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The paper seeks to identify and explain shifts in dominance relationships between the medical profession and allied health professions in Germany, taking the occupational fields of nursing and psychotherapy as examples. It suggests an actor-based perspective which focuses on the strategic interplay between collective actors in the fields in question, namely professional associations and unions, state actors, sickness funds, universities, polytechnics and associations of work organisations. It considers the context of governance of the German health care system and an awareness of a changed demand. The thesis is that the interplay between the actors has led to a small reduction of medical dominance. It is examined whether changes in governance structures of the health care system have led to a more favourable context for shifts in the dominance relationships. Moreover, the possible effects of the recent re-organisation of health provision are considered. Based on an empirical investigation using the method of document analysis, the paper shows that there has been a small reduction of medical dominance which is essentially the outcome of the interrelated strategic actions of various collective actors in the fields. A public perception of a new kind of health care demand has facilitated this development. [ABSTRACT FROM AUTHOR]

This paper reports findings from a comparative study of Israeli and German genetic counsellors' perceptions of the moral standing of the fetus. Data collected through in-depth interviews with counsellors in both countries (N=32) are presented, and their moral practices are analysed. The paper's findings suggest that while German counsellors perceive the fetus as an autonomous being and debate the particular biological stages through which this autonomy is acquired; Israeli counsellors do not consider the moral status of the fetus independently of its relations with its family hence, deploying a 'relational ethics'. It is suggested that these differences are influenced by historical, political, legal, and religious traditions in Germany and Israel regarding abortions and the fetus. It is concluded that the deployment of a 'biological ethics' by German counsellors reproduces the model of fetal developmental stages (in itself a construction), and hence goes hand in hand with perceptions of the fetus as a 'life', and thus as the bearer of autonomous rights which are understood to contradict those of its mother. On the other hand, the rejection of 'biological ethics' by Israeli counsellors enables a perception of fetuses that is first and foremost defined by their relationships with others. [ABSTRACT FROM AUTHOR]