Nothing in medicine makes sense except in the light of evolution. If one doesn’t know anything about evolution, it’s impossible to make sense of why organisms are vulnerable to disease, what it takes to build a robust, healthy human, why we age and die, how we are connected to the rest of the living world, why women and men differ with respects to their risk of developing certain diseases, and what types of conditions we’re adapted to live under, among other things.
Given that this is the case, it’s baffling that evolutionary science hasn’t been widely integrated into the field of medicine. At present, most students enrolled in study programs related to health and medicine learn little to nothing about natural selection, human evolution, hunter-gatherers, and other similar topics. Hence, it’s not surprising that most health professionals are largely in the dark with respects to these things.
I’m extremely concerned by this situation. There’s no doubt in my mind that countless people have failed to get the medical care they need and have suffered unnecessary as a result of mainstream medicine’s negligence of evolutionary science. Moreover, there’s no doubt in my mind that a lot of money and resources has been wasted as a result of this negligence.
Fortunately, there’s some indication that things are changing. More and more scientists are now recognizing that our health care system is in desperate need of an infusion of evolutionary wisdom…
Darwin to the rescue
In today’s article, I’m not going to get into a lengthy discussion of what evolutionary science can bring to medicine. That’s something I’ve done many times in the past. What I thought I’d do instead is to highlight a paragraph from a scientific paper that I came across a few days ago. The paper, which is entitled The Genome, Microbiome and Evolutionary Medicine, was published in the Canadian Medical Association Journal (CMAJ), a peer-reviewed general medical journal, at the beginning of last week.
The reason I’m drawing attention to the introductory paragraph to this paper is that I think it describes in a very concise and elegant manner what evolutionary science could do – and is doing – for medicine. It illuminates what Darwinian medicine is all about and highlights the fact that evolutionary science packs so much power that it is capable of reorganizing and restructuring pretty much our entire medical system. Here’s the paragraph…
The revolution in genomics is transforming medicine. Among its important contributions is a demonstration – through a greater understanding of the human genome and the microbiome – that evolutionary biology underpins the principles and practice of medicine. Evolutionary medicine provides the unifying framework by which clinical and public health physicians can incorporate genomics into medicine. It reconsiders the questions, “what is a patient?” and “what is a disease?”. Some areas of medicine have already incorporated genomics and evolutionary medicine into clinical practice (e.g., the disciplines of genetics, infectious diseases and cancer care). Other areas of medicine are likely to follow as new research emerges, and the practice of medicine will be increasingly based on an evolutionary understanding of the human genome and microbiome. (1)
Robert C. Brunham (MD), the author of the above paper, is not the only scientist who’s recognized that Darwinian/evolutionary medicine packs a lot of power. Many others have as well. That said, it’s undoubtedly going to take some time before this information trickles down into the clinical sections of medicine. Not just because clinical medicine is very dogmatic with respects to the way it operates and notoriously slow at picking up new scientific information, but also because the doors of our medical system are guarded by many different institutions and companies, some of which are more concerned about making money than curing illness.
Medicine in an ideal world: 10 core characteristics of a scientifically robust, evolution-based medical system
The knowledge and tools that Darwin and his followers possess can help bring order to medicine, which at the moment is in many respects a very chaotic and fractionated discipline.
As I see it, this is how things would be in an ideal world…
- Evolutionary science is so widely integrated into medical studies and health care practise that it is widely recognized as being the bedrock of medicine.
- The idea that all organisms are a product of evolution and have a set of evolved, genetically determined requirements that need to be fulfilled if they are to thrive forms the foundation of all health promotion and guides all preventative and curative medical care.
- Pharmaceutical drugs are only used in cases where they are absolutely needed.
- It’s widely recognized that the experiences of our hunter-gatherer forebears equipped the human body with a variety of features and that many of the health problems that plague the modern man arise as a result of a mismatch between these ancient features and modern environmental conditions.
- Microbiome restoration and nutritional counseling are an essential part of almost all clinical medical practice.
- It’s widely recognized that virtually all diseases are diet-related and that the gut is the ground zero for human health and disease.
- It’s widely recognized that natural selection has equipped organisms with a variety of defense systems and that blocking or suppressing the activity of these systems (e.g., via pharmaceutical interventions) often does more harm than good.
- It’s generally accepted that we humans are no different from other organisms with respects to the evolutionary reasons as to why we are vulnerable to disease and that the general principles of Darwinian medicine are universal with respects to their applicability in nature.
- Life history theory is routinely considered in the context of health and medicine.
- All health professionals are knowledgeable about evolutionary health principles and share this knowledge with their patients.
The bottom line: It’s time for a paradigm shift in medicine
Medicine is changing. It’s becoming increasingly recognized among accomplished scientists that medicine without evolution is like legs without feet. Some have gone as far as to say that Darwinian/evolutionary medicine should be allowed to largely take over and become the “new medicine”.
Obviously, not every part of contemporary mainstream medicine is so faulty that is has to be replaced or restructured; however, in some areas, in particular those related to the prevention and treatment of chronic illness, there’s no doubt that we could be doing a lot better than we currently are. By combining principles of Darwinian medicine with the best of what contemporary mainstream medicine has to offer, we can create a new and more scientifically robust medical paradigm.
Mainstream medicine is a big, slow-moving beast that’s controlled by many different parties, some of which are primarily concerned with making money; hence, we shouldn’t expect it to alter its course or behavior overnight. That said, ultimately, it will have to respond to all of the scientific research pertaining to Darwinian/evolutionary medicine that’s been coming – and continues to come – down the pipeline.