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The Roundtable


Welcome to the Roundtable, a forum for incisive commentary and analysis
on cases and developments in law and the legal system.


Expansion of APRN Autonomy Challenged by Physician Groups

8/11/2016

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By Christine Mitchell

Christine Mitchell is a junior at the University of Pennsylvania studying nursing.

With the passage of State Senate bill 717 (SB 717), Pennsylvania has become the most recent state to expand the autonomy and practice rights of nurse practitioners. The bill, which passed on a 41 to 9 vote, amends the Professional Nursing Law, which was passed in 1951. [1] Under the new law, certified registered nurse anesthetists, certified nurse-midwives and nurse practitioners (APRNs) can practice independently of physicians and issue oral orders. These practices will be regulated by the State Board of Nursing, as opposed to being regulated by individual facilities. Significantly, these practitioners will be permitted to prescribe Methadone, which is used to treat narcotic drug addictions. [2]

Advanced practice nurses are providers that have completed a bachelors of science in nursing (BSN) as well as a master's (MSN) or doctorate degree (DNP) in nursing. Throughout both the undergraduate and graduate training, students are placed in hospitals to gain direct patient care experience. Masters and doctoral students are paired with either a nurse practitioner or physician to receive advanced training in diagnosis and treatment planning. The majority of students entering master's programs have practiced as nurses, providing a foundation of knowledge about patient care.

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Whole Woman’s Health: A Victory for United States Women  

7/20/2016

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By Christine Mitchell

Christine Mitchell is a rising junior at the University of Pennsylvania studying nursing.

The Supreme Court's recent ruling in the case Whole Woman's Health v. Hellerstedt  may prove to be one of the biggest wins for pro-choice groups since Roe v. Wade. The 5-3 ruling found that laws passed in the state of Texas posed an undue burden to women seeking an abortion, and were therefore unconstitutional. [1] An “undue burden,” with regards to reproductive rights, emerges when a substantial obstacle is placed in the way of a woman seeking an abortion during the period when a fetus is unviable. [2 ] The undue burden test was established in the Supreme Court case Planned Parenthood v. Casey, where the court found that restrictions on abortion rights violate the Due Process Clause if they establish an undue burden on those seeking an abortion. [3]  


The laws brought into question required that physicians performing abortions in clinics have admitting privileges at local hospitals, and held abortion clinics to the same structural standards as surgical centers. Those supporting the Texas provisions claimed the laws improved the safety of women seeking an abortion by ensuring that facilities met high standards, and had the ability to admit a patient to the hospital in case of an emergency. [4]

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Mammogram Legislation Misses the Mark

4/4/2016

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By Christine Mitchell

Christine Mitchell is a sophomore at the University of Pennsylvania studying nursing.

Mammograms have long been heralded as a key component of women’s health. If performed regularly, they offer the potential to catch breast cancer before it becomes invasive, leading to lifesaving early interventions. While it is clear that mammography has had a positive impact on breast cancer treatment throughout the world, new legislation may risk taking the technology too far.

A mammogram is simply an x-ray image of the breast that is used to spot any unusual tissue masses, such as tumors. Although the recommended frequency of mammograms is controversial, The National Breast Cancer Foundation recommends that women aged forty and older receive a mammogram every one to two years. [1] The true controversy, however, is what doctors must report to patients following a mammogram. A mammogram can reveal dense breast tissue which is found in about half of the female population and is difficult to image using mammography. [2] While dense breasts do not cause breast cancer, they do make the disease more difficult to detect. Laws that have been passed in twenty-four states, and are pending in eleven others, require a physician to report any dense breast tissue detected by a mammogram to the patient, usually by mail after the visit. [3] These laws have been lobbied for by Are You Dense?, an advocacy group dedicated to passing density reporting laws. [4]

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