Role of science and technology in the process of medical specialisation
Abstract
The practice of medicine has undergone profound changes over
the past fifty years. Many aspects of this change have been dramatic
and sane of the techniques used in 1985 belonged to the realm of science
fiction only a decade ago. The incorporation of developments in science
and technology into medicine has widened the scope and range of
interventions available to doctors, and this is reflected in their
practice.
This thesis explores the general belief that scientific and
technological developments have- not only had a general influence on
medicine, but that they have affected the internal division and social
organisation of this profession.
The thesis begins with a section which explores the substantive
areas of sociolology which have relevance to this analysis. The sociology
of the professions and the'sociology of medicine are studied as well as
the approaches on the interaction of technology and society. The
development of the analytical framework drew on the work of both the
symbolic and technological interactionists as well the work connected
with power and control, and incorporated the metaphors of the
ecologists. The framework is based on the complex concept of territory
and though this concept is not new, I have extended it and made it
central to my work.
The second section of the thesis examines the developments that
have influenced medical practice over the past fifty years or so. It is
divided into two chapters, one being concerned with diagnosis and the
other with treatment. The concept of physical chemical and biological
manipulations is used and the imaging devices which extend the senses
-are described. The section ends with sane details on 'the changes in
disease theories.
The area of medicine selected for detailed analysis was that of
reproductive medicine. The conflicts
between obstetricians,
paediatricians, medical geneticists and other groups are explored and
the specific role of scientific and technological developr nts as
resources in these battles are focused upon. The recent developments in
this field are charted and contentions over the perinatal period are
described. -The work of the second section enabled me to set reproductive
medicine within the general practice of medicine, and show a commonality
of both practical and philosophical approaches.
Throught the thesis the emphasis has been very strongly on the
intra-professions conflicts in medicine and on the influence of
scientific and technological develop ents upon than. I have , however,
indicated in several places that there are other factors which influence
specialisation. I have also pointed, albeit it briefly to the
conflicts with para-medicals, especially midwives.