Evolutionary Medicine: Help or Hindrance?

Does evolutionary theory promote
development of new therapies to treat
disease? Proponents make big claims
but there is little evidence that it helps.

by Jerry Bergman, PhD

A claim often repeated in the media is that evolution can inform the field of medicine.[1] This idea was inspired by the famous and widely quoted statement by evolutionary biologist Theodosius Dobzhansky that “Nothing in biology makes sense except in the light of evolution.”[2] Dobzhansky elaborated, claiming that “If the living world has not arisen from common ancestors by means of an evolutionary process, then the fundamental unity of living things is a hoax and their diversity is a joke.”[3]

For this reason, evolutionists would expect that, since medicine is a branch of the biological sciences, Dobzhansky’s maxim would also be true in medicine. In 2012, Professor A. Vark applied it thus: “Nothing in medicine makes sense, except in the light of evolution.”[4] Vark complained that

The near complete absence of evolution in medical school curricula is a historical anomaly that needs correction. Otherwise, we will continue to train generations of physicians who lack understanding of some fundamental principles [of evolution] that should guide both medical practice and research.[5]

In Science Magazine’s September 26 issue, Landim-Vieira and Pinto provide an example that they think illustrates how evolution can inform the field of medicine. Their research is focused on the cause of cardiomyopathies, or pathologies of the heart muscle that cause it to lose its ability to pump blood effectively. It can lead to more serious medical problems, including irregular heartbeat.

The authors focus on the structural components of heart muscle that are essential for heart contraction and relaxation called sarcomeric proteins. These proteins are targets for new drugs designed to treat cardiomyopathies, which have not yet reached the acceptance level required to approve their use in clinical applications. This new approach enhances cardiac muscle contraction required to move the blood out of the heart and then relaxes it to suck new blood into the heart in preparation for the next contraction.[6]

Focus of the research: the TNN13 gene

The research, touted as “Evolution based,” was actually, as the authors admit, nothing more than a “comparative genomic analyses.”[7] Any modern taxonomic analysis could have given the researchers similar information from the genetic comparisons made.

Actually, a good knowledge of biology was more helpful in their selection of an animal to compare with humans, specifically in this case a shrew, which has an inactivated exon 3 of the TNN13 gene that produces heart rates of up to 1500 beats per-minute. This genetic research has helped the researchers to better understand the function of the TNN13 gene which will help in developing functional drugs to treat cardiomyopathies.

In short, Landim-Vieira and Pinto found that comparative genomic analyses provide clues to cardiac muscle regulation. This conclusion is not only obvious, but unoriginal. Anatomical comparisons of animals and humans have been common in medicine for quite awhile now.

My Experience

I have three degrees from a medical school, The Medical University of Ohio. After graduation, I was hired to do research and teach classes at the medical school. Due to my strong interest in evolution, if evolution had ever been mentioned in my classes, or by my colleagues when I was teaching, I would have perked up, listened carefully, and remembered what was said. The fact is, evolution was never mentioned even once in any class that I completed! The reason was it was not relevant to my field of medicine and genetics. The word “design” was often used to describe certain biological systems, but the word or concept of “evolution” was never mentioned.

Why Darwinians Want to Include Evolution in Medicine

Despite my personal experience, some Darwinian physicians have persisted in advocating for the inclusion of Darwinian ideas in medicine. One example is Professor R.M. Nesse, who is attempting (without much success) to incorporate evolutionary ideas in the training of physicians, making evolutionary biology a basic medical science.[8] Nesse claims that

New applications of evolutionary biology in medicine are being discovered at an accelerating rate, but few physicians have sufficient educational background to use them fully…. Our general conclusion is that evolutionary biology is a crucial basic science for medicine.[9]

The examples Nesse gives do not require knowledge of evolutionary theory. They are already covered in medical training without reference to Darwinian evolution (defined here as from abiogenesis to human evolution). For support of his advocacy, Nesse includes the example of the development of bacterial resistance. This topic is currently and adequately covered in medical school, however, as well as in the microbiology course that I taught for over a decade, without reference to evolution. It is also adequately explained by creationists—not as evidence for evolution—but as a phenomenon arising by non-evolutionary mechanisms.

Nesse bemoans that it has been “one hundred and fifty years after publication of Darwin’s On The Origin of Species, one might expect that medicine would already have made full use of evolutionary biology. Far from it.” He correctly adds, as I learned in medical school, that

Mutations are inevitable; DNA is damaged by radiation and toxins, and replication is not perfect. Other random events are also important; genetic drift can push neutral or even deleterious alleles to high frequency, whereas a storm might eliminate all individuals with a useful mutation…. The strength of selection is weaker at older ages, so deleterious mutations can accumulate… Accurate measurements of mutation accumulation have also become a reality…  this might enable us to address long-standing questions about the consequences of mutation accumulation or the load of mutations….

Mutations are well known by observation. What is not observed is upward progression of specified complexity by natural selection of rare beneficial mutations. Nesse continues:

Some [persons] think  that mutations exist to speed evolution or that the evolutionary explanation for maintained genetic variation is well understood, when it is actually an issue of intensive  study in evolutionary biology.[10]

That part is wishful thinking. In the long run, mutations lead to extinction, not progressive evolution.[11] His words illustrate the point that what should be taught in medical school is not evolution, but rather anti-evolution.

Summary

Evolution is rarely covered in medical schools because it is irrelevant and a distraction from studying material that is relevant to the work of a physician and medical researcher. The examples noted in this review depend on a knowledge of comparative biology, not Darwinian evolution. Although some doctors endeavor to build a case for teaching evolution in medical school, most professors remain unconvinced. In contrast, anti-evolution should be taught because devolution is observable and thus is very relevant to understanding disease and treating patients.

References

[1] Landim-Vieira, M., and Renato Pinto, J.  “Can evolution-based studies inform modern medicine?,” Science 385(6716):1420-1421, 26 September 2024.

[2] Dobzhansky, T., “Nothing in Biology Makes Sense Except in the Light of Evolution,” American Biology Teacher 35(3):125–129, doi:10.2307/4444260, JSTOR 4444260, S2CID 207358177, March 1973.

[3] Dobzhansky, T., “Biology, Molecular and Organismic”  American Zoologist 4(4):443–452, doi:10.1093/icb/4.4.443, JSTOR 3881145, PMID 14223586, archived from the original, November 1964.

[4] Varki, A., “Nothing in medicine makes sense, except in the light of evolution,” Journal of Molecular Medicine 90(5):481-494, doi: 10.1007/s00109-012-0900-5, May 2012.

[5] Varki, A., 2012, p. 481.

[6] Landim-Vieira and Pinto, 2024, p. 1420.

[7] Landim-Vieira and Pinto, 2024, p.1420.

[8] Nesse, R.M., et al., “Making evolutionary biology a basic science for medicine,” Proceedings of the  National Academy of Science U.S.A. 107(Suppl_1):1800-1807, doi:10.1073/pnas.0906224106, 26 January 2009

[9] Nesse, R.M., et al., 2009.

[10] Nesse, R.M., et al., 2009. pp. 1800, 1801, 1803.

[11] Bergman, J., “Do bacteria grow old? Life cannot mutate for millions of years: A major challenge to old-age claims,” https://crev.info/2024/09/do-bacteria-grow-old/, 30 September 2024.

Recommended Resource: Your Designed Body by Laufman and Glicksman.

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Dr. Jerry Bergman has taught biology, genetics, chemistry, biochemistry, anthropology, geology, and microbiology for over 40 years at several colleges and universities including Bowling Green State University, Medical College of Ohio where he was a research associate in experimental pathology, and The University of Toledo. He is a graduate of the Medical College of Ohio, Wayne State University in Detroit, the University of Toledo, and Bowling Green State University. He has over 1,900 publications in 14 languages and 40 books and monographs. His books and textbooks that include chapters that he authored are in over 1,800 college libraries in 27 countries. So far over 80,000 copies of the 60 books and monographs that he has authored or co-authored are in print. For more articles by Dr Bergman, see his Author Profile.