Professions and the Public Interest : Medical Power, Altruism and Alternative Medicine

The importance and influence of professions in public life has grown increasingly over the twentieth century but the question of whether they subordinate their own self-interests to the public interest has yet to be adequately researched within a major sociological perspective. In Professions and the Public Interest Mike Saks develops a theoretical and methodological framework for assessing professional groups in Western society. The empirical applicability of this framework is demonstrated with particular reference to a novel case study of the response of the medical profession to acupuncture in the nineteenth and twentieth centuries. Professions and the Public Interest will be of great interest to all lecturers and students of social policy, sociology, and medical sociology as well as to professional groups and their members. Book Cover......Page 1 Half-Title......Page 2 Title......Page 3 Copyright......Page 4 Contents......Page 5 Acknowledgements......Page 7 Abbreviations......Page 8 Introduction......Page 10 Part I Sociology, professions and the public interest: a research framework......Page 18 1 The sociology of professions and the professional altruism ideal......Page 20 PROFESSIONAL ALTRUISM? THE TAXONOMIC APPROACH......Page 21 PROFESSIONAL ALTRUISM? THE VIEWS OF THE CRITICS......Page 26 The neo-Weberian perspective......Page 29 The Marxist perspective......Page 35 CONCLUSION......Page 41 2 The development of a viable conception of the public interest......Page 44 UNITARY CONCEPTIONS OF THE PUBLIC INTEREST......Page 46 PREPONDERANCE ACCOUNTS OF THE PUBLIC INTEREST......Page 49 THE PUBLIC INTEREST AS COMMON INTEREST......Page 52 TOWARDS A VIABLE DEFINITION OF THE PUBLIC INTEREST......Page 56 OPERATIONALIZING THE CONCEPT OF THE PUBLIC INTEREST......Page 61 Britain......Page 65 United States of America......Page 69 The Soviet Union and China......Page 73 CONCLUSION......Page 77 THE NATURE OF A PROFESSION......Page 80 THE CONCEPT OF PROFESSIONAL SELF-INTERESTS......Page 83 The positivist approach......Page 84 The realist approach......Page 86 The conventionalist approach......Page 89 OPERATIONALIZING THE CONCEPT OF PROFESSIONAL SELF-INTERESTS: THE CASE OF HEALTH CARE......Page 92 ASSESSING THE CAUSAL ROLE OF PROFESSIONAL SELF-INTERESTS IN DECISION-MAKING......Page 97 THE ROLE OF PROFESSIONAL SELF-INTERESTS: HEALTH CARE ILLUSTRATIONS......Page 102 CAUSALITY, INTENTION AND PROFESSIONAL SELF-INTERESTS......Page 105 CONCLUSION......Page 107 Part II An empirical application: the response of the medical profession to acupuncture in Great Britain......Page 110 ALTERNATIVE MEDICINE: A FRAMEWORK FOR ANALYSIS......Page 112 ACUPUNCTURE: ITS NATURE AND VARIANT FORMS......Page 116 THE DEVELOPMENT OF ACUPUNCTURE IN CHINA AND THE EAST......Page 117 THE DIFFUSION OF ACUPUNCTURE TO THE WESERN WORLD......Page 119 VARYING PATTERNS OF MEDICAL RESPONSE TO ACUPUNCTURE: EUROPE AND THE UNITED STATES......Page 121 THE RESPONSE OF THE BRITISH MEDICAL PROFESSION TO ACUPUNCTURE......Page 124 Early to mid-nineteenth century......Page 125 Mid-nineteenth to mid-twentieth century......Page 128 Mid-twentieth century to the present day......Page 132 ACUPUNCTURE AS AN ALTERNATIVE MEDICINE: THE SOCIAL IMPLICATIONS......Page 142 CONCLUSION......Page 147 5 Potential explanations for the rejection of acupuncture in Britain......Page 148 THE DIFFUSION OF KNOWLEDGE OF ACUPUNCTURE......Page 149 THE EFFECTIVENESS OF ACUPUNCTURE......Page 152 CONSIDERATIONS OF SAFETY......Page 155 PROBLEMS OF RESEARCH......Page 157 CONFLICTING PHILOSOPHIES OF MEDICINE......Page 161 THE MODUS OPERANDI OF ACUPUNCTURE......Page 164 ACUPUNCTURE AND THE POWER OF THE MIND......Page 167 PRACTICAL PROBLEMS OF INTEGRATING ACUPUNCTURE INTO ORTHODOX MEDICINE......Page 170 PRIORITIES IN MEDICINE......Page 173 CLIENT DEMAND AND THE DANGERS OF QUACKERY......Page 177 SPLITS IN THE ACUPUNCTURE MOVEMENT......Page 182 CAPITALISM AND THE POWER OF THE DRUG COMPANIES......Page 185 THE INFLUENCE OF NATIONALISM......Page 189 CONCLUSION......Page 191 THE POWER OF THE BRITISH MEDICAL PROFESSION......Page 194 Early to mid-nineteenth century......Page 195 Mid-nineteenth to mid-twentieth century......Page 198 Mid-twentieth century to the present day......Page 203 PROFESSIONAL POWER AND THE FATE OF ACUPUNCTURE: A COMPARATIVE PERSPECTIVE......Page 209 THE ROLE OF PROFESSIONAL SELF-INTERESTS IN THE RECEPTION OF ACUPUNCTURE IN BRITAIN......Page 212 Early to mid-nineteenth century......Page 213 Mid-nineteenth to mid-twentieth century......Page 218 Mid-twentieth century to the present day......Page 224 CONCLUSION......Page 236 PROFESSIONAL IDEOLOGIES, INTERESTS AND ACUPUNCTURE......Page 238 Early to mid-nineteenth century......Page 239 Mid-nineteenth to mid-twentieth century......Page 241 Mid-twentieth century to the present day......Page 242 THE MEDICAL PROFESSION, ACUPUNCTURE AND THE PUBLIC INTEREST......Page 249 Early to mid-nineteenth century......Page 250 Mid-nineteenth to the mid-twentieth century......Page 253 Mid-twentieth century to the present day......Page 257 CONCLUSION......Page 266 Conclusion......Page 268 Library study......Page 276 Alternative medicine......Page 277 Other organizations/individuals......Page 278 APPENDIX 2: ITEMS ON ACUPUNCTURE APPEARING IN THE BRITISH MEDICAL JOURNAL AND THE LANCET, 1820–1989......Page 279 GENERAL SOURCES......Page 280 MEDICO-SCIENTIFIC SOURCES......Page 301 OFFICIAL PUBLICATIONS......Page 307 Author index......Page 310 Subject index......Page 320 The importance and influence of professions in public life has grown increasingly over the twentieth century but the question of whether they subordinate their own self-interests to the public interest has yet to be adequately researched within a major sociological perspective. In Professions and the Public Interest Mike Saks develops a theoretical and methodological framework for assessing professional groups in Western society. The empirical applicability of this framework is illustrated with reference to health care, focusing particularly on a novel case study of the response of the medical profession to acupuncture in nineteenth and twentieth century Britain. Does the predominant climate of medical rejection of acupuncture, and many complementary forms of medicine, run counter to the public interest? Has this rejection been heavily influenced by professional self-interest? By considering the implications of this case study for the accountability of the medical profession Mike Saks makes broader recommendations about the direction of research into the relationship between the public and professions in this academically and politically important subject. Professions and the Public Interest will be of great interest to a wide audience including all lecturers and students of social policy, sociology, and medical sociology and well as to professional groups and their members. Mike Saks is Head of the School of Health and Life Sciences, De Montfort University, Leicester Part I: Sociology, Professions and the Public Interest: A Research Framework 1. The sociology of professions and the professional altruism ideal: a critical review 2. The development of a viable conception of the public interest 3. The role of professions: power, interests and causality Part II: An Empirical Application: The Response of the Medical Profession to Acupuncture in Britain 4. Alternative medicine: the case of acupuncture 5. Potential explanations for the rejection of acupuncture in Britain 6. Acupuncture and British medicine: the influence of professional power and interests 7. The As the Introduction to this book has indicated, the recognition given to the contemporary significance of professions in the Western occupational structure has certainly highlighted the pivotal question considered in this book - namely, that of whether professional groups act as altruistically as their own ideologies suggest.