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Research traditions and evolutionary explanations in medicine

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Abstract

In this article, I argue that distinguishing ‘evolutionary’ from ‘Darwinian’ medicine will help us assess the variety of roles that evolutionary explanations can play in a number of medical contexts. Because the boundaries of evolutionary and Darwinian medicine overlap to some extent, however, they are best described as distinct ‘research traditions’ rather than as competing paradigms. But while evolutionary medicine does not stand out as a new scientific field of its own, Darwinian medicine is united by a number of distinctive theoretical and methodological claims. For example, evolutionary medicine and Darwinian medicine can be distinguished with respect to the styles of evolutionary explanations they employ. While the former primarily involves ‘forward looking’ explanations, the latter depends mostly on ‘backward looking’ explanations. A forward looking explanation tries to predict the effects of ongoing evolutionary processes on human health and disease in contemporary environments (e.g., hospitals). In contrast, a backward looking explanation typically applies evolutionary principles from the vantage point of humans’ distant biological past in order to assess present states of health and disease. Both approaches, however, are concerned with the prevention and control of human diseases. In conclusion, I raise some concerns about the claim that ‘nothing in medicine makes sense except in the light of evolution’.

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Notes

  1. It should be noted that Gluckman et al. [8] are using a different concept of ‘mismatch’ that brings in epigenetic and other developmental processes. Whereas Gluckman’s concept of mismatch concerns individuals who can be mismatched to their environment to various extents, Nesse’s concept bears on Homo sapiens. It is the latter concept that is being discussed in this section.

  2. There are a number of difficulties concerning how to measure the ways in which nosocomial diseases affect mortality, morbidity, and costs that I shall put to one side; see Marshall and Marshall [49].

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Acknowledgments

This article benefited from discussions with Samuel Alizon, Jean-Sebastien Bolduc, Raffaella Campaner, John Dupré, Jean Gayon, Paul Griffiths, Michel Morange, Staffan Müller-Wille, Maureen O’Malley, Michael Strevens, and Bernard Swynghedauw. Previous versions of the article were presented at the Philosophy of Medicine Roundtable in Rotterdam and at the Progress in Medicine conference in Bristol. I would also like to thank the organizers of both events. Special thanks go to Julian Reiss for his encouragements during the writing of this article and to Alex Powell for his linguistic help. This research was supported by a doctoral scholarship from the Social Sciences and Humanities Research Council of Canada (no. 752-2007-1257) and by the ESRC Centre for Genomics in Society at the University of Exeter.

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  1. Pierre-Olivier Méthot

    Present address: ESRC Centre for Genomics in Society, University of Exeter, Byrne House, St German’s road, EX4 4PJ, Exeter, UK

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  1. Institut d’Histoire et de Philosophie des Sciences et des Techniques, CNRS, Université Panthéon-Sorbonne (Paris1), 13 rue du Four, 75006, Paris, France

    Pierre-Olivier Méthot

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Méthot, PO. Research traditions and evolutionary explanations in medicine. Theor Med Bioeth 32, 75–90 (2011). https://doi.org/10.1007/s11017-010-9167-4

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