Neurosurgeon: Evolutionary medicine = waste of time

I recently watched a PowerPoint presentation that neurosurgeon Michael Egnor gave at Birmingham, Alabama last month on "why we got eugenics." He said pretty clearly something that I have been driving at for some time:

Evolutionary explanations are merely stories appended to the proximate (scientific) explanations. They contribute nothing to the scientific understanding of the disease beyond the contribution of the proximate explanations.

Evolutionary stories are ad-hoc and generally untestable guesses, and offer no meaningful framework for science. The proximate explanations (anatomy, physiology, biochemistry, molecular biology, genetics, microbiology, etc.) are the framework for science.

Strategies for disease treatment and prevention depend on data from the relevant medical sciences, not on speculative stories about origins.

Darwinian medicine is scientifically vacuous, and the Darwinian theory of human origins is the antithesis of human exceptionalism and human dignity.

Of course. The whole concept of evolutionary medicine is a waste of time for a very simple reason:

Medicine can never be a discipline without a subject. Astrobiology can be a discipline without a subject because there are no space aliens to complain that their needs are not attended to. But medicine can't be a discipline without a subject (conventionally, a patient) because medicine must offer solutions, not just theories.

Supposed ancestors, just like space aliens, are not a subject, as far as medicine is concerned.

If you go to your doctor with severe chest pain, you will hardly wish to hear that some professor somewhere has theorized that Pleistocene man did not suffer from your condition because his selfish genes gave him lots of exercise bopping his numerous squeezes around, so ...

So you are supposed to pay for this information, if - out of charity - it can be called information?

Medicine exists, in the words of William Osler to provide cure sometimes, relief often, and comfort always - but never mere theories.

In my view, "evolutionary medicine" is another example of people trying to find a use for something that isn't really any particular use.

Interesting, sure. Useful, no.

I will try to get Dr. Egnor's PowerPoint put up on line somewhere.

Does the study of evolution have practical benefits for science or medicine?

Here's a podcast by Casey Luskin, one of the evil Discos, on whether the study of evolution has any practical benefits for science:

Does evolution have any practical benefits for science? In this episode of ID the Future, Casey Luskin reveals that the answer, surprisingly, is no. Listen as Luskin discusses past biological discoveries, reviews recent surveys of biologists, and quotes several scientists, including noted Professor of Biology and intelligent design critic Jerry Coyne. All three sources agree: the theory of evolution has yielded few practical benefits for scientific discovery.

Actually, that's not really very surprising.

The study of evolution is the study of - to use the vernacular - what used to was and ain't no more. It is necessarily heavy on speculation and interpretation. That's okay, as long as it doesn't become a cult.

Fast forward to Darwinism, which - unfortunately - has become a cult, big time.

Plus, I have been meaning to post this for months - Catriona J MacCallum (PLOS Biology, April 2007 Volume 5 Issue 4 e112) argues for the alleged importance of evolution in medicine. She complains,

One reason that evolution doesn’t figure prominently in the medical community is that although it makes sense to have evolution taught as part of medicine, that doesn’t make it essential. ... , medicine is primarily focused on problem-solving and proximate causation, and ultimate explanations can seem irrelevant to clinical practice. Crudely put, does a mechanic need to understand the origins, history, and technological advances that have gone into the modern motor vehicle in order to fix it?

Crudely put, medicine is about saving lives and limbs today in the real world.

MacCallum thinks that evolution can help us understand epidemics, and this may be so if we mean the evolution of bacteria in a test tube. Not that bacteria evolve much, if you go by Edge of Evolution, except that they tend to junk intricate machinery under stress.

Apart from that, consider the example of heart attacks: What if the lemur-like creature from which humans are said to descend never had heart attacks? What if it usually did, under stress? How does such information help the medical interne whose patient presents with cardiac arrest? Whatever the interne decides to do must work in half a minute, not half a billion years.

Yes, evolution is very interesting - like any other type of ancient history - but no, it is not essential. I think it should definitely be studied, along with the cave paintings, ancient Egypt and theories about the origin of life and the universe and all that. But the burden of pretending that evolution is useful in a concrete way is tiresome and surely avoidable.

Find out why there is an intelligent design controversy:

Darwinism and popular culture: Darwinism becoming the West's myth, doctor says

My friend and colleague Deborah Gyapong reports on a recent talk by Dr. John Patrick, Ottawa pediatrician and retired professor of medicine, noting that

the “Darwinian myth” is becoming the “ordering myth” for the West, replacing the Christian story, with potentially disastrous consequences.

“Who would you rationally trust when we legalize doctor-assisted suicide?” he asked. “A Darwinist physician or a doctor who believes in judgment after death?”

Darwin’s theories of natural selection, survival of the fittest and of evolutionary progress are making an impact on health care, even though Patrick describes the art of medicine as “very anti-Darwinist” in its care for the sick and the vulnerable. But that is changing as society becomes “profoundly incoherent,” he said.

Patrick was speaking at a conference of Christian medical doctors, June 3-9 at St. Augustine College in Ottawa. Unfortunately, other speakers attempted to soothe the audience with tales of some kind of accommodation with Darwinism, as long as the Darwinists would just remember that Darwinism is not supposed to be the ordering myth of the West. Yeah really.

The most interesting aspect of the current aggressive promotion of evolutionary medicine (Darwinism in medicine and veterinaray practice ) is its sheer clinical uselessness.

The proclamations are grand, to be sure:

"Nothing in biology makes sense, except in the light of evolution," is the oft-quoted title of a 1973 article for biology teachers by the great evolutionary biologist Theodosius Dobzhansky. In it, he writes, "Seen in the light of evolution, biology is, perhaps, intellectually the most satisfying and inspiring science. Without that light it becomes a pile of sundry facts some of them interesting or curious but making no meaningful picture as a whole."

Evolution's role is equally central in the subset of biology addressing human health and disease. The co-evolution of humans and our pathogens, the rapidly shifting resistance of those pathogens to our antibiotics, and our persistent vulnerability to chronic disease all gain significance when viewed in the context of continuing evolution. These subjects form the core of "Darwinian medicine," also known as "evolutionary medicine."

But how exactly do these ills "gain significance when viewed in the context of continuing evolution"? For the purpose of counselling and treatment of the patient in the present day, it hardly matters when they appeared or who - besides immediate ancestors and sibs, and people who live nearby - has them.

Consider, for example, an illness for which there is apparently a genetic predisposition: alcoholism. Fundamentally, the patient has decisions to make (Will I drink or not? Will I get drunk or not?) What if Alley Oop had the same problem? What if he didn't?

For that matter, what if there is really no genetic predisposition to alcoholism? It makes no difference to the patient in the end. He either drinks or he doesn't, and accepts the consequences.

One could say the same thing about obesity, that other scourge of the family practitioner's office in prosperous countries everywhere. If the Willendorf Venus was fat, so what? What if she had been thin? I doubt that most Stone Age women were as certain of their next meal as she must have been. But in the end, today's woman decides whether she wants obesity, along with its problems, or not. And she's the only one who can really do something about it.

Similarly, with antibiotic resistance (an often-cited passage in the Gospel According to Darwin), I have it on good authority that the main cause of the resistance is overprescription (and other overuse) of antibiotics. We helped the bugs get where they are. We could stop helping them. But that doesn't mean telling the old, old story of Darwinism over and over again; it means getting patients to accept alternative treatments. They will only do that if they can be persuaded that other approaches work.

I suspect that Darwinian medicine will just go the way of evolutionary psychology. I wonder how much harm it will do first.

Neurosurgeon: Darwin doesn't matter

Award-winning neurosurgeon Michael Egnor makes the obvious clear: Contrary to promotional campaigns aimed at students - at taxpayer expense - Darwinian evolution is not a useful asset to a medical doctor.

Of course not. Basically, the doctor has to deal with a human patient in front of her today. Suppose the doctor has a patient just diagnosed with adult onset diabetes - we'll call her Mrs. Plunkett (wow, does she love sugar in her tea). What difference would it make if cave women never got diabetes? Or always did? The information would be interesting - but not useful. The doctor must persuade Mrs. Plunkett to quit smoking, give up her charge account at Fanny Farmer's, get more exercise, and lose some weight. And so forth. Whatever the evolutionary history of diabetes is, it's just history. The doctor is concerned with futures - specifically, Mrs. Plunkett's future, especially if she doesn't listen to the wise advice she is offered.

Egnor now blogs with the evil Discos (follow the link above).