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Medical Evolution

Dr. Darwin Will See You Now

by Denyse O'Leary

Evolutionary medicine is a current cottage industry. In the Journal of Anthropological Sciences, neuroscientists Paola Palanza and Stefano Parmigiana recently told us that "an evolutionary perspective is necessary to understand vulnerability to diseases and behavioral disorders."1 And another recent article in Medical Science Educator informed us that "evolutionary medicine is a growing field focusing on the evolutionary basis of human diseases and their changes through time."2

Article originally appeared in
Salvo 38

But it turns out that there is little new to be learned from this source. Lecture and seminar topics covered in courses in evolutionary medicine include: "Perception of psychiatric ailments in various cultures," "Modern maladaptations—drugs and other addictive agents; socioeconomic mental health inequalities," "The future of humankind (discussion)," and "Ethics in future medical practice and public health."3 One could hang some pop Darwinism on these pegs for sure, but to what effect?

One finds the same thing with The Evolution and Medicine Review ("bridging the gap"), launched in 2008 at Arizona State University to create "a virtual home for evolution and medicine."4 It offers educational materials like "Doctor Darwin: Is Evolutionary Medicine the Future of Health?" But in reading through the materials, one struggles to learn anything beyond Darwinian accounts of how the human body came to be the way it is.

A Problem of Relevance

Perhaps that problem has not gone unnoticed. In 2008, Robert Perlman, who taught courses in evolutionary medicine at the University of Chicago, complained in the Review,  "This spring, under the chairmanship of Edmund Pellegrino, the Council [President's Council on Bioethics] published a reader, 'Human Dignity and Bioethics', to expand and clarify the concept of human dignity. The neglect or dismissal of evolution in this volume is striking."5

Striking? Why? No non-human ancestor is on the examining table.

Of course, writers and editors for publications like the Review might not think that matters. When one is sufficiently steeped in Darwinian evolution, bodies of scientific fact gain value principally by their association with it.

Ramming Darwin down medicine's throat is actually more of a project in social transformation, as we learn from a 2015 Pacific Standard article by Francie Diep, riffing off Ben Carson's bid for the U.S. presidency and obsessing about doctors who do not "accept evolution."6

Even from her sympathizers, Diep does not find much support for the view that what doctors believe about evolution matters much: "Routine medical care doesn't require a whole lot of thinking about underlying biology or evolution," she quotes Gilbert Omenn, a doctor and researcher at the University of Michigan, as saying. And David Gorski, a surgeon and researcher at Wayne State University, told her, "To be honest, to do an operation, you probably don't need to understand evolution."

Then Diep helpfully spells her mission out for us:

Many Americans believe in some kind of "guided" evolution—perhaps some doctors do too. That said, the full form of evolutionary theory explains how all the species on Earth today arose without guidance and continue to evolve, by reacting to the pressures from each other, other species, and their environment.

And with time, "more specialties might require understanding and accepting evolution in full."

In other words, more specialties might require adherence to unguided evolution (Darwinism) as an ideological basis for the right to practice medicine. But again, her supporting evidence (selective pressure on tumors, for example) is, to put it charitably, unconvincing.

Unclear Future

Is this the shape of things to come? For once, that's not clear. There is a sea change going on in evolution. Consider, for example, the growing body of information about convergent evolution (vastly different species arrive at the same goal), horizontal gene transfer (gene transfer between different species, via bacteria), and epigenetics (genetic change caused by environmental factors that is then passed on to descendants).7 These are some of the reasons why even the Royal Society has found it wise to rethink just what evolution entails.8

But has anyone ever argued that horizontal gene transfer, for example, shows that evolution is unguided? It is a demonstrated mechanism, not a doubtful metaphysic, such as Diep seeks to impose on doctors.

If the new approach catches on, "evolutionary medicine," far from being the shape of things to come, could be a low rumble in Darwin's last hurrah.


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