Abstract
Monographs commemorating the work of Charles Darwin (1809–1882) typically cover a wide range of topics on which the theory of evolution has thrown some light. The influence of evolutionary thought on medicine was, until recently, often left in the dark, however. Yet evolutionary biology has crossed path with medicine more than once during the last 150 years, and the changing nature of these interactions has only begun to be examined historically and philosophically. Since more than 20 years, researchers are increasingly addressing the nature and causes of health and disease from an evolutionary standpoint. In this chapter after surveying the reception of Darwin’s work by medical doctors and the relation between evolutionary thinking and eugenics, 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, 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 (i.e. the Pleistocene) in order to assess present states of health and disease. Both approaches, however, are ultimately 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’.
The second part of this article was originally published in Theoretical Medicine and Bioethics (2011), 32: 75–90. I thank Springer for permission to reprint it here in a revised form and augmented with a new historical section. Note that this essay in its revised form was mostly completed in the autumn 2011 and only minor changes were made prior to publication in order to take into consideration recent literature.
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Notes
- 1.
In her essay, Betty Smocovitis relates the organization of the 1959 centenary in the United States by the Darwin Centennial Committee. To the exception of Ilza Veith who was from the department of medicine and was interested in the history of medicine, the other committee members were from the departments of zoology, geography, and paleontology. Veith’s own contribution to the centenary, however, was not on medicine but on “Creation and Evolution in the Far East” (Smocovitis 1999, 318).
- 2.
See, for example, Buklijas and Gluckman (2013), Cournoyea (2013), Alcock (2012), Ruse (2012), Valles (2011), Antolin (2011), Zampieri (2009a), Bynum (1983, 2002). Needless to say, a complete survey of the complex and changing relations between medicine and evolutionary biology is far beyond the scope of this paper.
- 3.
See the contributions in the special issue in The Lancet, December 2008. See also the more recent special issue “In the Light of Evolution: Interdisciplinary Challenges in Food, Health, and the Environment” in Evolutionary Applications 2011 4(2) and the one on “Evolution and Medicine” in Evolution: Education and Outreach 2011 4(4).
- 4.
I follow Downes S (2008) “Evolutionary psychology”, in Stanford Encyclopedia of Philosophy. Recently, Nesse suggested that “in order to provide a designation as general and inclusive as possible” he prefers to call the field neither Darwinian medicine nor evolutionary medicine but “evolution and medicine” (2007, p. 419).
- 5.
In Zoonomia (1794), the elder Darwin argued that there is a need in the medical profession for “a theory founded upon nature, that should bind together the scattered facts of medical knowledge and converge into one point of view the laws of organic life” (cited in. Wilson P.K. (2007) “Erasmus Darwin and the ‘noble’ disease (gout): Conceptualizing heredity and disease in Enlightenment England”. In: Mueller-Wille and Rheinberger (eds.) Heredity Produced: At the Crossroads of Biology, Politics, and Culture, 1500–1870, MIT Press, pp. 133–153, p. 134.
- 6.
- 7.
The nature and cause(s) of Darwin’s illness have been the focus of much speculation and are still debated nowadays. It might have been lactose intolerance. For a recent view see Hayman (2009).
- 8.
- 9.
- 10.
See Richardson (1889).
- 11.
Until the end of the nineteenth century, the now common distinction between hereditary and infectious cause of disease was not obvious to most scientists. Even so, several forms of cancer have infectious origins.
- 12.
- 13.
In particular, here is Darwin’s response to Greg’s pamphlet: “Natural selection follows from the struggle for existence; and this from a rapid rate of increase. It is impossible not to regret bitterly, but whether wisely is another question, the rate at which man tends to increase; for this leads in barbarous tribes to infanticide and many other evils, and in civilised nations to abject poverty, celibacy, and to the late marriages of the prudent” (1871, p. 142).
- 14.
Pearson, however, was opposed to Mendelian genetics. On the debate between biometricians and Mendelians see Olby (1988).
- 15.
Williams and Nesse do not seem committed to a form of explanatory adaptationism, namely the idea that organismal design is the most important problem to solve in biology.
- 16.
Here is an example of trade-offs between different demands: “No trait is perfect. Every trait could be better, but making it better would make something else worse. Our vision could be as acute as that of an eagle, but the price would be a decreased capacity to detect color, depth, and movement in a wide field of vision. If the bones in our wrists were thicker they would not break so readily, but we would not be able to rotate our wrists in the wonderful motion that makes throwing efficient. It the stomach made less acid we would be less prone to ulcers, but more prone to GI infections. Every trait requires analysis of the trade-offs that limit its perfection” (Stearns, Nesse, and Haigs (2008), p. 11).
- 17.
For a discussion of how to test and apply evolutionary hypotheses in medicine and in biology see Nesse (2011).
- 18.
It should be noted that Gluckman et al. (2009) are using a different concept of ‘mismatch’ that brings in epigenetic and other developmental processes. In effect, the term ‘mismatch’ has changed its meaning in Gluckman et al’s work. In classic Darwinian medicine, there is a mismatch between the modern environment and the ancient ‘environment of evolutionary adaptedness’. While to some extent this sense persists in Gluckman’s explanation, the mismatch that figures in the actual mechanism is a mismatch produced in a single generation by a mechanism of phenotypic plasticity. 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.
- 19.
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 (2005).
- 20.
See for instance Martinez et al. (2007).
- 21.
Revisiting Dobzhansky’s quotation Nesse recently emphasized that it is inadequate in relation to biology itself, and is even less appropriate to medicine, precisely because “medicine is not a science, it is a profession” (2007, p. 417).
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Acknowledgments
This chapter 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, Julian Reiss, Michael Strevens, and Bernard Swynghedauw. Previous versions of the paper were presented at the Philosophy of Medicine Roundtable in Rotterdam and at the Progress in Medicine conference in Bristol. I would like to thank the organizers of both events. I would like to thank the editors for producing an English version of Les mondes darwiniens – a real ‘tour de force’. I am also thankful to Randolph Nesse for his comments on a previous version of the paper. On the occasion of this reprint I have tried to address most of the points he raised although I sense he may still disagree with some of the positions defended here. The final version of the manuscript was written as part of a research residency at the Brocher Foundation in Hermance (Switzerland) and at the Philosophy Department at Laval University (Québec, Canada).
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Méthot, PO. (2015). Darwin, Evolution, and Medicine: Historical and Contemporary Perspectives. In: Heams, T., Huneman, P., Lecointre, G., Silberstein, M. (eds) Handbook of Evolutionary Thinking in the Sciences. Springer, Dordrecht. https://doi.org/10.1007/978-94-017-9014-7_27
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