| Behaviors are shaped by the intersection of diverse and even conflicting logics of action embodied in institutions, cultures, habits, worldviews, and identities. This dissertation investigates the consequences of these plural logics for individual and collective behaviors. As an empirical application, it examines the health consequences of plural medical systems, or the coexistence of biomedicine and traditional, complementary, and alternative medicine (TCAM).;It is composed of a cross-national quantitative analysis of plural medical systems in ninety-seven countries over three time points and a comparative-historical analysis of acupuncture and herbal medicine in the U.S. and Japan. The quantitative analysis demonstrates that plural medical systems lead to worse national health outcomes when medical-theoretical and political-cultural tensions between biomedicine and TCAM are not mitigated. When these tensions are managed through government insurance schemes and medical knowledge production, to the contrary, more plural systems result in better health outcomes.;The comparative-historical analysis adds that these tensions can be reduced by efforts at multiple levels to coordinate TCAM with biomedicine, such as formal regulations of TCAM practitioners and products, integrative medical care organizations, inclusive health insurance policies, knowledgeable practitioners, and doctor-patient communication of plural medical behaviors. It also elaborates that the deficiency in these coordination efforts produces less effective treatment outcomes of TCAM and adverse biomedicine-TCAM treatment interactions, whereas coordination leads to a variety of synergic treatment interactions. The manifold comparison of acupuncture and herbal medicine in the U.S. and Japan adds that herbal medicine in Japan is the most integrated and the most effective, with herbal medicine in the U.S. being the least in both measures; acupuncture in the U.S. and Japan being in the middle in both measures.;In the conclusion, the dissertation develops an alternative model of the behavioral influences of plural logics of action in general. This model re-conceptualizes plural logics as maneuverability of four different types according to quantitative and qualitative characteristics of plural logics. One type of maneuverability can change into another, depending on how quantitative and qualitative attributes of plural logics are managed. Existing models of plural logics and their behavioral influences are limited so that they fail to comprehend this variability in the behavioral consequences of plural logics that is illustrated in plural medical systems. This dissertation's maneuverability approach not only accommodates existing models but provides a new conceptual frame necessary for exploring the variable and contradictory consequences of plural logics in general. |
