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medpundit |
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Sunday, February 02, 2003The professor has a stringent set of criteria for letters of recommendation. That’s his perogative. But he puts a curiously high value on evolutionary theory, particulary macroevolution, and its importance to the practice of medicine: If you set up an appointment to discuss the writing of a letter of recommendation, I will ask you: "How do you think the human species originated?" If you cannot truthfully and forthrightly affirm a scientific answer to this question, then you should not seek my recommendation for admittance to further education in the biomedical sciences. Why do I ask this question? Let’s consider the situation of one wishing to enter medical school. Whereas medicine is historically rooted first in the practice of magic and later in religion, modern medicine is an endeavor that springs from the sciences, biology first among these. The central, unifying principle of biology is the theory of evolution, which includes both micro- and macro-evolution, and which extends to ALL species. How can someone who does not accept the most important theory in biology expect to properly practice in a field that is so heavily based on biology? It is hard to imagine how this can be so, but it is easy to imagine how physicians who ignore or neglect the Darwinian aspects of medicine or the evolutionary origin of humans can make bad clinical decisions. The current crisis in antibiotic resistance is the result of such decisions. For others, please read the citations below. Good medicine, like good biology, is based on the collection and evaluation of physical evidence. So much physical evidence supports the evolution of humans from non-human ancestors that one can validly refer to the "fact" of human evolution, even if all of the details are not yet known. One can deny this evidence only at the risk of calling into question one’s understanding of science and of the method of science. Such an individual has committed malpractice regarding the method of science, for good scientists would never throw out data that do not conform to their expectations or beliefs. This is the situation of those who deny the evolution of humans; such a one is throwing out information because it seems to contradict his/her cherished beliefs. Can a physician ignore data that s/he does not like and remain a physician for long? No. If modern medicine is based on the method of science, then how can someone who denies the theory of evolution -- the very pinnacle of modern biological science -- ask to be recommended into a scientific profession by a professional scientist? Dr. Dini states in his autobiographical sketch that evolutionary biology is one of his special interests, so it's understandable that it plays an important role in his life. But he vastly overestimates its importance to the daily practice of medicine. I can tell you exactly how many times I’ve thought about evolution, not counting exasperated forays into social Darwinism (of which I repent almost as soon as I think them) , while learning and practicing medicine - zilch. Clayton Cramer has a better understanding of the daily practice of medicine than the professor: Does Professor Dini think that this crisis in overprescription was because creationist doctors said to themselves, "I don't believe that we can evolve strains of antibiotic resistant bacteria, so I'm going to prescribe amoxicillin for anyone that comes into the office." This is absurd. Doctors overprescribe because they don't want to argue with a patient, because they are unsure whether a particular set of symptoms they are seeing are viral or bacterial, and because it's faster to write a prescription than to analyze the symptoms carefully. Perhaps I’m wrong, but I thought that the dispute between evolutionists and creationists lay in how we were created, not in how things work in the here and now. There’s no reason to think that creationists are incapable of accepting the concept of gene mutations, or of antibiotic resistance. And while it’s certainly his perogative to decide who he’ll honor with a letter of recommendation, it ‘s too bad that he’s decided to automatically exclude anyone who diagrees with his view of the world. Keep in mind, he doesn’t specifiy that it’s only creationists he disdains. He disdains anyone who might doubt the evolutionary theory of the origin of species. The ability to entertain possibilities that differ profoundly from the prevailing theories of the day is the hallmark of all the great scientific revolutionaries, including Darwin. One could easily imagine a long ago professor of science refusing to write a letter of recommendation to anyone who rejected the Ptolemaic model of the universe. It was proven, accepted fact. Indeed it was the cornerstone of all science. How could anyone call themselves a man of science and reject it? Just ask Copernicus. Just ask Galileo. We like to blame the Church entirely for their problems today, but in truth they were harassed just as much by their fellow scientists. Sorry to see a professor of Dr. Dini’s background continuing the tradition. He would do well to consider another quote, this time from Pope, “One science only will one genius fit; So vast is art, so narrow human wit.” And Besides: Dr. Dini makes a mistake when he assumes that the practicing physician is a scientist. We aren’t, really. Sure, our art is grounded in science. We have to understand fundamentals of biochemistry, physiology, molecular biology, and anatomy to practice it well. But, the actual practice of medicine is closer to what a police detective or a mechanic does everyday than to what a scientist does. If we were strictly scientists we would just be observing and recording things rather than intervening. But we aren’t scientists when we practice medicine. We’re humanists. If we acted as scientists, as biologists, and applied Darwinian principles to the practice of medicine, we would fail our patients miserably. In fact, some doctors have used the principles of evolution to create a theory of practice called Darwinian medicine: Defenses are often confused with diseases. Knowing the difference is crucial, because interfering with a defense is often unwise. Pain is a defense against tissue damage; people who lack this defense usually die by age thirty. Fever is a defense that protects against infection. The low iron levels associated with infection are the body's way of keeping iron away from invading bacteria. Nausea and vomiting and diarrhea are useful ways to rid the body of infection and toxins. The nausea that accompanies pregnancy discourages the mother from eating toxic substances that may harm her baby. Even anxiety and sadness can be useful. As for the runny nose that accompanies colds, we don't yet know if it benefits us or viruses, but we certainly need to know in order to decide if nose sprays will help or harm us. Much of clinical medicine relieves people's discomfort by blocking defenses like fever, pain, nausea and diarrhea. How can this be safe? Just as smoke detectors are designed to give many annoying but inexpensive false alarms so that they are sure to warn about any actual fire, the mechanisms that regulate the body's defenses have evolved to express defenses whenever they are possibly useful, thus causing much unnecessary suffering While it’s true that fever helps fight infection, it’s also true that high fevers make a person feel miserable, and sometimes make them delirious. While it’s true that diarrhea helps rid the body of the offending organism, it’s also true that severe diarrhea can kill you. While it’s true that runny noses may help shed the offending virus from the nose, it’s also true that the infected mucous helps to spread the virus to others. Our mission is to relieve the suffering, to save the life, and to prevent the spread of illness to others - so we intervene. We are, really, anti-evolutionary; for everything we do seeks to keep the status quo, and our greatest efforts are spent on insuring the survival of the least fit. Thanks to modern medicine, we might be the end of the line for human evolution. posted by Sydney on 2/02/2003 08:04:00 AM 0 comments 0 Comments: |
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