New paper:
Abstract
Background and objectives
Evolutionary medicine is a rapidly growing field that uses the principles of evolutionary biology to better understand, prevent and treat disease, and that uses studies of disease to advance basic knowledge in evolutionary biology. Over-arching principles of evolutionary medicine have been described in publications, but our study is the first to systematically elicit core principles from a diverse panel of experts in evolutionary medicine. These principles should be useful to advance recent recommendations made by The Association of American Medical Colleges and the Howard Hughes Medical Institute to make evolutionary thinking a core competency for pre-medical education.
Methodology
The Delphi method was used to elicit and validate a list of core principles for evolutionary medicine. The study included four surveys administered in sequence to 56 expert panelists. The initial open-ended survey created a list of possible core principles; the three subsequent surveys winnowed the list and assessed the accuracy and importance of each principle.
Results
Fourteen core principles elicited at least 80% of the panelists to agree or strongly agree that they were important core principles for evolutionary medicine. These principles over-lapped with concepts discussed in other articles discussing key concepts in evolutionary medicine.
Daniel Z Grunspan Randolph M Nesse M Elizabeth Barnes Sara E Brownell, Core principles of evolutionary medicine: A Delphi study, Evolution, Medicine, and Public Health, Volume 2018, Issue 1, 1 January 2018, Pages 13–23, https://doi.org/10.1093/emph/eox025 Published: 26 December 2017 pdf.
Neurosurgeon Michael Egnor noted some while back:
Defenders of Darwinian medicine assert that understanding the evolutionary cause of a disease process, beyond the understanding of the proximate cause (i.e. the scientific cause, traditionally understood) is of significant value in medicine.
I believe that the evolutionary cause is a matter of speculation, and of no real value to medicine. It may be of value to evolutionary biology, but that’s a different matter.
Here’s my challenge:
Please provide examples of evolutionary speculation offered for any disease that has provided medical scientists with information valuable for management of the disease that was not already available from the proximate evidence. More. (2011)
Translating from medspeak, Dr. Egnor means, how does this stuff help the patient sitting on the examining table who is seeking diagnosis and treatment?
Science historian Michael Flannery writes to say,
A few things about this piece are worth noting. First, the study asserts that evolutionary medicine will help “to better understand, prevent and treat disease,” but nowhere does it actually demonstrate HOW it will do this clinically. It merely restates evolutionary assumptions and sometimes not even that. For example, one of its so-called “core principles” states that fever is a “useful defense” mechanism reacting to a pathological condition. How is this noteworthy? Physicians have been writing about this very thing since Hippocrates. In another of its “core principles” it says disease risks differ for those in different environments from their ancestors. The notion of environment conditioning disease susceptibility and response is not new either. Third, the panel of “experts” who made these “core principle” determinations was generated by an original six “initial experts” who were presumably all convinced of the priority of evolutionary principles in the first place. Furthermore, the final panel of 56 was NOT primarily composed of physicians; 26 were described as “primarily biologists” with another 11 described as “anthropologists.” In fact, of the 56 panelists only 12 were physicians, so that whatever this panel determined it was hardly the voice of medical consensus. The panel merely affirmed a priori positions held by the vast majority of the panelists in the first place. Finally, its main conclusion is that these “core principles” will be helpful “for researchers and instructors in evolutionary medicine.” In other words, we’ve established 14 principles that will affirm and justify ourselves. Again, there is no indication of specific, practical clinical application.
Medicine historically has been dominated (plagued one might say) with theory-first doctrines. Humoral pathology was one, but there have been many others (e.g., Paracelsus’s “archeus and mysterious iatrochemistry, William Cullen’s “solidism,” Samuel Hahnemann’s homeopathy, etc.). The idea was come up with a theory of disease and then marshal all your therapeutics through that theoretical construct. I fail to see how the procedure and recommendations of this paper differs.
It’s worth asking, why would anyone invest in this stuff, given all the controversies around human evolution? It would be easy to come up with a list of more urgent but more costly medical priorities. Think about that, will you?
See also: Evolutionary medicine: Insomnia in the elderly is due to evolution?
and
What exactly does “evolutionary medicine” do that requires this expensive outlay?
a few notes
Of related note to developing an antibiotic that is beyond Dr. Behe’s ‘Edge of Evolution’, ‘drug cocktails’ seem to surpass the 1 in 10^40 double protein-protein binding site limit that Dr. Behe found for the ‘edge of evolution’, i.e. for the 1 in 10^40 limit of what Darwinian processes could be expected to accomplish over the entire history of the earth.
Using Behe’s ‘Edge of Evolution’ to Fight Disease
Moreover, the multiple drug cocktail that has been so effective in controlling HIV uses much the same strategy of being beyond the ‘edge of evolution’ that Dr. Behe has elucidated:
Thus it seems readily apparent that some of the most effective strategies and medicines for fighting some of the most horrific diseases are developed primariy by taking into account the strict limits for what Darwinian evolution can do, and then developing medicines that present barriers that evolutionary processes cannot overcome.
Moreover, in so far as Darwinian presuppositions have influenced medical opinions in the past they have been a disaster, besides the medical travesty of Eugenics in Nazi Germany (and even America), the Darwinian presupposition of so called vestigial organs has led to much medical malpractice in the present day:
Moreover, testing medicines on animals is largely a huge, and very expensive, failure in developing medicines precisely because of the false evolutionary assumption of common ancestry that underlies such animal testing:
In other words, the basic physiology of different species are not nearly as similar as people are falsely led to believe under Darwinian presuppositions. And this false Darwinian presupposition is costing billions of dollars in needless research.
As a recently retired pathologist after 38 years of practice. I would like to second BA77’s comment. Never found any use for Darwinian speculation. It was always just a superficial gloss on the findings.
Latemarch at 2: It’s a reasonable inference that the typical patient doesn’t care what happened to long-gone life forms. The future (typically, his own near future) is the focus.
What if the trilobites all died of cancer? What follows?
Latemarch:
“Never found any use for Darwinian speculation. It was always just a superficial gloss on the findings.”
I agree.
Moreover, some of the “core principles” listed in the paper are really funny:
Great news indeed! Whoever would have thought that? 🙂
Now that we know that immune responses are a form of defense, but that autoimmune diseases also exist, and that migrants can be specially exposed to infections that were not present in their homeland, and that the use of antibiotics and birth practices can have some influence on public health, new avenues of thought certainly open to medical research.
We are lucky that evolutionary thinking provides us with such unexpected intuitions! 🙂
Some of Flannery’s criticisms are just silly. A group got a team together to work out some core principles for a subject. And Flannery criticises them for … getting some experts in that subject together.
Bob O’H:
I think that the point is: if you are trying to detect the “Core principles of evolutionary medicine”, one expects that you stick to specific principles, IOWs ideas that are provided by the evolutionary network, not only that are vaguely compatible with it.
And, above all, you expect ideas that are new and not trivial, not just that fever can be useful or deleterious, and so on.
Now, I am not saying that the problem is with the authors of the paper. The problem is more probably with the experts, or maybe with the discipline itself. 🙂
Of related note to the disastrous effect that Darwinian presuppositions have had on influencing medical opinions,,, a new video was just posted on ENV:
Also of related note to this “catastrophic failure to appreciate the value of human life”, that is inherent within the Darwinian worldview,,, mental health is itself severely negatively effected by the atheistic presuppositions inherent within Darwinism:
Indeed longevity itself is severely negatively effected by Atheistic Darwinian presuppositions:
Since mental, and physical, health is so detrimentally effected by the Atheistic/Darwinian worldview, might I suggest that the scientific evidence itself, contrary to what Darwinists may want to believe, clearly indicates that humanity is not nearly as inconsequential as Darwinian atheists have tried to portray us to be?
Bob O’H
Now that’s not what I criticized them for at all. What I basically said was a panel was put together to develop “core principles” on evolutionary medicine that had 1) ALREADY assumed the value of evolutionary medicine, and 2) was composed of “experts” largely outside medicine itself. In fact, the largest single group of “experts” were biologists. That is not “silly,” that is empaneling confirmation bias.
Flannery – I don’t think you’re helping yourself. Why wouldn’t you want a panel that are putting together some core principles to start from the assumption that this is an important problem? And why wouldn’t you want the group to consist of biologists, i.e. people who study organisms (including humans) and their evolution, to provide input?
If the panel was put together to assess whether evolutionary medicines was important, then you might have an argument. But that clearly wasn’t the intention.
Right. So what this empaneled group did was establish “core principles” based upon their assumption that evolutionary medicine was important. That actually compounds the problem. Not only did they engage in confirmation bias, but, not surprisingly, a fair amount of question begging.
We cannot predict the impact of genuinely new knowledge. So, it’s unclear how you can expect it to predict any “new” in the sense you’re implying.
For example, Evolution doesn’t predict that goats will eventually appear based on the initial conditions of the universe. That’s untraceable. But it does have a few principles by which evolution is the best explanation.
And, as I’ve pointed out, ID’s designer is abstract and has no defined limitations. As such, virtually all of the “predictions” ID proponents here make do not follow from it. For that to be the case, assumptions would need to be made about the designer that we supposedly cannot know. IOW, ID proponents seem to simultaneously hold two conflicting positions.
For example, ID is not about the designer, but is supposedly a clear, distinct and superior response to eugenics. However, not being about the designer, it cannot exclude one that intervened via eugenic techniques to improve the design of organisms or even entire species, including human beings.
CR@11
Precisely the problem with Evolution. It fails to predict anything. Rapid extinction = Evolution. Stasis for millions of years = Evolution. Feature unique = Evolution. Feature in multiple lines = Convergent Evolution. The fit survive – those that survive are fit – the fit survive…..tautology much?
Apparently, the main principal of evolution is stuff happens.
Perhaps you’d like to lay out some of those weighty principals I’ve overlooked. The authors of the paper, as gpuccio@4 pointed out, only gave us trivialities.
I think it would be easy to come up with a list of more urgent but less costly medical priorities.
@laremsrch
ID’s designer could have decided to design organisms as if evolution was true for some reason we cannot understand. “That’s just how the abstract designer with no defined limitations wanted it to turn out” is compatible with anything.
On the other hand, Neo-Darwinism has limitations. Knowledge grows from variation and criticism of some form. That’s the simple principle. So, there are necessary consequences, where there are none for ID.
CR@14
How convenient. Another evolution just so story.
Yes it does. Well defined limitations which were written about in Behe’s The Edge of Evolution.
Good to see that you have finally gotten around to admitting that “;^)