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Professional Autonomy Reconsidered: The Case of Czech Medicine under State Socialism

Published online by Cambridge University Press:  25 April 2012

Lily M. Hoffman
Lily M. Hoffman
Affiliation:
City College and Graduate Center, The City University of New York
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Extract

The opening of the formerly closed, state socialist societies of East Central Europe has provided the opportunity to bring new empirical evidence to bear upon models of profession-state relations developed in pluralist western societies. The classic view of Tocqueville and Durkheim has been that professions are an intermediary group linking individuals and the state. Although not always explicitly stated, this model served as the basis for scholarly work on the professions in the post-World War II period, where it (more or less) fit the image of a differentiated pluralist society. Most work on the professions was based on the Anglo-American case.

But even in the United States, state support was more central to maintaining professional authority than was originally thought. Without explicitly discarding the model, Freidson (1970) introduced a distinction between corporate and technical (clinical) autonomy that provided a way out of the paradox he identified, that both aspects of professional autonomy are protected by the state. Corporate autonomy refers to the political power of the organized profession to define the social and economic context of professional work, and clinical autonomy, to the control of decision making in the workplace. Testing his hypothesis on the United States, the United Kingdom, and the Soviet Union, Freidson argued that despite differing degrees of corporate autonomy, the medical profession retained clinical control of decision making, the core of professional autonomy, even in the extreme case of the former Soviet Union.

Type
Occupational Identity
Information
Comparative Studies in Society and History , Volume 39 , Issue 2 , April 1997 , pp. 346 - 372
Copyright
Copyright © Society for the Comparative Study of Society and History 1997

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