Diagnose als Element öffentlicher Ordnungstätigkeit

Wenn wir an die medizinische Diagnose denken, so tun wir dies in der Regel im wissenschaftlichen Sinne. Nach herkömmlichem (und zutreffendem) Verständnis werden Erkrankungen auf der Grundlage wissenschaftlicher Forschung benannt und klassifiziert. So spiegelt die etwa alle zehn Jahre erfolgende Überarbeitung der Internationalen Klassifikation von Krankheiten (ICD) der Weltgesundheitsorganisation (WHO) u.a. die Fortschritte im Verständnis von Krankheiten und Verletzungen wider.

Die Katalogisierung und Benennung von Erkrankungen ist ebenso Grundlage wissenschaftlicher Forschung wie deren Produkt. Wie auch sollten Ärzte Erkrankungen erklären und beherrschen ohne eine gemeinsame Sprache für die von ihnen beobachteten Phänomene? Die ICD umfasst das gesamte Spektrum menschlicher Erkrankungen und Verletzungen, und ihre Aktualisierungen spiegeln den neusten Kenntnisstand wider und schaffen die Voraussetzungen für die nächste Welle medizinischen Fortschritts.

Die formelle Klassifizierung von Erkrankungen beinhaltet jedoch noch einen weiteren Gesichtspunkt, der eine Vielzahl wichtiger sozialer Funktionen betrifft: Sie stellt eine Auflistung von Krankheitsnamen und Schlüsselnummern für die Zuweisung und Rückverfolgung von Ausgaben und Leistungen des Gesundheitswesens bereit. Regierungen, Versicherungsgesellschaften und Patienten nutzen diese Namen und Schlüsselnummern für ihre Buchhaltung und Wirtschaftsplanung.

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