Le Diagnostic comme politique publique

Quand on pense au diagnostic médical, on pense habituellement en termes scientifiques. Les idées reçues (et précises) sont que les maladies sont nommées et classifiées sur la base de la recherche scientifique. Par exemple, les révisions de la Classification internationale des maladies (CIM) de l’Organisation mondiale de la santé, faites tous les dix ans à peu près, reflètent en partie les avancées de la compréhension médicale des maladies et traumatismes.

Le catalogage et la désignation des maladies sont les conditions de la recherche scientifique ainsi que leur produit. En effet, comment les médecins peuvent-ils expliquer et contrôler les maladies sans un langage commun pour le phénomène qu’ils observent ? La CIM comprend la totalité des maladies et traumatismes humains et ses mises à jour reflètent les meilleures connaissances de pointe et définit également les conditions de la vague suivante des avancées médicales.

Cependant, la classification formelle des maladies possède un autre aspect, qui concerne diverses fonctions sociales d’importance. Elle fournit un ensemble de noms de maladies et de codes numériques pour affecter et suivre les services et dépenses en matière de santé. Les gouvernements, les compagnies d’assurance et les patients utilisent ces noms et ces codes dans leurs comptabilités et leurs budgets.

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