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There have been many minor methods for cobuilding the ICD and its bureaucracy in this fashion. Laws have been passed in individual countries demanding that all causes of death be reported by the relevant statistical service. A single standardized death certificate (developed in the 1920s) has been adopted worldwide. |
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Doctors frequently bemoan the (clinical) resources wasted on searching for the one true cause of death, and as discussed below, consider filling out the certificate virtually a waste of time. Many attempts have been made to educate them in the epidemiological value of a good death certificate. None of these measures alone has rendered the ICD a perfect tool, as Kerr White complained of the ICD up to the ninth edition: ''There is no coherent conceptual or organizing theme, to say nothing of theory, and yet this classification and its modifications seek to meet the needs of policymakers, statisticians, third-party payers, managers, clinicians, and investigators of all persuasions and preoccupations in a wide range of socioeconomic and cultural settings around the worlds" (Kerr White 1985, 1718). Both the acceptance of the role of the state in garnering statistics, however, and its bureaucratic competence so to do, has increased drastically over the past 100 years. |
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Over the past several hundred years, there have been many critiques of the veracity of medical statistics. John Graunt in 1662 (using original spelling) noted: |
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17 . . . I found that all mentioned to die of the French-Pox were retured [sic] by the Clerks of Saint Giles's, and Saint Martin's in the Fields onely; in which place I understood that most of the vilest, and most miserable houses of uncleanness were: from whence I concluded, that onely hated persons, and such, whose very Noses were eaten of, were reported by the Searchers to have died of this too frequent Maladie. |
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18 In the next place, it shall be examined under what name, or Casualtie, such as die of these diseases are brought in: I say, under the Consumption: forsasmuch, as all dying thereof die so emaciated and lean (their Ulcers disappearing upon Death) that the Old-women Searchers after the mist of a Cup of Ale, and the bribe of a two-groat fee, instead of one, given them, cannot tell whether this emaciation, or leanness were from a Phthisis, or from an Hectick Fever, Atrophy, etc; or from an Infection of the Spermatick parts, which in length of time, and in various disguises hath at last vitiated the habit of the Body, and by disabling the part to digest their nourishment brought them to the condition of Leanness above-mentioned. (Graunt 1662, 37) |
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William Farr, almost two centuries later made a similar remark (constituting an example of the assertion that systems have progressive histories but their work-arounds do not): |
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