The development of nosological classifications in the context of the social construction of scientific facts problem

Western medicine, having gone through the historical path of becoming scientific knowledge, found itself included in epistemological discussions on the nature of scientific fact, the process of cognition social context and the organization of science as a social institution. The purpose of the article is to answer the question of what the construction of a scientific fact is, when we discuss the history of medicine as a science and specifically the development of nosological classification principles. Methodologically, the work is based on the constructivist paradigm of the philosophy and sociology of science. Furthermore, the logic of the practical turn in the humanities and an interdisciplinary approach are relevant to this study. The study analyzes two key texts related to the constructivist tradition: L. Fleck’s “The Genesis and Development of Scientific Fact” and M. Foucault’s “The Birth of the Clinic”. The result of the analysis is a description of the development of medicine in the perspective of a constructivist epistemological paradigm. Fleck wrote about how understanding disease depends on a culture's style of scientific thinking. Foucault's work allows us to confirm the hypothesis that the nosological construct of a disease is formed under the influence of certain institutions, such as the clinic. The clinic structures the hospital space by analogy with the laboratory space and places the disease phenomenon into the cells of the nosological classification created as a result of practical actions. The constructivist approach to medical knowledge also allowed us to consider the ICD system as an epiphenomenon of the development of clinical thinking in the era of biopolitics and to explicate the logic of the conflict around the transition from ICD-10 to ICD-11, the effect of differences in value horizons influencing the styles of scientific thinking.

constructivism, social constructionism, disease, nosology, scientific fact, thought-styles, social institutions, clinic, medical perception, International Classification of Diseases