Civil society emphasizes the importance for citizens to be involved and developed in association with other people. The importance of socialization for citizens to learn civic values and develop virtues of tolerance and solidarity is generated by voluntary associations. Mediating structures are the entities that help to integrate disconnected elements of civil society and strengthen communities. Social capital is one of the elements that is actively utilized by mediating structures to connect people to, and get involved with others in mobilizing their efforts collectively for both public and private causes through volunteering. Traditionally only charitable nonprofits were perceived to be mediating structures. However, there are scattered examples of non-charitable professional membership 501(c)(6) associations engaging themselves and their members in social programs and community volunteering unaccountable for in the literature. Using the theories of mediating structures and social capital this research questions the assumption of limited applicability of mediating structures. Extensive empirical analysis of the American Society of Association Executives (ASAE) dataset is performed to determine how social capital and other organizational factors affect the performance of mediating roles by professional membership associations.

Disputes between patients and providers regarding life-sustaining medical treatment (LSMT) are universal across all U.S. states, yet policies regarding these disputes differ significantly. This dissertation determines that all 50 states have advance directive laws that protect a patient’s right to refuse LSMT even when a healthcare provider objects, yet only some states have policies that protect the patient’s right to choose to continue LSMT when a healthcare provider objects (a dispute known as medical futility). Some states have pro-patient laws that protect the patient’s right to make the final decision, while other states have enacted pro-provider medical futility policies that explicitly grant the provider authority to remove LSMT against the patient’s wishes. Finally, in one state, the law delegates the final decision to a third-party: institutional healthcare ethics committees. This dissertation studies the innovation and adoption of these 17 state medical futility policies, examining the theory that values determine both whether the state adopts a medical futility policy as well as what type of medical futility policy a state will adopt- as the policy actors that represent these values: policy entrepreneurs and interest groups. A comparative case study of successful third-party policy adoption in Texas contrasted against a failed effort …