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Abstract

An analysis of changing physician ideologies regarding the care of elderly dying patients, as expressed in technical journals read by American physicians. Markedly more titles concerning terminal care are found in Index Medicus in 1968- 78 than in 1960-67. In one journal, physicians are only after 1964 urged to tell patients openly about their condition and after 1969, to improve cooperation within professional teams. Two explanations of these data are tentatively explored: 1) a Parsonian explanation, whereby medical ideologies reflect professional autonomy and the influence of internalized moral norms; 2) a Marxist explanation, whereby medical ideologies reflect physicians' transformation from independent intrepreneurs into technological/ bureaucratic agents of the state under monopoly capitalism. Data are summarized which fail to support the Parsonian explanation, but which do support the Marxist explanation concerning the growth in salary payment of doctors and the government's role in terminal care.

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