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Why isn’t evolutionary medicine more popular?

Screen Shot 2018-01-04 at 3.35.51 PMI came across this essay by philosopher of science Michael Ruse that was published in the Chronicle of Higher Education. It asks the question: why isn’t evolutionary medicine a bigger deal? Some of the best insights may come from the comment section. A link to the entire article and comments is here: Why isn’t evolutionary medicine more popular than it is? Some excerpts are here:

“Why then is evolutionary medicine not embraced by all? Why was it not embraced at once after Darwin published his Origin of Species in 1859? My suspicion is that today it is, in major part, natural conservatism coupled with reluctance to give time to such ideas. In biology departments, we know how hard it is to get in courses on evolution. There is always someone arguing for yet one more course on biochemistry. I would not be at all surprised to find that there is also a religious factor here.”

He also cites Thomas Huxley as a surprising player in resistance to evolution in medicine:

“However, going back further, fascinatingly and paradoxically, the person most responsible for keeping evolution out of medical education was Thomas Henry Huxley, Darwin’s self-styled “bulldog.” Huxley was a fanatical evolutionist and preached it publicly on every occasion. But he was never that keen on natural selection and thought overall that evolution was too speculative – and of no real value – to biological education. As I discovered by looking at student notebooks, in a 165-lecture course on biology, he would give less than half a lecture to evolution, and selection got all of 10 minutes.”

A comment on the article makes the following observation:

“There are plenty of places in medical practice where appreciating evolution is useful; (senescence) is only one. Others include antibiotic use and the presumed function of most pharmaceuticals. It is shocking how little MDs (or even biomedical researchers) understand of underlying mechanisms and their origins, and how much better medical treatment would be if they paused to think adaptively before rushing to address symptoms.”

Another commenter added:

“An evolutionary perspective is critical to management of infectious diseases and malignancies. But, there, the focus is on the evolutionary process as it applies to the cells of infectious agents or tumors, not on the evolutionary history of humans”

I think this is key. We are happy to imagining evolution as being important for pathogens, and open to the idea of evolution as a malign force in cancer. Curiously we have a harder time thinking about how our own evolution might be important. This no doubt has cultural, historical, and potentially religious reasons. I see this dynamic playing out here at the medical school where I work at the University of New Mexico.

In my mind the importance of evolutionary medicine is in its practical applications. We who are interested in this field need to think strategically about which areas will be the most fruitful in convincing our colleagues of the importance of the evolutionary approach to medicine. This is one of the themes we will explore this summer in Park City Utah at the 4th annual meeting of ISEMPH – The International Society for Evolution, Medicine and Public Health.

Categories: Uncategorized

Joe Alcock

Emergency Physician, Educator, Researcher, interested in the microbiome, evolution, and medicine

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