Internal consensus

As internal consensus a is consensus referred to, which consists only within a limited group of people.

The term gained particular importance in Germany around the mid-1990s in the critical debate about the reform of health insurance law . It refers in particular to a formulation in Section 135 of Book V of the Social Code (SGB V) with regard to the use of new examination and treatment methods at the expense of the solidarity community:

New examination and treatment methods may only be provided in the contract medical and contract dental care at the expense of the health insurance companies if the Federal Joint Committee ... has made recommendations about

1. Recognition of the diagnostic and therapeutic benefit of the new method as well as its medical necessity and cost-effectiveness - also in comparison to methods already provided at the expense of the health insurance companies - according to the current state of scientific knowledge in the respective direction of therapy ... ( Section 135 (1) SGB V)

In connection with the enactment of the statutory health insurance reorganization laws , the German Medical Association asked the Bundestag in 1997 to delete the words “in the respective therapy direction” without substitution. It was feared that the principle of internal recognition could be extended immeasurably to all new, unconventional therapy methods. At the same time it was demanded that the privileges of the special therapeutic directions in the drug guidelines of the Federal Joint Committee (Section 92, Paragraph 3a, SGB V) be lifted.

There is also an internal consensus regarding the reimbursement of non-prescription medicines from anthroposophy and homeopathy . The doctor can prescribe them for serious illnesses at the expense of the statutory health insurance, "if the use of these drugs for these indication areas is indicated according to the state of knowledge as a therapy standard in the respective therapy direction." This has recently been confirmed by social courts.

In terms of pharmaceutical law, there is an internal consensus in Germany with regard to pharmaceuticals for phytotherapy , homeopathy and anthroposophic medicine that are subject to authorization . For them, the German Medicines Act provides that in the decision on the granting or extension of a marketing license, the "medical experience" or "the special features" of these therapies must be taken into account ( Section 25 (2) and Section 105 (4f) AMG) .

The term internal consensus is also used in other areas. In the current scientific debate, it plays a role in the field of ethnological consensus analysis (mostly internal consensus in English texts ).

Individual evidence

1. ↑ ^{a b} Resolution protocol of the 100th German Medical Congress from 27.-30. May 1997 in Eisenach (PDF; 304 kB), page 4
2. ↑ The phrase “in the respective direction of therapy” is reproduced in the political debate with the term “internal consensus” (namely: the respective direction of therapy ). The term internal recognition is also used synonymously. Examples of the use of both terms in the political debate about the special forms of therapy: On the one hand, Irmgard Oepen's contribution “Unconventional procedures and positive list - From the perspective of scientific medicine: deficiencies in jurisprudence”, archive link ( Memento of the original from September 29, 2007 in Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. , Pp. 27-34; from the other side an abstract of a contribution by Rüdiger Zuck, "The constitutional framework of evaluation and pluralism" Archive link ( Memento of the original from December 1, 2016 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice.  
3. ↑ Guidelines of the Federal Committee of Doctors and Health Insurance Funds on the Prescription of Medicines in Contract Medical Care ("Medicines Guidelines / AMR") (PDF; 199 kB)
4. ↑ S 7 KR 283/06 (SG Speyer) , S 8 KR 321/04 (SG Dusseldorf) ( Memento on 10 February 2009 at the Internet Archive ), S 18 KR 534/05 (SG Dresden)
5. ↑ Cf. e.g. AK Romney / SC Weller / WH Batchelder: Culture as consensus: A theory of culture and informant accuracy. American Anthropologist , 1986, vol. 88, pp. 313-338; for the use of the German term see Micha Strack: Sozialperspektiven, Göttingen 2004 (PDF; 3.9 MB), pp. 268 and 308.