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As the first systematic and in-depth study in any language on the subject, this thesis makes original contributions by unravelling the relationship between Chinese healthcare state governance, health law and medical practitioners, and casting a spotlight on the ethically problematic medical practices raised by cases of SARS and others. More specifically, this thesis examines the role of state governance and regulation in China’s healthcare system and their impact on professional practices and ethics. The thesis addresses the issues from a social-legal perspective. It provides evidence from an integration of historical, empirical and theoretical approaches to explore the role of Chinese medics in their relations with healthcare state governance and law. It explores the character of power relations and the consequences of imbalance of power in these relations. Diagrammatic models are used throughout this work to illustrate the findings from the above approaches and to represent the changing nature of the author’s thinking about the dynamics at work in the relationships under scrutiny. The basic principle advocated in this thesis is that the effective formation and delivery of healthcare is facilitated by ethically-based systems of policy, rules and regulation. More particularly, it is argued that the roles of medical professionalism and patient control are central to good governance of healthcare in China. Set within this context, the thesis has three main goals. First, it aims to contribute to the development of theories about the relationship between the medical profession and the Communist state of China, examining the relatively powerless position of medical professionals in China as demonstrated by both historical and original empirical evidence generated by the research undertaken for this thesis. Secondly, the thesis examines the nature and extent of de-professionalisation among Chinese medical professionals. More particularly, it considers the consequences of challenges to Chinese medics’ professional autonomy which have occurred as a result of the Chinese healthcare power structure. Ultimately, it is argued that a re-structured model which places Chinese medical practitioners in a more professional and responsible role is urgently required.

The aim of the research reported here is to answer the following primary research questions: Is the relationship between CAM, the medical profession and the State changing in Portugal? If there has been a change, how and why has such a change occurred? Two CAM therapies, acupuncture and homeopathy, have been chosen as case studies. The main sources of data were in-depth individual interviews and documents. The research sample (n=41) was made of three groups of interviewees: (1) 20 traditional CAM practitioners, (2) 10 orthodox medical doctors not committed to CAM and (3) 11 orthodox medical doctors committed to CAM. This research draws on a neo-Weberian perspective of professions which emphasises the power relations between related occupational groups who seek to gain or maintain power and status in their field of work. This research also makes extensive use of the concept of ‘countervailing powers' (Light, 2010), as it attempts to illuminate the influence of CAM practitioners on Portuguese healthcare, as well as the influence of other powerful players, such as the State, and major corporations, such as pharmaceutical and health insurance companies, on CAM's relationship with the medical profession. On the basis of this research, I argue that the relationship between CAM, the medical profession and the State has changed in Portugal over the last 16 years. I suggest a concept that helps to explain CAM practitioners' recent countervailing actions within the Portuguese mainstream healthcare. This concept is ‘camisation', a process through which everyday human problems are transformed into health problems which are treated in CAM terms and within a CAM framework. Although the main drivers of camisation have been CAM practitioners, I also show how the Portuguese State, the medical profession and the pharmaceutical industry have all been active collaborators in this process, whilst maintaining different interests and constantly bargaining and negotiating to maximise their power and status within the field of healthcare.

This research investigates the relevance of professional subcultures in a climate of change at a large hospital in South-Western Sydney and addresses the question : 'How do changes associated with health reform impact upon cultural interdependence between professional identities?'. As a corollary, cultural interdependence between professional identities may have profound consequences for health reform and for hospital management. By exploring the two main ideas, Professional Sub-group culture and change, this research draws from existing theory in areas such as organisational culture and cultural change, professional identities and health reform. The thesis addresses three anthropological perspectives of cultural change. It addresses the integration perspective as a homogenous unity by analysing the organisation-wide key ideas (or myths) that make action possible, often espoused by senior management. It addresses the fragmentation perspective as a gathering of transient concerns, by acknowledging the ambiguity and anxiety associated with a state of constant flux. It analyses the differentiation perspective as a collection of subcultures and its commonalities and differences. The change discussed in the thesis was not of an archetypal nature. There was no transformation of the organisational business model at government level. However, at lower levels, actors in the organisation experienced jolts through decreed change from a small district level hospital to a large tertiary level trauma centre. This research re-evaluates the theory on professional identity by establishing to what extent environmental changes and organisational changes impact upon professional identity from three cultural perspectives. This research does this by first assessing the health care organisation for existence of occupational subcultures through survey. The research continues by investigating the relationships between occupational groups through focus group discussion and in-depth interviews. Participant observation is used to illustrate and reflect commonality and diversity. This combination of methods facilitates the analysis of change and professional identity / Doctor of Philosophy (PhD)

The subject of this thesis is the Swedish animal welfare movement, its origin and early development 1875-1920. The first national Swedish animal welfare society was formed in Stockholm 1875. It was soon followed by other associations for the protection of animals. The animal welfare movement grew rapidly in Sweden. Not until towards the 1920s did the membership decline. The material studied in this thesis consists of a broad variety of documents from the animal welfare societies, such as journals and books as well as children's stories and parliamentary publications. The aim is to study both the origins and early development in Sweden of societies for the protection of animals, wild and domestic, during the decades around the turn of the century. The Swedish debates on animal welfare laws are of interest as well as discussions about vivisection and slaughter. The aim is to provide a wider analysis by taking various ideas and groups of people, such as veterinarians, schoolteachers and women into account.

Doctors, academically educated and authorized, assert that there is more to being a real doctor than having fulfilled the formal criteria. It has been said that there is a particular doctor's ethos, which is based not only on thorough medical education but also on traditional know-how, internalized ethics and good character. This paper contains several studies of the efforts of Swedish physicians to define themselves as doctors, individually and collectively, during the period 1890-1960 and to identify the ethos of their profession. The empirical material consists mainly of texts written by doctors for doctors on different social and political questions pertaining to the profession's interests. Studying the identities, interests and ideals that have been expressed by Swedish doctors in society and on the professional and individual level made it possible to distinguish and describe different aspects of their particular ethos. The starting point for these studies was the discussions during the inter-war period – held above all in Germany but also in Sweden – about the crisis of medicine and of the medical profession (chapter 1). Developments in legislation concerning the authorization of doctors show the ambiguity of the Swedish doctor's legal identity (chapter 2). The Swedish medical profession's efforts to hold on to the concept of internalized ethics meant that formal ethical rules were not accepted until 1951 (chapter 3). A study of medical obituaries revealed that the ideal doctor was seen as a man and a good colleague with his ethics rooted in antiquity (chapter 4). The heterogeneous medical profession has not been able to reach a consensus as to a common identity or common interests and ideals. The efforts of leading men amongst Swedish doctors gain charismatic, traditional and legal legitimacy for the profession have been opposed. After 1960, however, doctor's legitimacy in the scientific field has gained ground (chapter 5). Debate concerning the ethos of the doctors served as a strategy to unite the profession and to draw boundaries against those considered to be unqualified actors in the field of the healing arts. This, in itself, is part of this ethos.

This thesis investigates the historical American medicine show of 1880-1900 through the lens of contemporaneous social and cultural debates, primarily regarding class and race relations. The medicine show pitchmen, the central figure of the medicine show, is the progeny of the confidence man of the mid to late-nineteenth century, best personified through the autobiographies of Benjamin Franklin and P.T. Barnum and novels of Herman Melville and Mark Twain. The confidence man utilized a performative identity directed towards the assumed needs and desires of his audience, which gave him a purely pragmatic orientation. As the confidence man filtered through emerging forms of popular entertainment, he found his place in the traveling medicine show in the figure of the medicine man. In many ways, the medicine show functioned as a cultural arena in which the concerns of rural audiences about the ongoing professionalization of the classes, specifically within the medical profession, were investigated and manipulated.