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The purpose of this paper is to explore how, and under what conditions, professionals involve relatives in clinical practice.

Two cases were constructed from two studies in Denmark, theoretically inspired by Bourdieu’s concepts of doxa and position and analyzed with focus on the involvement of relatives from the perspective of professionals.

Support to relatives in practice is rarely included in the way that treatment and care are organized in healthcare. Professionals’ views of the involvement of relatives were characterized by the values of neoliberal ideology and medical-professional rationality, in which relatives are not regarded as a subject of care and support in clinical practice. The involvement of relatives aimed to ensure patients’ participation in randomized clinical trial and to help professionals to care for patients when the professionals were not absolutely needed. Professionals were relatively higher positioned in the clinic than relatives were, which allowed professionals to in – and exclude relatives. Neoliberal ideology and medical-professional rationality go hand in hand when it comes to patient treatment, care and the involvement of relatives; it is all about efficiency, treatment optimization and increased social control of the diagnosed patient. These neoliberal, organizational values consolidate doxa of the medical field and the positions that govern the meeting with patients’ relatives – if it takes place at all.

The results put into perspective how the combination of neoliberalism and medical logic work as an organizing principle in contemporary healthcare systems, and challenge a normative, humanistic view on involving patients’ relatives in the medical clinic.

This paper is concerned with enlarging the traditional view of rationality that has dominated management and planning in modern times. The inquiry begins by re‐examining Weber’s discussion of rationality as interpreted by contemporary analysts. Weber saw rationality as multi‐faceted and included notions of a social rationality involving more than simple instrumental or “practical” rationality. Habermas’ ideas concerning communicative action are then introduced as the basis for parsing out Weber’s differing conceptions of rationality based on the dual underlying motivations of pursuing social agreement along with technical or instrumental goals. In dialectical fashion, the paper introduces the concept of adaptive rationality involving a synthetic form of reason that mediates between substantive, or social, rationality and instrumental, or technical, rationality. This adaptive form of reason is seen as the heart of management and planning and requires a combined technical, political and moral imagination in the service of creating new forms of social practice and marshaling both the collective will and resources for their fulfillment. Thus, the paper argues for a wider conception of rationality that explicitly acknowledges social norms and the distribution of power and concludes with the hope of a renewed focus of research for a richer understanding of rational action.

Through a questionnaire survey, the purpose of this paper is to understand and analyse the cognitions of medical service price of medical workers in various regions of China, and discuss the policy suggestions on the price dynamic adjustment of medical service.

The authors conducted a questionnaire survey on the cognition of medical service price medical workers in various regions of China, and then the grey relational analysis theory is used to analyse the data obtained from the questionnaire survey.

The investigation and analysis shows some cognitions of hospital workers on the price of medical services in various regions in China, the authors analyse the results of grey relational analysis and come up with suggestions for relevant departments.

Although a plenty of research on the current situation of medical service price cognition of China is discussed in the paper, it is not complete; thus, a large amount of information needs to be consulted further. The data obtained from the questionnaire are less used and the utilisation rate is lower, which may result in one-sided results and need further investigation.

Through the investigation and analysis, the authors can determine about the implementation of medical service prices in various parts of China from the perspective of hospital workers to a certain degree, and try to explore the relevant policy recommendations for the dynamic adjustment of medical service prices.

The price of medical services refers to the fees for registration, diagnosis, inspection, surgery, nursing and medicine. In a narrow sense, the price of medical services refers to the standard of charge for medical services except drugs. This paper mainly refers to the narrow sense. As one of the important means and methods for the government to control the medical service market, medical service price is also an important basis for the economic source of medical institutions. The adjustment of medical service price is related to the interests of all aspects of society.

Medical service price is an important basis for the economic source of medical institutions, the adjustment of medical service price is related to the interests of all aspects of society and it is a hot issue of social concern. Through the investigation and analysis, the authors use grey relational analysis to know about the medical service prices in various parts of China from the perspective of hospital workers to a certain degree, and try to explore the relevant policy recommendations for the dynamic adjustment of medical service prices.

Three-way decision (3WD) and probabilistic rough sets (PRSs) are theoretical tools capable of simulating humans' multi-level and multi-perspective thinking modes in the field of decision-making. They are proposed to assist decision-makers in better managing incomplete or imprecise information under conditions of uncertainty or fuzziness. However, it is easy to cause decision losses and the personal thresholds of decision-makers cannot be taken into account. To solve this problem, this paper combines picture fuzzy (PF) multi-granularity (MG) with 3WD and establishes the notion of PF MG 3WD.

An effective incomplete model based on PF MG 3WD is designed in this paper. First, the form of PF MG incomplete information systems (IISs) is established to reasonably record the uncertain information. On this basis, the PF conditional probability is established by using PF similarity relations, and the concept of adjustable PF MG PRSs is proposed by using the PF conditional probability to fuse data. Then, a comprehensive PF multi-attribute group decision-making (MAGDM) scheme is formed by the adjustable PF MG PRSs and the VlseKriterijumska Optimizacija I Kompromisno Resenje (VIKOR) method. Finally, an actual breast cancer data set is used to reveal the validity of the constructed method.

The experimental results confirm the effectiveness of PF MG 3WD in predicting breast cancer. Compared with existing models, PF MG 3WD has better robustness and generalization performance. This is mainly due to the incomplete PF MG 3WD proposed in this paper, which effectively reduces the influence of unreasonable outliers and threshold settings.

The model employs the VIKOR method for optimal granularity selections, which takes into account both group utility maximization and individual regret minimization, while incorporating decision-makers' subjective preferences as well. This ensures that the experiment maintains higher exclusion stability and reliability, enhancing the robustness of the decision results.

This paper examines the role of various boundaries in giving both professional groups and individuals a sense of identity that provides both with status and legitimacy. Close attention is paid to the boundaries between personal and professional identities and values. Sociologists working with a discursive approach argue that professional identity and status are achieved through the rhetorical presentation of certain values and responsibilities as personal, and therefore outside the boundaries of professional practice. This paper takes this argument forward, by arguing that in particular contexts, certain kinds of values are consciously articulated as personal and incorporated into the defence of professional legitimacy. Bringing personal claims inside professional boundaries is further evidence of the fluid and negotiated quality of the boundary between personal and professional values and notions of self. The paper consists of a discussion of the construction of professional boundaries, professional involvement in risk, issues raised by antenatal screening and analysis of a study of a group of professionals involved in antenatal screening. The paper explores the circumstances within which even senior professional groups and individuals look to representations of the personal self as a defence against critiques of their professional practice. Where the risks that professionals generate and interpret are medically ambiguous and socially contentious the abstract professional and medical framework is insufficient and other rhetorical values become resources in securing the professional role.

Using as an example the mental health mass screening and treatment programmes instituted in some US states, Joseph Dumit describes how the western world has arrived at a state of ‘dependent normality’ in which being diagnosed and dependent on medication is rendered ordinary, largely through the marketing activities of the pharmaceutical industry, which seeks constantly to expand its market by defining at‐risk populations as broadly as possible, and through persuading the public that all risks must be combated with drugs.

The purpose of this paper is to demonstrate the role of power relations in initiating and blocking accounting change that involves increased “responsibilisation” and “incentivisation”, and to understand how institutional entrepreneurship is steered by power strategies.

An in-depth case study was carried out between 2010 and 2015 in a cardiothoracic surgery service (CSS) where a responsibility centre was introduced.

Introducing a responsibility centre within a CSS led to a change process, despite pressures for stability. The institutionalisation of change was conditioned by entrepreneurship that flowed through three circuits of power. Strategies were adapted according to changes in exogenous environmental contingencies and alterations in the actors’ relationships.

The contributions of the paper are several: first, it demonstrates that the existing literature discussing the implementation of responsibility centres cannot be isolated from power issues; second, it expands understanding of the power dynamics and processes of institutional entrepreneurship when implementing accounting change; third, it shows how change introduced by exogenous political economic events structured organisational circuits of power and blocked the introduction of the change initiative.

Studies the transformation of social systems in health organizations in New Zealand and the way in which accounting systems are an integral part of the challenge to extant structures of signification, legitimation and domination. By categorizing various modes or types of social change, and providing analytical means of clarifying social systems, Giddens’s structuration theory is enabling of empirical study. Accounting systems contribute to the binding of time and space in some circumstances, yet can play a part in major discontinuities and disruptions to institutionalized procedures and practices in other circumstances.

The relationship between the state and the individual is, more than ever before, being mediated by public portals. The requirement specifications for public portals can be said to define the level of expectation among influential actors concerning the roles of the individual in this relationship at a certain point in time. At the same time, they are part of an emergent‐development process. The purpose of this paper is to test this perspective in the empirical context of healthcare.

This research proposes a framework for analysing the requirement specifications for public portals, making various roles possible, such as being a patient, a citizen, a consumer, and a customer. The framework is tested in a case study of a Swedish national healthcare portal.

It can be concluded that prominent actors in this particular context of design defined the requirement specification so that the patient and citizen roles were well supported, whereas the roles of the consumer and customer were supported in a less well‐developed manner. The case study also indicated the importance of reusing already existing functionality to attain quick and tangible results. Consequently, the individual is both enhanced and limited by the “travel of ideas” in the form of the reuse of existing functionality.

This paper puts forward the view that the requirement specifications for public portals are part of the emergent formation of an e‐governance relationship.

The purpose of this paper is to contribute knowledge on ethical issues and reasoning in expert reports concerning healthcare governance, commissioned by the Swedish healthcare system.

An in-depth analysis of ethical issues and reasoning in 36 commissioned expert reports was performed. Twenty-seven interviews with commissioners and producers of the reports were also carried out and analysed.

Some ethical issues were identified in the reports. But ethical reasoning was rarely evident. The meaning of ethical concepts could be devalued and changed over time and thereby deviate from statutory ethical goals and values. Several ethical issues of great concern for the Swedish public healthcare were also absent.

The commissioner of expert reports needs to ensure that comprehensive ethical considerations and ethical analysis are integrated in the expert reports.

Based on an extensive data material this paper reveals an ethical void in expert reports on healthcare governance. By avoiding ethical issues there is a risk that the expert reports could bring about reforms and control models that have ethically undesirable consequences for people and society.