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Social processes in the rise of the hegemonic medicine in Sweden: hinges and avatars in question
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Educational Sciences, Department of Education. (SEC/Praxeologi)
2012 (English)Conference paper, Presentation (Other academic)
Abstract [en]

The paper presents a sketch of an analysis of one branch in the field of medicine, namely the hegemonic medicine and its core profession – the physicians, and their subordinates – nurses and biomedical scientists. The analysis, is underpinned by historical studies (mainly secondary data) and departures from the state formation process in Sweden in the 1500’s to the 1990’s and revolves around; the development of a medical science and professional knowledge as a legitimizing resource as well as paradigmatic and cognitive elements in nosologies, professionalization strategies and jurisdictional claims/conflicts/solutions. As an overarching frame these processes are analyzed in relation to the progressing, expanding and differentiating health care system and state administration structures. The social, political, technical, historical and economic aspects forms a web of conditions for the rise of the field of medicine as a whole, but also differentiating conditions for branches in medicine, where some was more successful in their professionalization strivings than others. The sociological tools used in modeling the field structure emanates from Pierre Bourdieu’s sociology, which are supplemented with Andrew Abbotts conceptual framework i.e. concepts of jurisdiction and cognitive strategies. A reconstruction of four periods is done; 1) The rise of the state medicine and the pre-professional era 1600-1850 2) The biomedical paradigmatic shift 1860-1920, 3) The golden age and effects of rationalization 1930-1960 4) The diminishing welfare state and the growing market 1960-1990. These phases roughly correspond to periods of: 1) Establishment of a field, 2) Qualitative, or cognitive, take-off, 3) Quantitative take-off and cultural hegemony, 4) Subordination to external governance; loss of autonomy. The aim of this paper is to raise and advance some themes emanating from the first-step analysis through a focused discussion about the social processes in the establishment of a hegemonic medicine, the qualities of professional knowledge and in particular how the processes involve relations to the state, universities and external forces of the rationalization movement and as well as intra professional processes of professionalization and specialization. Due to limited space in the paper format and to the historical data used in the first step analysis I will focus on the medicine as a separate social space and on the dominant and earliest professional actor – the doctors. The time span discussed is very long but stretches to 1990’s in general (however with less detail the closer to contemporary time and some passages even into 2000’s). The conceptual tools mainly used in this paper are based in Andrew Abbotts’ framework of linked ecologies, hinges and avatars.

Place, publisher, year, edition, pages
Keyword [en]
professions medicine doctors nurses biomedical analysts Abbott history Sweden hinges avatars
National Category
Social Sciences
Research subject
Sociology of Education
URN: urn:nbn:se:uu:diva-174126OAI: oai:DiVA.org:uu-174126DiVA: diva2:526514
FRAMING EXPERTISE: Scientific Knowledge and Systems of Professions IUC,7th – 11th May 2012, Dubrovnik, Croatia
Available from: 2012-05-13 Created: 2012-05-13 Last updated: 2012-06-29Bibliographically approved

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Carlhed, Carina
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