Governing the Chinese medical profession : a socio-legal analysis
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.