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"Halfmann, Drew"
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Political Institutions and the Comparative Medicalization of Abortion
Comparative-historical research on medicalization is rare and, perhaps for that reason, largely ignores political institutions, which tend to vary more across countries than within them. This article proposes a political-institutional theory of medicalization in which health care policy legacies, political decentralization, and constitutionalism shape the preferences, discourses, strategies, and influence of actors that seek or resist medicalization. The theory helps explain why abortion has been more medicalized in Britain than the United States. The analysis finds that the American medical profession, unlike its British counterpart, focused on defending private medicine rather than protecting its power to “diagnose” the medical necessity of abortions; that American political decentralization aided the establishment of abortion on request by encouraging strategic innovation and learning that shaped social movement strategies, medical issue avoidance, and the growth of nonhospital clinics; and finally, that constitutionalism promoted rights discourses that partially crowded out medical ones.
Journal Article
Political Institutions and the Comparative Medicalization of Abortion
Comparative-historical research on medicalization is rare and, perhaps for that reason, largely ignores political institutions, which tend to vary more across countries than within them. This article proposes a political-institutional theory of medicalization in which health care policy legacies, political decentralization, and constitutionalism shape the preferences, discourses, strategies, and influence of actors that seek or resist medicalization. The theory helps explain why abortion has been more medicalized in Britain than the United States. The analysis finds that the American medical profession, unlike its British counterpart, focused on defending private medicine rather than protecting its power to “diagnose” the medical necessity of abortions; that American political decentralization aided the establishment of abortion on request by encouraging strategic innovation and learning that shaped social movement strategies, medical issue avoidance, and the growth of nonhospital clinics; and finally, that constitutionalism promoted rights discourses that partially crowded out medical ones.
Journal Article
Mechanisms of Social Movement Market Innovation: The Birth of the American Abortion Clinic
How do social movements affect the development and diffusion of new organizational forms? This article theorizes and probes the plausibility of five mechanisms: 1) shaping state administrative regulation 2) entrepreneurship for the purpose of modeling 3) regulating market actors through competition and brokerage 4) developing and disseminating new technologies and 5) conducting scientific research on the efficacy and safety of new and existing technologies, products and services. It provides evidence for the role of these mechanisms in the creation and diffusion of non-hospital abortion clinics in New York City between April 1970, when the state of New York legalized early \"on-request\" abortions, and January 1973, when the U.S. Supreme Court legalized such abortions nationwide
Journal Article
Recognizing medicalization and demedicalization: Discourses, practices, and identities
Scholars of the medicalization of social problems have paid inadequate attention to medicalization's multiple dimensions – discourses, practices and identities – and to the multiple levels of analysis at which it occurs – macro, meso and micro. As a result, scholars of a given social problem typically examine only a few aspects of its medicalization, fail to recognize changes in medicalization, and miss occasions where medicalization and demedicalization occur simultaneously. Moreover, by conceptualizing medicalization as a category or state rather than a continuous value, and failing to specify the threshold at which a phenomenon becomes 'medicalized' or 'demedicalized', scholars have discouraged attention to demedicalization. The article provides a new typology of medicalization and illustrates its utility through an analysis of two episodes in American abortion history. Previous analysts of these episodes miss many aspects of medicalization and disagree about whether these episodes involve medicalization or demedicalization. The typology helps resolve these differences.
Journal Article
Doctors and demonstrators
Since Roe v. Wade, abortion has continued to be a divisive political issue in the United States. In contrast, it has remained primarily a medical issue in Britain and Canada despite the countries' shared heritage. Doctors and Demonstrators looks beyond simplistic cultural or religious explanations to find out why abortion politics and policies differ so dramatically in these otherwise similar countries.
Drew Halfmann argues that political institutions are the key. In the United States, federalism, judicial review, and a private health care system contributed to the public definition of abortion as an individual right rather than a medical necessity. Meanwhile, Halfmann explains, the porous structure of American political parties gave pro-choice and pro-life groups the opportunity to move the issue onto the political agenda. A groundbreaking study of the complex legal and political factors behind the evolution of abortion policy, Doctors and Demonstrators will be vital for anyone trying to understand this contentious issue.
eBook
Historical Priorities and the Responses of Doctors' Associations to Abortion Reform Proposals in Britain and the United States, 1960–1973
In the 1960s and early 1970s, policy-makers in Britain and the United States considered proposals to make abortions more readily available. The main doctors' associations in each country responded differently to these proposals. Doctors' associations in both countries initially sought to preserve clinical autonomy by ensuring that doctors could continue to \"diagnose\" the \"medical necessity\" of abortions. However, the American Medical Association (AMA) eventually changed its position to allow abortion on request. The study explains this difference by way of an \"historical priorities\" approach to analyzing the construction of collective political demands. It argues that \"policy legacies\" provide contexts in which collective actorsprioritizeamong their policy desires. The study finds that because of differing health care policy legacies British doctors' associations viewed abortion clinical autonomy as a higher priority than did the AMA. Moreover, British doctors' associations were most concerned aboutpatientinfringements on clinical autonomy, while the AMA was equally concerned about state infringements on autonomy.
Journal Article