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Understanding Evolution and Being a Good Doctor

I need to dip into the topic suggestions more often. Here is a good recent question:

Hi Dr. Novella,

Over at Why Evolution is True Jerry Coyne wrote about Ben Carson, the creationists doctor at Johns Hopkins, saying some bizarre stuff about evolution. In the comments a couple people have made the point that they don’t think understanding evolution is directly relevant to being a doctor (especially a surgeon, ENT, or oncologists). One commenter even said he thought oncologists “have precisely and exactly zero need to understand evolutionary theory.”

I tried to argue that understanding the foundational principle of biology was directly relevant to physicians, in a variety of areas. I am very interesting in your views on the subject. Does understanding evolution help a doctor be better as her/his job? Is understanding evolution going above and beyond as a doctor, or something that should be expected of physicians?

Here’s the link to the main comment I had in mind (#30) and a couple responses, including mine:


In my opinion there are two basic questions here: how relevant is evolution to the science of medicine, and how does understanding the science of medicine impact the practice of medicine?

Evolution in Medicine

The topic of evolution in medicine has been discussed many times before, mainly the context of a creationist challenge to the relevance of evolutionary principles in medicine. Their argument is that evolution is of no practical use, because it’s wrong. Legitimate science, they argue, always has a practical use. While I think there is a kernel of legitimacy to this premise – that valid science has utility – it is not always true and it is not a litmus test for legitimate science. There does not need to be an immediate practical application of dark matter, for example, in order to consider the evidence for dark matter compelling. A claim, however, that has an obvious practical application, like ESP, does raise skepticism when it cannot be used for the purpose to which it is so obviously suited (if it existed). Creationists, therefore, are misapplying this notion, or perhaps overapplying it. Evolution can be completely true without having direct application to the science of medicine.

Their other premise, however – that evolution is of no practical use to medicine, is also false. (Here is a website dedicated to the issue.) Evolutionary principles are important in understanding antibiotic resistance, genetic illness, and the natural history and response of cancers to treatment, to name the most obvious examples. It is also critical to understanding any animal model of biology or human disease. A great deal of the basic science on which science-based-medicine depends requires an evolutionary perspective in order to interpret it properly.

The creationist claim, therefore, is based upon two false premises.

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