant also filed an affidavit in which she averred
that she was not licensed as a nurse or engaged in a licensed
profession.
	On April 7, 2000, the Director issued a cease and desist order
against defendant, commanding her to immediately cease and
desist from engaging in conduct constituting the practice of
nursing and midwifery, until she complied with the licensing
requirements for a professional nurse and an advanced practice
nurse contained within the Act. Specifically, the cease and desist
order stated that defendant was not registered as a professional
nurse pursuant to section 10-5 of the Act (225 ILCS 65/10-5(a),
(b), (c) (West 2000)); that defendant did not hold a current,
national certificate as a nurse midwife from the appropriate
national certifying body (225 ILCS 65/15-10(a)(3) (West 2000));
that defendant had not complied with a post-basic advanced
formal education program in the area of midwifery (225 ILCS
65/15-10(a)(5) (West 2000)); that defendant does not have a
collaborative agreement with a physician as required of a certified
nurse midwife under the Act (225 ILCS 65/15-15 (West 2000));
and that defendant has been practicing midwifery without the
appropriate license and certificate.(1)
	On October 3, 2000, plaintiff filed a verified complaint for
injunctive relief against defendant. Pursuant to section 20-75(a)
of the Act (225 ILCS 65/20-75(a) (West 2000)), the Director may,
in the name of the People of the State of Illinois and through the
Attorney General of Illinois, petition the circuit court for an order
enjoining any violation of the Act or for an order enforcing
compliance with the Act. The verified complaint alleged that the
Department is statutorily authorized to enforce minimum
standards of professional education and licensure for the practice
of nursing and advanced practice nursing. According to the
complaint, defendant, as a midwife, is improperly engaged in
rendering prenatal, childbirth and postpartum care without a
nursing license. The complaint further alleged that defendant
violated provisions of the Act when she assisted with the birth of
Spencer Verzi, at the Verzi home on August 19, 2000. According
to the complaint, "[w]hile defendant was physically assisting with
the delivery, the Verzi baby was born in a breech position.
Defendant waited approximately more than 15 minutes before
calling paramedics. Defendant made efforts to resuscitate the
Verzi baby which were unsuccessful." The complaint further
alleged that "[v]ideotape shot at the scene shows the entire
incident and shows defendant physically assisting in the birth of
baby Verzi, which amounted to the continued practice of nursing
or Midwifery" without the requisite license. The complaint
concluded by asserting that "[d]efendant's actions of continuing
to practice nursing and Midwifery without the proper
qualifications, licensing and supervision is creating an imminent
danger of harm to the public."
	On October 5, 2000, the circuit court entered a temporary
restraining order against defendant's practice of nursing and
midwifery, pending a hearing on plaintiff's complaint for
preliminary injunction. The circuit court conducted a hearing on
the preliminary injunction complaint on October 13, 2000.
Plaintiff called Louis Verzi, the father of Spencer Verzi, to testify
with respect to Spencer's birth. Verzi stated that he and his wife,
Heather, hold "alternative ideas on health that are not shared with
most doctors in hospitals." Accordingly, the Verzis decided that it
was best that they have their child at home without the presence of
a doctor or nurse. The Verzis desired to take a natural approach to
childbirth and decided on a "water birth," wherein the mother
gives birth while being partially submerged in a birthing pool.
Verzi stated that the water-birth option was not available at any
nearby hospitals, and that he and his wife hired defendant to work
with them to accomplish a home water birth. According to Verzi,
defendant never claimed to be a nurse, and he and his wife did not
view defendant as a nurse. Rather, Verzi testified, the purpose of
defendant being in their home during Spencer's birth was "to give
us advice and to help us through the birth of our child, to help us
in things that we didn't know." According to Verzi, defendant
discussed with him and his wife the fact that if complications were
to arise during the birth, medical assistance would not be
immediately available.
	According to Verzi, defendant had Heather fill out a "client
form," in which Heather indicated that the Verzis believed in
"natural health" and did not believe in prescriptions or over-the-counter medications. The responses on this form also indicated
that the Verzis viewed Heather's mother as their "doctor,"
meaning that they relied on her for advice with respect to their
health. According to Verzi, Heather had several prenatal visits
with defendant, during which defendant monitored the baby's
heartbeat using both a specially designed stethoscope known as a
"fetoscope," and also a device known as a "Doppler," in which
reflected sound waves are used to estimate the speed and direction
of blood flow. Verzi stated that a few months before Spencer's
birth, defendant had disclosed that a cease and desist order was
issued against her by the Department. This information, however,
did not deter the Verzis from continuing their relationship with
defendant, as defendant was someone that they "had come to trust"
and they "felt strongly" that defendant was the person to deliver
their child.
	Verzi testified that at mid-morning on August 19, 2000, his
wife's water broke, and that defendant arrived at their home
between 1 and 1:30 p.m. Several family members and friends had
gathered at the Verzi house to witness the birth. At approximately
3:45 p.m., Heather began to deliver the baby when his left foot
emerged from the birth canal. According to Verzi, during the
delivery defendant used the fetoscope "four or five times" to listen
to the baby's heartbeat, and also used the Doppler device. Verzi
recalled that at one point during the birthing process, Heather
asked defendant to physically pull the baby out, and that defendant
refused Heather's request. Verzi stated that defendant instead told
Heather to push the baby out, and that Heather's body would know
the right thing to do. However, Verzi testified that Heather
continued to have difficulty in delivering the baby and that "when
matters became urgent" defendant did attempt to physically extract
the baby. By 4:30 p.m., the baby was born. However, upon his
birth Spencer was not breathing. Verzi stated that although
defendant administered CPR to Spencer for approximately 10
minutes using an "Ambu bag," which is a device used to push air
into a baby's lungs after birth, the baby was not responsive. Verzi
testified that at that point defendant requested that 911 be called.
According to Verzi, defendant was still at their home, attempting
to resuscitate Spencer, when the ambulance and paramedics
arrived.
	Verzi further testified that the delivery of Spencer was
videotaped by two cameras which were present in the room: one
video camera was mounted on a tripod and was stationary, while
the other video camera was hand-held and operated by a friend of
the family. Verzi stated that, during the evening prior to his
testimony, a police officer delivered a videotape to his home.
Upon viewing the videotape, Verzi realized that the one tape
contained the video recordings from both cameras present during
the birth. He also testified that the tape ran for approximately 1
hour, 20 minutes. Verzi testified that although he did not know
who combined the two videotapes together, the videotape he
viewed on the evening prior to his testimony truly and accurately
reflected the events which transpired at his home on August 19,
2000. The videotape was not played in court.
	Plaintiff thereafter moved to enter the videotape into
evidence. Defendant objected to the admission of the videotape on
the ground that plaintiff had failed to lay a proper foundation for
the tape recording. Defendant argued that plaintiff was required to
call the individuals who made the video recordings to testify. The
circuit court, over defendant's objection, held that Verzi's
testimony that the videotape truly and accurately reflected the
events of Spencer's birth provided a sufficient foundation for the
admission of the videotape. The court then admitted the tape into
evidence. However, the circuit court judge did not view the
videotape at any time during the proceedings.
	Plaintiff next called defendant to testify. Defendant invoked
her fifth amendment (U.S. Const., amend. V) privilege against
self-incrimination because of criminal charges pending against her
as a result of Spencer Verzi's death, and refused to answer any
questions.
	At this juncture, plaintiff rested its case.
	After plaintiff rested its case, defendant moved for a directed
finding, arguing that plaintiff had presented no evidence showing
that any acts performed by defendant during the birth of Spencer
Verzi constituted acts of nursing or of advanced practice nursing.
The circuit court agreed, and granted defendant's motion. The
circuit court stated that plaintiff produced no evidence that what
occurred during the Verzi birth violated any provisions of the Act.
The circuit court also dissolved the temporary restraining order
previously entered against defendant. However, the circuit court
stayed its order subject to an interlocutory appeal of its ruling.
	The appellate court vacated the circuit court's order denying
plaintiff's motion for preliminary injunction and remanded the
cause to the circuit court. People ex rel. Sherman v. Cryns, 321 Ill.
App. 3d 990 (2001) (Cryns I). The appellate court determined that
the circuit court abused its discretion in ruling on plaintiff's
request for a preliminary injunction without viewing the videotape
that it had admitted into evidence.
	On August 7, 2001, the circuit court entered an order
reaffirming its decision to grant a directed finding in favor of
defendant. The circuit court held that after viewing the videotape
and reviewing the transcript of the hearing, it remained convinced
that "there is no evidence in the record *** from which this court
could conclude that the activities of [defendant] constituted the
practice of nursing or Midwifery."
 	The appellate court reversed. 327 Ill. App. 3d 753 (Cryns II).
The appellate court first rejected defendant's contention that the
circuit court abused its discretion by admitting into evidence the
videotape recording of the events that transpired at the Verzi home
on August 19, 2000. The appellate court held that a videotape is
properly admitted if it is identified as an accurate and complete
portrayal of certain facts relevant to a particular issue and is
verified by a witness with personal knowledge who attests that it
is a correct representation of these facts. In the matter at bar, the
appellate court determined that Verzi was a competent witness
who had personal knowledge to identify the videotape as being a
correct representation of the birth of his child. The appellate court
also rejected defendant's contention that although Verzi testified
that the videotape he viewed the night before the hearing
accurately depicted the events portrayed in the tape, there was no
verification at the hearing that the videotape admitted into
evidence was the same one that Verzi had viewed. The appellate
court observed that defendant failed to cite to any authority that a
videotape must be viewed at trial in order to establish a foundation
for its admission into evidence. In addition, the appellate court
held that defendant's suggestion that the videotape entered into
evidence might not have been the same as that viewed by Verzi the
night before was completely unsubstantiated.
	The appellate court then turned to the question of whether the
circuit court erred in granting defendant's motion for a directed
finding at the conclusion of plaintiff's case in chief. The appellate
court determined that in the matter at bar plaintiff, through the
testimony of Louis Verzi and the events depicted in the videotape,
established a prima facie case that during Spencer's birth
defendant was practicing nursing or midwifery without a license.
	 The appellate court observed that under section 5-10(l) of the
Act, "[r]egistered professional nursing practice" includes "the
assessment of healthcare needs, nursing diagnosis, planning,
implementation, and nursing evaluation," the "promotion,
maintenance, and restoration of health," and "counseling, patient
education, health education, and patient advocacy." 225 ILCS
65/5-10(l) (West 2000). The appellate court noted that Verzi had
testified that he and his wife, Heather, had hired and paid
defendant to advise and assist them in the delivery of their baby.
In addition, the court observed that prior to Spencer's birth,
defendant used various medical instruments to listen to his
heartbeat and ascertain his health status. Further, defendant
actively assisted in delivering the baby and in resuscitation efforts.
In light of these facts, the appellate court concluded that defendant
was practicing nursing or midwifery, as she was assessing the
healthcare needs of the mother and baby, making nursing
evaluations, attempting to promote, maintain and restore the
baby's health, and attempting corrective measures to improve the
baby's health status. The appellate court also concluded that the
Act provides adequate notice of what duties a person without a
nursing license is unable to perform. Accordingly, the appellate
court held that the trial court erred in finding that plaintiff
presented no evidence from which the court could conclude that
defendant's activities constituted the practice of nursing or
midwifery in violation of the Act.
	Defendant petitioned this court for leave to appeal pursuant to
our Rule 315(a) (177 Ill. 2d R. 315(a)). We granted defendant's
petition.

ANALYSIS
	The narrow issue presented in this appeal is whether plaintiff
adduced evidence during the October 13, 2000, hearing sufficient
to establish a prima facie case that defendant's conduct on August
19, 2000, during the birth of Spencer Verzi constituted the practice
of nursing and advanced practice nursing without a license in
violation of the Act. For the reasons that follow, we hold that the
circuit court erred in directing a finding for defendant.
	At the conclusion of plaintiff's case in chief, defendant,
pursuant to section 2-1110 of the Code of Civil Procedure (735
ILCS 5/2-1110 (West 2000)), moved for a finding in her favor.
Section 2-1110 provides that in all cases tried without a jury, a
defendant may, at the close of the plaintiff's case, move for a
finding or judgment in his or her favor. In ruling on this motion,
a court must engage in a two-prong analysis. Kokinis v. Kotrich,
81 Ill. 2d 151, 155 (1980). First, the court must determine, as a
matter of law, whether the plaintiff has presented a prima
facie case. A plaintiff establishes a prima facie case by proffering
at least "some evidence on every element essential to [the
plaintiff's underlying] cause of action." Kokinis, 81 Ill. 2d  at 154.
If the plaintiff has failed to meet this burden, the court should
grant the motion and enter judgment in the defendant's favor.
Kokinis, 81 Ill. 2d  at 155. Because a determination that a plaintiff
has failed to present a prima facie case is a question of law, the
circuit court's ruling is reviewed de novo on appeal. See Kokinis,
81 Ill. 2d at 154-55; Evans v. Gurnee Inns, Inc., 268 Ill. App. 3d
1098, 1102 (1994).
	If, however, the circuit court determines that the plaintiff has
presented a prima facie case, the court then moves to the second
prong of the inquiry. In its role as the finder of fact, the court must
consider the totality of the evidence presented, including any
evidence which is favorable to the defendant. Contrary to the
Pedrick standard, which governs a motion for directed verdict
during a jury trial (Pedrick v. Peoria & Eastern R.R. Co., 37 Ill. 2d 494 (1967)), under section 2-1110 the court is not to view the
evidence in the light most favorable to the plaintiff. Kokinis, 81 Ill. 2d  at 154. Rather, the circuit court must weigh all the evidence,
determine the credibility of the witnesses, and draw reasonable
inferences therefrom. 735 ILCS 5/2-1110 (West 2000); Kokinis,
81 Ill. 2d  at 154-55. This weighing process may result in the
negation of some of the evidence presented by the plaintiff. After
weighing the quality of all of the evidence, both that presented by
the plaintiff and that presented by the defendant, the court should
determine, applying the standard of proof required for the
underlying cause, whether sufficient evidence remains to establish
the plaintiff's prima facie case. If the circuit court finds that
sufficient evidence has been presented to establish the plaintiff's
prima facie case, the court should deny the defendant's motion and
proceed with the trial. Kokinis, 81 Ill. 2d  at 155. If, however, the
court determines that the evidence warrants a finding in favor of
the defendant, it should grant the defendant's motion and enter a
judgment dismissing the action. Kokinis, 81 Ill. 2d  at 155. A
reviewing court will not reverse the circuit court's ruling on appeal
unless it is contrary to the manifest weight of the evidence.
Kokinis, 81 Ill. 2d  at 154.
	As stated, in the matter at bar, the circuit court determined
that plaintiff failed to present a prima facie case that defendant's
conduct during the Verzi birth violated provisions of the Act and,
therefore, denied plaintiff's petition for a preliminary injunction by
granting defendant's motion for a directed verdict. The circuit
court arrived at this conclusion by finding that plaintiff failed to
adduce any evidence that defendant was engaged in the practice of
nursing without a license in violation of the Act. Because the
circuit court determined that plaintiff failed to establish a prima
facie case as a matter of law, we consider the circuit court's ruling
under a de novo standard of review.
	The purpose of a preliminary injunction is to maintain and
preserve the status quo, pending a decision on the merits of a
cause. Callis, Papa, Jackstadt & Halloran, P.C. v. Norfolk &
Western Ry. Co., 195 Ill. 2d 356, 365 (2001). A preliminary
injunction is not intended to determine controverted rights or
decide the merits of a case. People ex rel. Sklodowski v. State, 162 Ill. 2d 117, 131 (1994). Under section 20-75 of the Act (225 ILCS
65/20-75 (West 2000)), the Director is authorized to petition the
circuit court for an injunction against any individual who is
practicing nursing without a license. Where, as here, the State or
a governmental agency is expressly authorized by statute to seek
injunctive relief, the traditional equitable elements necessary to
obtain an injunction need not be satisfied. Sadat v. American
Motors Corp., 104 Ill. 2d 105, 111-13 (1984); see People v. Van
Tran Electric Corp., 152 Ill. App. 3d 175, 184 (1987); People ex
rel. Hartigan v. Stianos, 131 Ill. App. 3d 575, 580 (1985). The
State or the agency seeking the injunction need only show that the
statute was violated and that the statute relied upon specifically
allows injunctive relief. Sadat, 104 Ill. 2d at 111-13; see Midland
Enterprises, Inc. v. City of Elmhurst, 226 Ill. App. 3d 494, 504
(1993). This principle of law is animated by the rationale that
because statutes authorizing injunctive relief often do so on behalf
of a public official in his or her capacity as the enforcer of a
regulatory scheme, "the violation of such a statute implies an
injury to the general public [and] [s]uch injury necessitates the
statutory authorization for equitable relief and supplants the
traditional equitable pleading requirements." Sadat, 104 Ill. 2d  at
113. It is presumed that public harm occurs when a statute is
violated. See Midland, 226 Ill. App. 3d at 504; Stianos, 131 Ill.
App. 3d at 580 ("The principle underlying the willingness of the
courts to issue statutory injunctions to public bodies to restrain
violations of a statute is that harm to the public at large can be
presumed from the statutory violation alone"). Once it has been
established that a statute has been violated, no discretion is vested
in the circuit court to refuse to grant the injunctive relief
authorized by that statute. See Midland, 226 Ill. App. 3d at 504.
	Accordingly, in order to establish a prima facie case for
statutory injunctive relief, and to withstand a motion for a directed
finding, plaintiff at bar was required to present at least some
evidence in the circuit court that defendant's conduct during the
Verzi birth violated the provisions of the Act. Defendant contends
that the circuit court correctly held that plaintiff failed to meet this
evidentiary burden. Defendant characterizes herself as a
"traditional (non-nurse) midwife" and contends that she is part of
a class of individuals that is not specifically identified in the Act.
Defendant argues that because there is no explicit prohibition
against traditional (nonnurse) midwifery in the Act, her conduct,
therefore, is not subject to regulation by the Department. Plaintiff
responds that the broad language chosen by the General Assembly
to describe the conduct governed by the Act, coupled with the
legislature's stated purpose in passing the Act of protecting the
public health, safety and welfare, as well as the legislature's
explicit command that the terms of the Act be liberally construed
to effectuate this stated purpose, evince that the General Assembly
intended that conduct, such as that engaged in by defendant during
the Verzi birth, be regulated under the Act.
	The question of whether the conduct of defendant on August
19, 2000, falls within the scope of the Act requires us to interpret
the statutory provisions found within that statute. Accordingly, the
issue before us is a matter of statutory construction, and our
review is de novo. Sylvester v. Industrial Comm'n, 197 Ill. 2d 225,
232 (2001). Our inquiry is guided by well-settled principles. 
	In construing the meaning of a statute, the primary objective
of this court is to ascertain and give effect to the intention of the
legislature. In re Detention of Lieberman, 201 Ill. 2d 300, 307
(2002); Michigan Avenue National Bank v. County of Cook, 191 Ill. 2d 493, 503-04 (2000). All other rules of statutory construction
are subordinate to this cardinal principle. Sylvester, 197 Ill. 2d  at
232; Henrich v. Libertyville High School, 186 Ill. 2d 381, 387
(1998). We ascertain the intent of the legislature by examining the
language of the statute, which is "the most reliable indicator of the
legislature's objectives in enacting a particular law." Michigan
Avenue National Bank, 191 Ill. 2d  at 504; see also Yang v. City of
Chicago, 195 Ill. 2d 96, 103 (2001). The language of the statute
must be afforded its plain, ordinary and popularly understood
meaning (Lieberman, 201 Ill. 2d  at 308; Bubb v. Springfield
School District 186, 167 Ill. 2d 372, 381 (1995)), and we are to
give the statutory language the fullest, rather than the narrowest,
possible meaning to which it is susceptible (Lake County Board of
Review v. Property Tax Appeal Board, 119 Ill. 2d 419, 423
(1988)). This court will not depart from the plain language of a
statute by reading into it exceptions, limitations or conditions that
conflict with the express legislative intent. Petersen v. Wallach,
198 Ill. 2d 439, 446 (2002); Yang, 195 Ill. 2d  at 103.
	All provisions of a statutory enactment are viewed as a whole.
Michigan Avenue National Bank, 191 Ill. 2d  at 504; Bubb, 167 Ill. 2d  at 382. Therefore, words and phrases must be interpreted in
light of other relevant provisions of the statute and must not be
construed in isolation. Sylvester, 197 Ill. 2d  at 232; Michigan
Avenue National Bank, 191 Ill. 2d  at 504. Each word, clause and
sentence of the statute, if possible, must be given reasonable
meaning and not rendered superfluous. Sylvester, 197 Ill. 2d  at
232. Accordingly, in determining the intent of the General
Assembly, we may properly consider not only the language of the
statute, but also the purpose and necessity for the law, the evils
sought to be remedied, and goals to be achieved. In re Detention
of Lieberman, 201 Ill. 2d  at 308; People v. Pullen, 192 Ill. 2d 36,
42 (2000). "Legislative intent can be ascertained from a
consideration of the entire Act, its nature, its object and the
consequences that would result from construing it one way or the
other." Fumarolo v. Chicago Board of Education, 142 Ill. 2d 54,
96 (1990). In construing a statute, we presume that the General
Assembly, in its enactment of legislation, did not intend absurdity,
inconvenience or injustice. In re Lieberman, 201 Ill. 2d  at 309;
Burger v. Lutheran General Hospital, 198 Ill. 2d 21, 40 (2001).
	It is well settled that the General Assembly has wide
regulatory power with respect to the health-care professions, and
it is within the broad discretion of the legislature " 'to determine
not only what the public interest and welfare require, but to
determine the measures needed to secure such interest.' " Burger,
198 Ill. 2d  at 41, quoting Chicago National League Ball Club, Inc.
v. Thompson, 108 Ill. 2d 357, 364 (1985). An example of the
legislature's exercise of these broad regulatory powers is its
enactment of the Nursing and Advanced Practice Nursing Act (225
ILCS 65/5-1 et seq. (West 2000)). In passing this Act, the General
Assembly explicitly stated that because "[t]he practice of
professional and practical nursing in the State of Illinois is hereby
declared to affect the public health, safety, and welfare," it is
"subject to regulation and control in the public interest." 225 ILCS
65/5-5 (West 2000). In this Act, the legislature clearly expressed
its intent that it is "a matter of public interest and concern that the
practice of nursing, as defined in this Act, merit and receive the
confidence of the public and that only qualified persons be
authorized to so practice in the State of Illinois." 225 ILCS 65/5-5
(West 2000). Therefore, the legislature mandated that "[f]or the
protection of life and the promotion of health *** any person
practicing or offering to practice professional *** nursing in
Illinois shall submit evidence that he or she is qualified to practice,
and shall be licensed as provided under this Act." 225 ILCS
65/5-15 (West 2000). In order to effectuate the important
regulatory and remedial purposes of the Act, the legislature
explicitly instructed that the Act is to be "liberally construed to
best carry out these subjects and purposes." 225 ILCS 65/5-5
(West 2000).
 	The Act authorizes the licensure of nurses in three categories:
licensed practical nurses, registered professional nurses, and
advanced practice nurses. Only the latter two categories are at
issue in this appeal. A "registered professional nurse" is defined in
section 5-10(k) of the Act as "a person who is licensed as a
professional nurse under this Act and practices nursing as defined
in paragraph (l) of this Section." 225 ILCS 65/5-10(k) (West
2000). Paragraph (l) of section 5-10 of the Act (225 ILCS
65/5-10(l) (West 2000)) sets forth the conduct that constitutes a
"[r]egistered professional nursing practice" for purposes of the
Act:
			" 'Registered professional nursing practice' includes all
nursing specialties and means the performance of any
nursing act based upon professional knowledge,
judgment, and skills acquired by means of completion of
an approved registered professional nursing education
program. A registered professional nurse provides nursing
care emphasizing the importance of the whole and the
interdependence of its parts through the nursing process
to individuals, groups, families, or communities, that
includes but is not limited to: (1) the assessment of
healthcare needs, nursing diagnosis, planning,
implementation, and nursing evaluation; (2) the
promotion, maintenance, and restoration of health; (3)
counseling, patient education, health education, and
patient advocacy; (4) the administration of medications
and treatments as prescribed by a physician licensed to
practice medicine in all of its branches, a licensed dentist,
a licensed podiatrist, or a licensed optometrist or as
prescribed by a physician assistant in accordance with
written guidelines required under the Physician Assistant
Practice Act of 1987 or by an advanced practice nurse in
accordance with a written collaborative agreement
required under the Nursing and Advanced Practice
Nursing Act; (5) the coordination and management of the
nursing plan of care; (6) the delegation to and supervision
of individuals who assist the registered professional nurse
implementing the plan of care; and (7) teaching and
supervision of nursing students."
	A nurse who specializes in the delivery of babies is referred
to as a "certified nurse midwife" in the Act and is characterized as
an "[a]dvanced practice nurse." 225 ILCS 65/15-5 (West 2000).
An advanced practice nurse (APN) is a registered professional
nurse, as defined in section 5-10(k) of the Act (225 ILCS
65/5-10(k) (West 2000)), who meets the additional licensing
requirements set forth in section 15-10 of the Act (225 ILCS
65/15-10 (West 2000)). Advanced practice nursing licenses are
granted for four categories of APNs, only one of which is relevant
here: certified nurse midwife. Pursuant to section 15-10 of the
Act, a registered nurse shall be qualified for licensure as a certified
nurse midwife if that person has applied in writing to the
Department; holds a current license to practice as a registered
nurse in this state; has successfully completed requirements to
practice as, and holds a current, national certification as, a nurse
midwife; has paid the required fees; and has successfully
completed a post-basic advanced practice formal education
program in nurse midwifery. 225 ILCS 65/15-10 (West 2000). In
addition, pursuant to section 15-15 of the Act (225 ILCS
65/15-15 (West 2000)), a certified nurse midwife must enter into
a written collaborative agreement with a physician who provides
medical direction as authorized in the collaborative agreement. A
certified nurse midwife must meet all of the above requirements
in order to be qualified to treat patients "by using medical,
therapeutic, and corrective measures to treat illness and improve
health status." 225 ILCS 65/15-5 (West 2000).
	As an initial matter, we address an evidentiary argument
raised by defendant with respect to the videotape of Spencer's
birth admitted into evidence by the circuit court. In her brief to this
court, defendant reiterates her position that the circuit court erred
in allowing the videotape into evidence. Plaintiff is correct, and
defendant acknowledges, that defendant failed to raise this
argument in her petition for leave to appeal to this court (see 177
Ill. 2d R. 315(b)(3) (the petition shall state "the points relied upon
for reversal of the judgment of the Appellate Court")), and that a
party's failure to raise an argument in the petition for leave to
appeal may be deemed a waiver of that argument. Federal Deposit
Insurance Corp. v. O'Malley, 163 Ill. 2d 130, 154 (1994).
However, the rule of waiver is a limitation on the parties and not
on the court. Michigan Avenue National Bank, 191 Ill. 2d  at 518.
We choose to address defendant's contention.
	A videotape may be admitted as demonstrative evidence when
it is properly authenticated and is relevant to a particular issue in
the case. Cisarik v. Palos Community Hospital, 144 Ill. 2d 339,
341-42 (1991). First, a foundation must be laid, by someone
having personal knowledge of the filmed object, that the film is an
accurate portrayal of what it purports to show. Cisarik, 144 Ill. 2d 
at 342. "Verification may be furnished by the testimony of any
competent witness who has sufficient knowledge to testify that the
videotape fully represents what it purports to portray." Missouri
Portland Cement Co. v. United Cement, Lime, Gypsum & Allied
Workers International Union, Division of Boilermakers, AFL-CIO,
Local No. 438, 145 Ill. App. 3d 1023, 1027 (1986). Second, a
videotape will be considered relevant only as long as its probative
value is not substantially outweighed by the danger of unfair
prejudice. Cisarik, 144 Ill. 2d  at 342. The admission of a videotape
into evidence is within the sound discretion of the circuit court and
will not be disturbed absent an abuse of discretion. Missouri
Portland Cement Co., 145 Ill. App. 3d at 1027.
	In her submission to this court, defendant does not quarrel
with the above-discussed principles of law. She does assert,
however, that the circuit court erred in admitting the videotape
into evidence because although Louis Verzi stated that the
videotape he viewed in his home the evening before his court
testimony was an accurate portrayal of the events that occurred
during his son's birth, this testimony was inadequate support for
the admission of the videotape that was actually admitted into
evidence. We agree. Whether the videotape viewed by Verzi at his
home on the evening prior to the October 13, 2000, hearing was
the same tape produced by plaintiff in court and admitted into
evidence is unknown. During the hearing, the videotape that was
admitted into evidence was not played for the parties, the
witnesses or the court. Plaintiff proffered no testimony during the
hearing that, based upon Verzi's personal knowledge, the
videotape that was actually admitted into evidence was a true and
accurate depiction of what it purported to show. The testimony
proffered by Verzi with respect to the videotape he viewed at his
home during the previous evening was insufficient to establish a
proper evidentiary foundation for the videotape that was actually
admitted. Accordingly, we hold that because the foundation for
admission of the videotape was insufficient, the circuit court
abused its discretion in admitting the videotape into evidence.
	Upon reviewing the record in this matter, absent the
videotape, we conclude that the conduct of defendant on August
19, 2000, during the birth of Spencer Verzi constituted prima facie
evidence of "professional nursing" within the meaning of the Act.
Therefore, we hold that the circuit court erred in finding that
plaintiff failed to present any evidence to establish a prima facie
case that during the Verzi birth defendant engaged in conduct
which violated the Act. It is clear that the General Assembly
passed the Act as a comprehensive regulation of the practice of
nursing, and that the Act reflects serious policy concerns about the
detrimental effect to the public health and safety when unlicenced
individuals engage in the conduct described in, and regulated by,
the Act. To this end, the legislature explicitly provided in section
5-15 (225 ILCS 65/5-15 (West 2000)) that only those persons
qualified and licenced under the Act are authorized to engage in
the conduct defined as "professional nursing" in section 5-10(l) of
the Act. 225 ILCS 65/5-10(l) (West 2000). The legislature chose
broad language to define those individuals covered by the Act,
stating that "any person" who practices or offers to practice
professional nursing in this state must abide by the rules and
regulations set forth in this statute. 225 ILCS 65/5-15 (West
2000).
	The General Assembly, however, also deemed it appropriate
to enumerate certain limited and explicit exceptions to the
coverage of the Act. For example, the Act does not apply to
individuals who "furnish[ ] *** nursing assistance in an
emergency" (225 ILCS 65/5-15(c) (West 2000)) or to instances
where "[t]he incidental care of the sick [is performed] by members
of the family, domestic servants or housekeepers" (225 ILCS
65/5-15(e) (West 2000)). The Act also excludes from coverage
those individuals who care for the sick "where treatment is by
prayer or spiritual means" (225 ILCS 65/5-15(e) (West 2000)) and
exempts from its coverage persons "employed as nursing aides,
attendants, orderlies, and other auxiliary workers in private homes,
long term care facilities, nurseries, hospitals or other institutions"
(225 ILCS 65/5-15(f) (West 2000)). Under the principle of
expressio unius est exclusio alterius, the enumeration of
exceptions in a statute is construed as an exclusion of all other
exceptions. See 2A N. Singer, Sutherland on Statutory
Construction §47.23 (6th ed. 2000). We have previously observed
that this rule of statutory construction "is based on logic and
common sense," as "[i]t expresses the learning of common
experience that when people say one thing they do not mean
something else." Bridgestone/Firestone, Inc. v. Aldridge, 179 Ill. 2d 141, 152 (1997). Applying this rule of construction to the
matter before us, we conclude that the General Assembly intended
to exempt from the coverage of the Act only those instances
specifically enumerated. We discern no contrary legislative intent
which would overcome this rule of construction and support
defendant's contention that traditional midwives, as a class, were
intended by the General Assembly to be excluded from coverage
under the Act. See Bridgestone/Firestone, Inc., 179 Ill. 2d  at 153-54 ("the principle that the expression of one thing in a statute
excludes any other thing is only a rule of statutory construction,
not a rule of law *** [and] may be overcome by a strong
indication of legislative intent"). Indeed, the strong public policy
considerations of protecting the public health and safety which
underpin the Act lend additional support for our conclusion.
	 In addition to broadly defining the class of individuals subject
to regulation under the Act, the General Assembly also employed
broad language to define the conduct to which the Act applies.
Section 5-10(l) of the Act defines "professional nursing practice"
to include "the assessment of healthcare needs, nursing diagnosis,
planning, implementation, and nursing evaluation," the
"promotion, maintenance, and restoration of health," and
"counseling, patient education, health education, and patient
advocacy." 225 ILCS 65/5-10(l) (West 2000). The record
establishes that plaintiff proffered sufficient evidence to establish
a prima facie case that defendant's conduct with respect to the
Verzi birth constituted the practice of "professional nursing" and
was therefore prohibited for an individual without a nursing
license.
	Louis Verzi testified that he and his wife hired defendant "to
give us advice and to help us through the birth of our child, to help
us in things that we didn't know." Verzi stated that Heather had
several prenatal visits with defendant, during which defendant
monitored the status of the baby's health by using a fetoscope and
Doppler to listen for the baby's heartbeat. On the date of Spencer's
birth, August 19, 2000, defendant arrived at the Verzi home
shortly after Heather began her labor. After Heather delivered the
baby's left foot, she experienced difficulty in delivering any more
of the baby. Verzi testified that during the labor process,
defendant, on several occasions, used the fetoscope and Doppler
to check the baby's heartbeat while the baby was still in Heather's
uterus. Once Spencer was born, defendant attempted to resuscitate
him with the aid of an Ambu bag to push air into his lungs.
Defendant attempted resuscitation in this manner for
approximately 10 minutes, stopping every minute or so to listen to
Spencer's heartbeat with the fetoscope.
	We conclude that the above described evidence is sufficient
to establish a prima facie case that defendant engaged in the
practice of nursing without a license. We agree with the appellate
court below that throughout her interaction with the Verzis,
defendant was assessing the "healthcare needs" of both Heather
and the baby, and making "nursing evaluation[s]" in violation of
section 5-10(l) of the Act (225 ILCS 65/5-10(l) (West 2000)). We
also agree with the appellate court that defendant's conduct was
aimed at "promot[ing], maint[aining], and restor[ing]" the health
of the mother and child, also in violation of section 5-10(l) of the
Act (225 ILCS 65/5-10(l) (West 2000)). Further, defendant
provided "counseling, patient education, [and] health education,"
also in violation of the Act. 225 ILCS 65/5-10(l) (West 2000).
Finally, we agree with the appellate court that defendant's actions
in attempting to resuscitate the baby constituted "corrective
measures" to improve his health status and constituted additional
violations of the Act (225 ILCS 65/15-5 (West 2000)).
 	Defendant further contends that, if we determine that her
conduct during the Verzi birth constituted "nursing practice"
within the meaning of the Act, she is nevertheless exempted from
the Act's coverage because she engaged in the practice of nursing
only because she was faced with an emergency situation when she
could not hear the baby's heartbeat. We disagree. Louis Verzi
testified that prior to Spencer's birth, defendant provided the
Verzis with "advice" and "help" with respect to the birthing
process, and that during prenatal visits with Heather, defendant
checked the baby's heartbeat with the aid of the fetoscope and
Doppler. Further, on the day Spencer was born, defendant used
both the fetoscope and Doppler on several occasions to listen to
Spencer's heartbeat in utero. Thus, the record reveals that
defendant performed several acts which constituted the practice of
nursing, within the meaning of the Act, prior to any indication that
the baby was in distress. Accordingly, we reject defendant's
contention that she is not subject to the provisions of the Act.
	In sum, we conclude that the circuit court erred in holding that
plaintiff failed to present a prima facie case that defendant
engaged in conduct violative of the Act. As stated, in construing
the meaning of statutes, the primary objective of this court is to
ascertain and give effect to the legislature's intent. Michigan
Avenue National Bank, 191 Ill. 2d  at 503-04. In exercising its
broad powers in regulating matters of public health and safety, the
General Assembly employed broad language in the provisions of
the Act to effectuate the Act's stated purpose of protecting life and
promoting health. See 225 ILCS 65/5-15 (West 2000). In addition,
the legislature explicitly instructed that the provisions of the Act
are to be liberally construed to effectuate these public policy goals.
225 ILCS 65/5-5 (West 2000). In interpreting statutory provisions,
we are to afford the statute's plain language its fullest meaning to
effectuate the legislative intent (Lake County Board of Review,
119 Ill. 2d at 423), and we may not read into a statute exceptions,
limitations or conditions that conflict with the intent of the
legislature (Petersen, 198 Ill. 2d at 446).
	Our holding today effectuates the intent of the General
Assembly, as evidenced in the Act, to promote the public health,
safety and welfare by ensuring that those individuals who engage
in the conduct described in the Act are properly trained and
licensed. Indeed, a contrary result would thwart the intent of the
legislature in regulating conduct it has defined as the practice of
nursing. Were we to accept defendant's argument that those
persons who label themselves as traditional nonnurse midwives
are not regulated by the Act, an absurd result would occur. An
individual would be able to bypass the licensing and training
requirements of the Act simply by referring to herself as a
"traditional nonnurse midwife," even if that person provided
exactly the same type of nursing care as a certified nurse midwife.
This would mean that a person's status under the Act would
depend merely upon how she labeled herself, and the conduct in
which that person engaged would become irrelevant. In construing
statutes, we presume that the General Assembly, in enacting the
legislation, did not intend absurdity or injustice. Burger, 198 Ill. 2d  at 40. The stringent training and licensing requirements for a
certified nurse midwife demonstrate the legislature's intent to
regulate this specific area of nursing practice. Defendant's
interpretation of the Act would render a certified nurse midwife's
license meaningless. Certainly, the General Assembly could not
have intended such an absurd result.
	Defendant also raises the contention on appeal that the
provisions of Act that prohibit the practice of nursing without a
license are unconstitutionally vague as applied to her, thereby
violating her right to due process. According to defendant, the Act
contains no language to indicate that it is intended to govern the
practice of traditional midwifery, as the Act fails to include a
definition of midwifery and does not expressly prohibit the
practice of midwifery by persons other than nurses. Thus,
defendant concludes, the Act does not provide adequate notice of
the conduct prohibited.
	The constitutionality of a statute is a question of law subject
to de novo review. Burger, 198 Ill. 2d  at 31; Miller v. Rosenberg,
196 Ill. 2d 50, 57 (2001). Statutes are presumed to be
constitutional, and the party challenging the validity of the statute
has the burden to clearly establish the constitutional invalidity.
Arangold Corp. v. Zehnder, 187 Ill. 2d 341, 351 (1999); Russell
v. Department of Natural Resources, 183 Ill. 2d 434, 441 (1998).
A court must construe a statute so as to affirm its constitutionality,
if the statute is reasonably capable of such a construction. Burger,
198 Ill. 2d  at 32. Accordingly, " 'if [a] statute's construction is
doubtful, a court will resolve the doubt in favor of the statute's
validity.' " Miller, 196 Ill. 2d  at 58, quoting People v. Shephard,
152 Ill. 2d 489, 499 (1992). We conclude that defendant has failed
to satisfy her burden of clearly establishing that the provisions of
the Act are unconstitutionally vague as applied to her.
	 A statute violates the due process clauses of the United States
Constitution or the Illinois Constitution on the basis of vagueness
" 'only if its terms are so ill-defined that the ultimate decision as
to its meaning rests on the opinions and whims of the trier of fact
rather than any objective criteria or facts.' " Stern v. Norwest
Mortgage, Inc., 179 Ill. 2d 160, 168 (1997), quoting People v.
Burpo, 164 Ill. 2d 261, 265-66 (1995). In order to succeed on a
vagueness challenge to a statute that does not involve a first
amendment right, a party must establish that the statute is vague
as applied to the conduct for which the party is being prosecuted.
People v. Jihan, 127 Ill. 2d 379, 385 (1989); see People v. Stults,
291 Ill. App. 3d 71, 83 (1997). A statute is not vague, and
therefore does not violate due process, if the duty imposed by the
statute is set forth in terms definite enough to serve as a guide to
those who must comply with it. Chastek v. Anderson, 83 Ill. 2d 502, 507 (1981). "[T]he party must show that the statute did not
provide clear notice that the party's conduct was prohibited."
Jihan, 127 Ill. 2d  at 385; see also Stults, 291 Ill. App. 3d at 83. In
other words, the provisions of a statute must be definite so that a
" 'person of ordinary intelligence [has] a reasonable opportunity
to know what is prohibited, so that he may act accordingly.' "
Jihan, 127 Ill. 2d  at 385, quoting Grayned v. City of Rockford, 408 U.S. 104, 108, 33 L. Ed. 2d 222, 227, 92 S. Ct. 2294, 2298-99
(1972). When the statute is examined in the light of the facts of the
case and the statute clearly applies to the party's conduct, then a
challenge to the statue's constitutionality based upon vagueness
will be unsuccessful. People v. Ryan, 117 Ill. 2d 28, 33-34 (1987).
	In the matter at bar, defendant asserts that the Act is
unconstitutionally vague, as it affords her no advance notice of the
type of acts which constitute "professional nursing." We disagree.
The provisions of the Act that describe the practice of professional
nursing and advanced practice nursing are sufficiently explicit to
inform those subject to the Act of the conduct to which it applies.
The legislature has provided clear definitions of the conduct it
considers to be the practice of nursing, which includes: assessing
a health-care need and making a nursing evaluation; promoting,
maintaining and restoring health; counseling, patient education
and health education; and using medical, therapeutic and
corrective measures to treat illness and improve health status. 225
ILCS 65/5-10(l), 15-5 (West 2000). We hold that the provisions
of the statute are set forth in terms definite enough to afford an
individual of ordinary intelligence with clear notice as to what
conduct is prohibited absent a nursing license. We conclude that
defendant has not met her burden of rebutting the presumption of
constitutionality and establishing that the provisions of the Act are
vague as applied to her. As stated, this court will construe a statute
as constitutional where it can do so reasonably. Bonaguro v.
County Officers Electoral Board, 158 Ill. 2d 391, 397 (1994). 
	Defendant also asserts that our decision in People v. Jihan,
127 Ill. 2d 379 (1989), is controlling in this case. We disagree. Our
decision in Jihan is factually distinguishable from the matter at
bar. At issue in Jihan was a provision of the now-repealed Medical
Practice Act (Ill. Rev. Stat. 1985, ch. 111, par. 4401 et seq.), which
prohibited any person from the "practice *** [of] midwifery"
without a state license to do so (Ill. Rev. Stat. 1985, ch. 111, par.
4403). The defendant in Jihan was convicted of practicing
midwifery without a license and sentenced to one year of
probation. The defendant appealed her conviction, asserting that
the statute under which she was convicted was unconstitutionally
vague as applied to her because the term "midwifery" was not
defined. We held that the term "midwifery," as applied to the
defendant, was ambiguous because it was not clear whether the
term had "the broad meaning of assisting at childbirth" or "the
more narrow meaning of actually delivering the child at birth."
(Emphases in original.) Jihan, 127 Ill. 2d  at 388. This court held
that evidence had been presented that the defendant assisted at the
birth, but that there was no showing that the defendant delivered
the child. Accordingly, this court concluded that the Act was
unconstitutionally vague as it applied to the defendant in that it did
not provide sufficient notice that her conduct in that case was
prohibited. Jihan, 127 Ill. 2d  at 389.
	Unlike in Jihan, where the term "midwifery" was not defined
in the statute, the Nursing and Advanced Practice Nursing Act
clearly and extensively defines "professional nursing" and
"advanced practice nursing." The constitutional infirmity in Jihan
stemmed from the fact that there was a broad range of activity that
could be encompassed by the term "midwifery," and it was unclear
whether the legislature intended to proscribe the assistance at a
delivery or whether the proscription was limited to the actual
performance of the delivery. In contrast, viewing the terms
"professional nursing" and "advanced practice nursing" in the
context of the instant case, there are no ambiguities in those terms
as they are defined by the Act, and as was found by the Jihan court
in the term "midwifery." In addition, we observe that the
defendant in Jihan was the subject of criminal proceedings,
whereas in the matter at bar civil proceedings are at issue. As we
stated in Jihan, "there is a greater tolerance for statutory ambiguity
in civil proceedings than in criminal proceedings 'because the
consequences of imprecision are qualitatively less severe.' " Jihan,
127 Ill. 2d  at 387, quoting Village of Hoffman Estates v. The
Flipside, Hoffman Estates, Inc., 455 U.S. 489, 498-99, 102 S. Ct. 1186, 1193, 71 L. Ed. 2d 362, 371-72 (1982).
	We also reject defendant's contention that the appellate court
violated the doctrine of the separation of powers (Ill. Const. 1970,
art. II, §1) when, in defendant's words, the court "extended [the
Act's] jurisdiction to include traditional (non-nurse) midwives."
The Illinois Constitution provides that the legislative, executive
and judicial branches are separate, and that "[n]o branch shall
exercise powers properly belonging to another." Ill. Const. 1970,
art. II, §1. In " 'both theory and practice, the purpose of the
[separation of powers] provision is to ensure that the whole power
of two or more branches of government shall not reside in the
same hands.' " Best v. Taylor Machine Works, 179 Ill. 2d 367, 410
(1997), quoting People v. Walker, 119 Ill. 2d 465, 473 (1988). It
is the function of the judicial branch of government to determine
what the law is and to apply statutes to cases. Stern, 179 Ill. 2d  at
168. Where, as in the case of the appellate court below, a court
merely construes a statute and applies that statute to a specific set
of facts, there is no violation of the separation of powers doctrine.
See Stern, 179 Ill. 2d  at 168. We therefore conclude that
defendant's separation of powers argument is without merit.
	In her submission to this court, defendant also urges us to
examine case decisions rendered outside of this jurisdiction for
assistance in making our ruling today. Defendant places particular
emphasis upon the decisions of the Supreme Court of Kansas in
State Board of Nursing v. Ruebke, 259 Kan. 599, 913 P.2d 142
(1996), and the Supreme Judicial Court of Massachusetts in Leigh
v. Board of Registration in Nursing, 395 Mass. 670, 481 N.E.2d 1347 (1985). We have reviewed these opinions and conclude that
they are factually inapposite to the matter at bar.
	In Ruebke, the court affirmed the trial court's order denying
a request by the Kansas State Board of Nursing for a preliminary
injunction against the defendant, a lay midwife, from engaging in
"healing arts" without a license. The Ruebke court determined that
the definitional provisions of the regulatory statute at issue did not
cover midwifery. The court held that, in their ordinary usage, the
terms used to define "healing arts" within the statute "focus
exclusively on pathologies (i.e., diseases) and abnormal human
conditions (i.e., ailments, deformities or injuries)," and determined
that "[p]regnancy and childbirth are neither pathologies nor
abnormalities ***." Ruebke, 259 Kan. at 615, 913 P.2d  at 143.
Unlike the narrow definition of "healing arts" contained within the
Kansas statute, our Act defines "professional nursing" and
"advanced practice nursing" in a broader manner. Based upon the
differences in the relevant statutes, we find the Ruebke case
inapposite.
	In Leigh, a registered nurse had been suspended on the
grounds that she had practiced midwifery without the
authorization of the Massachusetts Board of Registration of
Nursing in violation of a statute requiring her certification as a
nurse midwife. The Supreme Judicial Court of Massachusetts held
that, by being a registered nurse and practicing as a midwife
without board authorization to practice as a nurse in the expanded
role of nurse midwife, Leigh violated the statute. Leigh, 395 Mass.
at 677, 481 N.E.2d  at 1347. In dicta,(2) the court went on to clarify
that Leigh's position as a nurse practicing midwifery without
certification constituted the statutory violation, and that it was not
Leigh's practice of midwifery alone which violated the statute.
The court, construing Massachusetts statutes which proscribe the
unauthorized practice of medicine, concluded that simply assisting
in normal cases of childbirth did not violate these statutes. Leigh,
395 Mass. at 680-81, 481 N.E.2d  at 1353. We find that the
decision in Leigh is factually distinguishable from the matter at bar
and, accordingly, is inapposite.
	In her written submission to this court, defendant also makes
a brief, one-paragraph argument that by construing the Act to
apply to her conduct during the Verzi birth, she is being denied her
"liberty and property interest in her employment as a traditional
midwife." We reject defendant's assertion. It is well settled that
"every citizen has the right to pursue a trade, occupation, business
or profession" and that "[t]his inalienable right constitutes both a
property and liberty interest entitled to the protection of the law as
guaranteed by the due process clauses of the Illinois and Federal
constitutions." Coldwell Banker Residential Real Estate Services
of Illinois, Inc. v. Clayton, 105 Ill. 2d 389, 397 (1985). However,
this constitutional right is not absolute; it is "limited by the right
of the State to regulate such freedom of action, through the proper
exercise of the police power, where the public health, safety or
welfare so requires." Coldwell Banker, 105 Ill. 2d  at 397. As
stated, the regulation of nursing practice contained within the Act
is designed to protect the health and safety of the public.
Therefore, defendant's claim that the application of the Act to her
conduct during the Verzi birth violates her liberty interest in her
employment as a lay midwife lacks merit.
	In sum, the General Assembly's intent to ensure the health,
safety and welfare of the public by regulating the practice of
nursing would be frustrated if the statute did not apply to the
conduct of defendant at bar during the birth of Spencer Verzi. The
public policy concerns which underpin the Act weigh in favor of
regulating the conduct here as the delivery of a child affects both
the mother's and child's well-being. The state has a substantial
interest in promoting the general welfare, and whether a course
chosen by the legislature to achieve a desired result is either wise
or the best means available is not a proper subject of judicial
inquiry. Potts v. Illinois Department of Registration & Education,
128 Ill. 2d 322, 333 (1989). Although we understand plaintiff's
concerns with respect to the continued existence of lay midwifery
in Illinois, we are constrained to apply the law as enacted by the
General Assembly. " 'Under the doctrine of the separation of
powers, courts may not legislate, rewrite or extend legislation. If
the statute as enacted seems to operate in certain cases unjustly or
inappropriately, the appeal must be to the General Assembly, and
not to the court.' " Michigan Avenue National Bank, 191 Ill. 2d  at
522, quoting People v. Garner, 147 Ill. 2d 467, 475-76 (1992).
	For the reasons stated above, we hold that plaintiff presented
a prima facie case that defendant engaged in conduct which
violated the Act. Accordingly, the circuit court erred in granting
defendant's motion for a directed finding at the close of plaintiff's
case.

CONCLUSION
	For the reasons stated, the judgment of the appellate court is
affirmed.


Affirmed.
 



 



1.      1On May 12, 2000, defendant filed a two-count complaint for
administrative review and declaratory judgment against the Department
and the Director seeking review of the April 7, 2000, cease and desist
order. On May 11, 2001, the circuit court vacated the April 7, 2001,
cease and desist order. The Department did not appeal from this ruling.
The propriety of the issuance of the cease and desist order is not before
this court, and we express no opinion on this matter. 

2.      2The court noted that "[w]hile the question whether the practice of
midwifery constitutes the unauthorized practice of medicine is not
before us, we think it appropriate to comment briefly on the question,
in light of the position of the parties." Leigh, 395 Mass. at 678, 481 N.E.2d  at 1352-53.