Impact of Regulatory Policy on Out-of-Hospital Care, Legal Mobilization, and Social Movements

本项目审查监管政策对经认证的保健专业人员提供的院外护理的影响。它考察了认证的卫生专业人员解释法规的不同方式，遵循规则，并了解他们的实践范围，因为他们在不同的监管环境中运作。该研究询问认证卫生专业人员的专业化和监管是否以及如何影响卫生保健的提供；监管是否按预期运作；以及监管缺失造成的空白是否会被其他方式填补。此外，该研究还考察了注册卫生专业人员是否以及如何寻求法律地位和监管，为此目的动员法律的不同方式，以及这种动员对注册卫生专业人员的职业身份和法律意识的影响。回答这些问题有助于从理论上理解法律与健康之间的重要关系，并对主导医疗模式之外的医疗保健政策制定和监管具有广泛的影响。这项研究的更广泛影响还包括对本科生的培训和教育。该项目利用民族志参与者观察、访谈研究和文献证据，结合解释性社会科学方法，以分析美国院外护理的相关法规。面对复杂的法规网络和各州不同的执行情况，该项目侧重于监管环境和实施情况各不相同的三个州，并依赖于注册专业助产士（cpm）的案例研究。本研究的结果将推动社会运动和专业行动者在法律实施、法律动员和法律意识方面的社会法学学术和理论。

This project examines the impact that regulatory policy has on out-of-hospital care provided by certified health professionals. It examines the different ways that certified health professionals interpret regulation, follow rules, and understand their scope of practice, given the differing regulatory environments in which they operate. The research asks whether and how the professionalization and regulation of certified health professionals impact the provision of health care; whether regulation operates as intended; and whether voids created by the absence of regulation are filled by other means. In addition, the research examines whether and how certified health professionals seek legal status and regulation, the varying ways in which law is mobilized toward this end, and the impact of such mobilization on the professional identities and legal consciousness of certified health professionals. Answering these questions contributes to theoretical understanding of the important relationship between law and health, and has broad implications for policy-making and the regulation of health care outside of the dominant medical model. The broader impact of the research also includes training and education of undergraduate students. The project utilizes ethnographic participant-observation, interview research, and documentary evidence coupled with interpretive social science methods in order to analyze the regulations surrounding out-of-hospital care in the United States. In the face of a complex web of regulations and disparate enforcement state-by-state, the project focuses on three states where regulatory environments and implementation varies, and relies on a case study of Certified Professional Midwives (CPMs). The findings of this research will advance sociolegal scholarship and theory on the implementation of laws, legal mobilization, and legal consciousness of social movement and professional actors.