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Competing Institutions: Law, Medicine, and Family in Neonatal Intensive Care

Published online by Cambridge University Press:  02 April 2024

Carol A. Heimer
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Abstract

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To understand the varying impact of law, we must compare the effects of legal institutions with the effects of rival institutions and the impact one law with the impact of another. We must also ask how the setting in which institutions compete and laws are implemented—very often an organization—shapes outcomes. Using the competition between legal, medical, and familial institutions in infant intensive care units as an example, this article elaborates a theory of institutional competition and therefore of the influence of law in organizations. I show that institutions, including legal institutions, gain influence by working through internal organizational processes. Thus, the impact of law on medical decisionmaking varies with whether legal actors have learned how to be present when decisions are to be made, make legal issues into organizational problems, introduce choice points that require action, and alter the possibility space of eligible solutions. Using variations among the major categories of laws that govern the practice of infant intensive care, the article also shows how organizational and institutional theories help explain why some laws have more impact than others.

Type
Articles
Information
Law & Society Review , Volume 33 , Issue 1 , 1999 , pp. 17 - 66
Copyright
Copyright © 1999 by The Law and Society Association.

Footnotes

The production of scholarly work is an iterative process, and I hope that John Braithwaite, Wendy Espeland, Richard Lempert, Arthur McEvoy, Lisa Staffen, Arthur Stinchcombe, and several anonymous reviewers will forgive me if their helpful comments are not fully reflected in the final work. I thank Sarah Gatson and Mitchell Stevens for very able research assistance. The American Bar Foundation generously supported the project on which this article is based, and the Law Program in the Research School of the Social Sciences, Australian National University, was a wonderful intellectual home as I revised.

References

References

Anspach, Renée (1993) Deciding Who Lives: Fateful Choices in the Intensive-Care Nursery. Berkeley: Univ. of California Press.CrossRefGoogle Scholar
Berger, Peter L., & Luckmann, Thomas (1967) The Social Construction of Reality. Garden City, NY: Doubleday.Google Scholar
Black, Donald (1973) “The Mobilization of Law,” 2 J. of Legal Studies 125–49.Google Scholar
Bopp, James Jr. & Nimz, Mary (1992) “A Legal Analysis of the Child Abuse Amendments of 1984,” in Caplan et al., eds. 1992.Google Scholar
Caplan, Arthur L., Blank, Robert H., & Merrick, Janna C., eds. (1992) Compelled Compassion: Government Intervention in the Treatment of Critically Ill Newborns. Totowa, NJ: Humana Press.CrossRefGoogle Scholar
Cohen, Michael D., March, James G., & Olsen, Johan P. (1972) “A Garbage Can Model of Organizational Choice,” 17 Administrative Science Q. 1–25.Google Scholar
Cook County State's Attorney's Task Force on the Foregoing of Life-Sustaining Treatment (1990) Report of the Cook County State's Attorney's Task Force on the Foregoing of Life-Sustaining Treatment. Chicago: Cook County State's Attorney's Office.Google Scholar
Cornblath, Marvin & Clark, Russell L. (1984) “Neonatal ‘Brain Damage‘—An Analysis of 250 Claims,” 140 Western J. Medicine 298–302.Google Scholar
DiMaggio, Paul J. (1988) “Interest and Agency in Institutional Theory,” in Zucker, L. G., ed., Institutional Patterns and Organizations: Culture and Environment. Cambridge, MA: Ballinger.Google Scholar
Zucker, L. G. (1991) “Constructing an Organizational Field as a Professional Project: U.S. Art Museums, 1920–1940,” in Powell & DiMaggio, eds. 1991.Google Scholar
DiMaggio, Paul J., & Powell, Walter W. (1983) “Iron Cage Revisited: Institutional Isomorphism and Collective Rationality in Organizational Fields,” 48 American Sociological Rev. 147–60.Google Scholar
Powell, Walter W. (1991) “Introduction,” in Powell & DiMaggio, eds. 1991.Google Scholar
Edelman, Lauren B. (1990) “Legal Environments and Organizational Governance: The Expansion of Due Process in the American Workplace,” 95 American J. of Sociology 1401–40.Google Scholar
Edelman, Lauren B. (1992) “Legal Ambiguity and Symbolic Structures: Organizational Mediation of Civil Rights Law,” 97 American J. of Sociology 1531–76.Google Scholar
Edelman, Lauren B., Abraham, Steven E., & Erlanger, Howard S. (1992) “Professional Construction of Law: The Inflated Threat of Wrongful Discharge,” 26 Law & Society Rev. 47–83.Google Scholar
Edelman, Lauren B., Erlanger, Howard S., & Lande, John (1993) “Internal Dispute Resolution: The Transformation of Civil Rights in the Workplace,” 27 Law & Society Rev. 497–534.Google Scholar
Edelman, Lauren B., & Suchman, Mark (1997) “Legal Environments of Organizations,” 23 Annual Rev. of Sociology 479–515.Google Scholar
Faden, Ruth R., & Beauchamp, Tom L., in collaboration with King, Nancy M. P. (1986) A History and Theory of Informed Consent. New York: Oxford Univ. Press.Google Scholar
Fost, Norman (1989) “Do the Right Thing: Samuel Linares and Defensive Law,” 17 Law, Medicine & Health Care 330–34.Google Scholar
Fost, Norman (1992) “Infant Care Review Committees in the Aftermath of Baby Doe,” in Caplan et al., eds. 1992.Google Scholar
Friedland, Roger, & Alford, Robert R. (1991) “Bringing Society Back In: Symbols, Practices, and Institutional Contradictions,” in Powell & DiMaggio, eds. 1991.Google Scholar
Frohock, Fred M. (1986) Special Care: Medical Decisions at the Beginning of Life. Chicago: Univ. of Chicago Press.Google Scholar
Frey, Darcy (1995) “Does Anyone Here Think This Baby Can Live?” New York Times, 9 July, sec. 6, p. 22.Google Scholar
Galanter, Marc (1974) “Why the ‘Haves’ Come Out Ahead: Speculations on the Limits of Legal Change,” 9 Law & Society Review 95–160.Google Scholar
Gerry, Martin H., & Nimz, Mary (1987) “Federal Role in Protecting Babies Doe,” 2 Issues in Law & Medicine 339–77.Google Scholar
Goldman, Gilbert M., Stratton, Karen M., & Brown, Max Douglas (1989) “What Actually Happened: An Informed Review of the Linares Incident,” 17 Law, Medicine & Health Care 298–307.Google Scholar
Gostin, Larry (1989) “Editor's Introduction: Family Privacy and Persistent Vegetative State,” 17 Law, Medicine & Health Care 295–97.Google Scholar
Guillemin, Jeanne H., & Holmstrom, Lynda L. (1986) Mixed Blessings: Intensive Care for Newborns. New York: Oxford Univ. Press.Google Scholar
Hack, Maureen, & Fanaroff, Avroy A. (1989) “Outcomes of Extremely-Low-Birth-Weight Infants between 1982 and 1988,” 321 New England J. of Medicine 1642–47.Google Scholar
Haralambie, Ann M. (1987) Family Law Series, vols. 1 & 2. Colorado Springs, CO: Shepard's McGraw-Hill.Google Scholar
Harrison, Helen (1986) “Neonatal Intensive Care: Parents' Role in Ethical Decision Making,” 13 Birth 165–75.Google Scholar
Harrison, Helen, with Kositsky, Anne (1983) The Premature Baby Book. New York: St. Martin's Press.Google Scholar
Heimer, Carol A. (1985a) “Allocating Information Costs in a Negotiated Information Order: Interorganizational Constraints on Decision Making in Norwegian Oil Insurance,” 30 Administrative Science Q. 395–417.Google Scholar
Heimer, Carol A. (1985b) Reactive Risk and Rational Action: Managing Moral Hazard in Insurance Contracts. Chicago: Univ. of Chicago Press.CrossRefGoogle Scholar
Heimer, Carol A. (1992) 'Your Baby's Fine, Just Fine: Certification Procedures, Meetings, and the Supply of Information in Neonatal Intensive Care Units,“ in Short, J. F. & Clarke, L., eds., Organizations, Uncertainties, and Risk. Boulder, CO: Westview Press.Google Scholar
Clarke, L. (1996) “Explaining Variation in the Impact of Law: Organizations, Institutions, and Professions,” 15 Studies in Law, Politics, & Society 29–59.Google Scholar
Heimer, Carol A., & Staffen, Lisa R. (1995) “Interdependence and Reintegrative Social Control: Labeling and Reforming ‘Inappropriate’ Parents in Neonatal Intensive Care Units,” 60 American Sociological Rev. 635–54.Google Scholar
Staffen, Lisa R. (1998) For the Sake of the Children: The Social Organization of Responsibility in the Hospital and the Home. Chicago: Univ. of Chicago Press.Google Scholar
Heimer, Carol A., & Stevens, Mitchell L. (1996) “Caring for the Organization: Social Workers as Frontline Risk Managers in Neonatal Intensive Care Units,” 24 Work & Occupations 133–63.Google Scholar
Hodgman, Joan E. (1990) “Neonatology,” 263 J. of the American Medical Assn. 2656–57.Google Scholar
Jepperson, Ronald L. (1991) “Institutions, Institutional Effects, and Institutionalism,” in Powell & DiMaggio, eds. 1991.Google Scholar
Katz, Jay (1984) The Silent World of Doctor and Patient. New York: Free Press.Google Scholar
Kingdon, John W. (1984) Agendas, Alternatives, and Public Policies. Boston: Little, Brown.Google Scholar
Klass, Perri (1990) Other Women's Children. New York: Random House.Google Scholar
Kopelman, Loretta M., Kopelman, Arthur E., & Irons, Thomas G. (1992) “Neonatologists, Pediatricians, and the Supreme Court Criticize the ‘Baby Doe’ Regulations,” in Caplan et al., eds. 1992.Google Scholar
Lantos, John D., Miles, Steven H., & Cassel, Christine K. (1989) “The Linares Affair,” 17 Law, Medicine, & Health Care 308–15.Google Scholar
Lempert, Richard O. (1976) “Mobilizing Private Law: An Introductory Essay,” 11 Law & Society Rev. 173–89.Google Scholar
Lieberman, Jethro K. (1981) The Litigious Society. New York: Basic Books.Google Scholar
Lukes, Steven (1974) Power: A Radical View. London: Macmillan.CrossRefGoogle Scholar
Lyon, Jeff (1985) Playing God in the Nursery. New York: Norton.Google Scholar
Macaulay, Stewart (1963) “Non-contractual Relations in Business: A Preliminary Study,” 28 American Sociological Rev. 55–66.Google Scholar
March, James G. (1994) A Primer on Decision Making: How Decisions Happen. New York: Free Press.Google Scholar
March, James G., & Olsen, Johan P., eds. (1976) Ambiguity and Choice in Organizations. Bergen: Universitetsforlaget.Google Scholar
Mehren, Elizabeth (1991) Born Too Soon. Garden City, NY: Doubleday.Google Scholar
Meisel, Alan, & Kabnick, Lisa D. (1980) “Informed Consent to Medical Treatment: An Analysis of Recent Legislation,” 41 Univ. of Pittsburgh Law Rev. 407–564.Google Scholar
Meyer, John W., & Rowan, Brian (1977) “Institutionalized Organizations: Formal Structure as Myth and Ceremony,” 83 American J. of Sociology 340–63.Google Scholar
Nelson, Lawrence J., & Cranford, Ronald E. (1989) “Legal Advice, Moral Paralysis and the Death of Samuel Linares,” 17 Law, Medicine & Health Care 316–24.Google Scholar
Newman, Stephen A. (1989) “Baby Doe, Congress and the States: Challenging the Federal Treatment Standard for Impaired Infants,” 15 American J. of Law & Medicine 1–60.Google Scholar
New York Times (1995) “Father Acquitted in Death of His Premature Baby,” 3 Feb. (late ed.), sec. A, p. 15.Google Scholar
Nocon, James J., & Coolman, David A. (1987) “Perinatal Malpractice: Risks and Prevention,” 32 J. of Reproductive Medicine 83–90.Google Scholar
Novak, D.H., Plumer, R., Smith, R. L., Ochitill, H., Morrow, G. D., & Bennett, J. M. (1979) “Changes in Physician's Attitudes toward Telling the Cancer Patient,” 241 J. of the American Medical Association 897–900.Google Scholar
O'Connell, Jeffrey (1979) The Lawsuit Lottery. New York: Free Press.Google Scholar
Oken, D. (1961) “What to Tell the Cancer Patient,” 175 J. of the American Medical Association 1120–28.Google Scholar
Paneth, Nigel (1990) “Technology at Birth,” 80 American J. of Public Health 791–92.Google Scholar
Pegalis, Steven E., & Wachsman, Harvey F. (1992) American Law of Medical Malpractice 2nd, Vol. 1. Deerfield, IL: Clark Boardman Callaghan.Google Scholar
Powell, Walter W. (1991) “Expanding the Scope of Institutional Analysis,” in Powell & DiMaggio, eds. 1991.Google Scholar
Powell, Walter W., & DiMaggio, Paul J., eds. (1991) The New Institutionalism in Organizational Analysis. Chicago: Univ. of Chicago Press.CrossRefGoogle Scholar
Rees, Joseph V. (1994) Hostages of Each Other: The Transformation of Nuclear Safety since Three Mile Island. Chicago: Univ. of Chicago Press.CrossRefGoogle Scholar
Rothman, David J. (1991) Strangers at the Bedside: A History of How Law and Bioethics Transformed Medical Decision Making. New York: Basic Books.Google Scholar
Schuck, Peter H. (1994) “Rethinking Informed Consent,” 103 Yale Law J. 899–959.Google Scholar
Scott, W. Richard (1991) “Unpacking Institutional Arguments,” in Powell & DiMaggio, eds. 1991.Google Scholar
Selznick, Philip (1969) Law, Society, and Industrial Justice. New York: Russell Sage.Google Scholar
Sewell, William H. Jr. (1992) “A Theory of Structure: Duality, Agency, and Transformation,” 98 American J. Sociology 1–29.Google Scholar
Shapiro, Robyn S., & Barthel, Richard (1986) “Infant Care Review Committees: An Effective Approach to Baby Does Dilemma?” 37 Hastings Law J. 827–62.Google Scholar
Silverman, William A. (1980) Retrolental Fibroplasia: A Modern Parable. New York: Grune & Stratton.Google Scholar
Soltan, Karol, Haufler, Virginia, & Uslaner, Eric M., eds. (1998) Institutions and Social Order. Ann Arbor: Univ. of Michigan Press.CrossRefGoogle Scholar
Starr, Paul (1982) The Social Transformation of American Medicine. New York: Basic Books.Google Scholar
Stinson, Robert, & Stinson, Peggy (1979) The Long Dying of Baby Andrew. Boston: Little, Brown.Google Scholar
Swidler, Ann (1986) “Culture in Action: Symbols and Strategies,” 51 American Sociological Rev. 273–86.Google Scholar
Walman, Terry (1992) “Decision Making in the Neonatal Intensive Care Unit: The Impact of the 1984 Child Abuse Amendments,” in Caplan et al., eds. 1992.CrossRefGoogle Scholar
Weir, Robert F. (1984) Selective Nontreatment of Handicapped Newborns. New York: Oxford Univ. Press.Google Scholar
Zucker, Lynne G. (1983) “Organizations as Institutions,” in Bacharach, S. B., ed., Research in the Sociology of Organizations. Greenwich, CT: JAI Press.Google Scholar
Zussman, Robert (1992) Intensive Care: Medical Ethics and the Medical Profession. Chicago: Univ. of Chicago Press.Google Scholar

Cases Cited

Canterbury v. Spence, 464 F.2d 772, 787 (D.C. Cir. 1972).Google Scholar
Helling v. Carey, 83 Wash. 2d 514, 519 P.2d 981 (1974).Google Scholar
American Academy of Pediatrics v. Heckler, 561 F. Supp. 395 (1983).Google Scholar
Bowen v. American Hospital Association, 106 S. Ct. 2101 (1986).Google Scholar

Statutes Cited—State

Abused and Neglected Child Reporting Act, 325 ILCS 5/1 et seq.Google Scholar
Clinical Social Work and Social Work Practice Act, 225 ILCS 20/1 et seq.Google Scholar
Consent by Minors to Medical Procedures Act, 410 ILCS 210/0.01 et seq.Google Scholar
Health Care Surrogate Act, 755 ILCS 40/1 et seq.Google Scholar
Illinois Nursing Act of 1987, 225 ILCS 65/1 et seq.Google Scholar
Juvenile Court Act of 1987, 705 ILCS 405/1 et seq.Google Scholar
Medical Patient Rights Act, 410 ILCS 50/0.01 et seq.Google Scholar
Medical Practice Act of 1987, 225 ILCS 60/1 et seq.CrossRefGoogle Scholar
Neglected Children Offense Act, 720 ILCS 130/0.01 et seq.Google Scholar
Right of Conscience Act, 745 ILCS 70/1 et seq.Google Scholar

Statutes Cited—Federal

Child Abuse Amendments of 1984, Public Law 98-457.Google Scholar
Reauthorization of Child Abuse Amendments of 1984, Public Law 101-126.Google Scholar

Administrative Rules

Office of the Secretary, Health and Human Services, Interim Final Rule, “Nondiscrimination on the Basis of Handicap” 48 Fed. Reg. 9630 (1983).Google Scholar
Office of the Secretary, Health and Human Services, Final Rule: “Nondiscrimination on the Basis of Handicap, Procedures and Guidelines Relating to Health Care for Handicapped Infants,” 49 Fed. Reg. (1984).Google Scholar
Office of Human Development Services, Health and Human Services, Final Rule.Google Scholar