Date of Award


Degree Type


Degree Name

Master of Arts (MA)




Victor W. Marshall




The nineteenth century was the most striking period in the history of Canadian medicine because it progressed from a relatively low-status occupation to a relatively high status profession. Canadian medicine was able to reach this goal as much on the basis of political maneuvrings as justifiable merit. This thesis is an attempt to "secularize" medicine (Freidson 1970a:24); to see it as a human creation. Owing to limitations of time and space I have decided to concentrate on one of the provincial forefathers of Canadian medicine, Ontario; with reference to the other progressive province, Quebec.

I have used three theoretical perspectives to help me organize the tremendous amount of data I accumulated. The majority of my discussion revolves around Terence Johnson's perspective in Professions and Power. Johnson looks at occupations within a socio-political milieu and on the basis of the latter suggests why certain occupations achieve or do not achieve professional autonomy. This approach is attractive because he does not examine professions in terms of innate characteristics but rather as an occupation that has been able because of the sociopolitical milieu to convince the State to transfer control over all administrative affairs to the profession. This includes any policing or disciplinary matters and therefore leaves the profession free from external scrutiny and control.

In order to analyze medicine's climb to autonomy in Ontario I have borrowed two occupational career stages from Johnson and devised one of my own. In the first stage medicine comes under Oligarchic control. Johnson suggested that when a client oriented occupation is in a situation where the power elite constitutes the sole consumer group then the occupation is controlled by the elite and is not free to maneuvre for more independence. The second stage in medicine's career is simply a transitional period when medicine comes out from under Oligarchic control and proceeds towards autonomy. The final stage is the achievement of occupational autonomy.

Eliot Freidson has also been used, but to a lesser extent in the analysis. He concurs with Johnson's definition of profession. Freidson's emphasis on the factor of technical competence is particularly useful in the transitory stage of medicine's status as one reason why medicine is unable to achieve occupational autonomy.

Johnson's theoretical perspective becomes a little less helpful in analyzing Canadian data towards the last third of the century because of his emphasis on the growing homogeneity of the occupation. It did not coincide with Canadian data. Thus I added Strauss and Bucher (1961) to keep the historical analysis in line with events. Their appreciation of the importance of conflict and differences of interest to the progress of occupations helped generate worthwhile hypotheses from what appeared superficially to be rather unimportant occurrences.


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