Biology & Philosophy

, Volume 27, Issue 2, pp 241–261 | Cite as

Evolutionary medicine at twenty: rethinking adaptationism and disease

  • Sean A. VallesEmail author


Two decades ago, the eminent evolutionary biologist George C. Williams and his physician coauthor, Randolph Nesse, formulated the evolutionary medicine research program. Williams and Nesse explicitly made adaptationism a core component of the new program, which has served to undermine the program ever since, distorting its practitioners’ perceptions of evidentiary burdens and in extreme cases has served to warp practitioner’s understandings of the relationship between evolutionary benefits/detriments and medical ones. I show that the Williams and Nesse program more particularly embraces the panselectionist variety of adaptationism (the empirical assumption that non-adaptive evolutionary processes are causally unimportant compared to natural selection), and argue that this has harmed the field. Panselectionism serves to conceal the enormous evidentiary hurdles that evolutionary medicine hypotheses face, making them appear stronger than they are. I use two examples of evolutionary medicine texts, on neonatal jaundice and on asthma, to show that some evolutionary medicine practitioners have allowed their fervent panselectionism to directly shape their recommendations for clinical practice. I argue that this escalation of panselectionism’s influence is inappropriate under Williams’ and Nesse original stated standards, despite being inspired by their program. I also show that the examples’ conflation of clinical and evolutionary considerations is inappropriate even under Christopher Boorse’s controversial evolution-rooted concepts of disease and health.


Adaptationism Biostatistical theory Darwinian medicine Evolutionary medicine Maladaptation Panselectionism 



I would like to thank Lisa Lloyd and Steve Lawrie for their patient and illuminating comments on the paper. I would also like to thank Marilyn Valles, R.N. for providing valuable background information on neonatal clinical care. Finally, I am indebted to the anonymous reviewer for his or her helpful comments and suggestions. All errors, of course, are mine alone.


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Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  1. 1.Lyman Briggs College and Department of PhilosophyMichigan State UniversityEast LansingUSA

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