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Thursday, June 28, 2007

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.

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