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Evolutionary medicine at twenty: rethinking adaptationism and disease

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Abstract

Two decades ago, the eminent evolutionary biologist George C. Williams and his physician coauthor, Randolph Nesse, formulated the evolutionary medicine research program. Williams and Nesse explicitly made adaptationism a core component of the new program, which has served to undermine the program ever since, distorting its practitioners’ perceptions of evidentiary burdens and in extreme cases has served to warp practitioner’s understandings of the relationship between evolutionary benefits/detriments and medical ones. I show that the Williams and Nesse program more particularly embraces the panselectionist variety of adaptationism (the empirical assumption that non-adaptive evolutionary processes are causally unimportant compared to natural selection), and argue that this has harmed the field. Panselectionism serves to conceal the enormous evidentiary hurdles that evolutionary medicine hypotheses face, making them appear stronger than they are. I use two examples of evolutionary medicine texts, on neonatal jaundice and on asthma, to show that some evolutionary medicine practitioners have allowed their fervent panselectionism to directly shape their recommendations for clinical practice. I argue that this escalation of panselectionism’s influence is inappropriate under Williams’ and Nesse original stated standards, despite being inspired by their program. I also show that the examples’ conflation of clinical and evolutionary considerations is inappropriate even under Christopher Boorse’s controversial evolution-rooted concepts of disease and health.

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Notes

  1. In this paper I discuss maladaptationism in the evolutionary medicine context, not as a general evolutionary subject. For an excellent discussion of broad maladaptationism, including an extensive bibliography on the subject, see (Hendry and Gonzalez 2008).

  2. Gould and Lewontin classify developmental constraints as a subset of phyletic constraints (Gould and Lewontin 1979, 594).

  3. See (Valles 2010) for a fuller discussion.

  4. Nesse says “five other reasons,” but actually goes on to list six other items (Nesse 2005, 66).

  5. There is, however, evidence that the blood brain barrier does not in fact block bilirubin from entering the brain in the first place (McDonagh 2010, 144).

  6. In the excised section portion of the text the authors also list other treatments, but space constraints prevent covering those here (Brett and Niermeyer 1999, 18).

  7. Nesse does not cite the Brett and Niermeyer chapter in this discussion (Brett and Niermeyer 1999; Nesse 2008).

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Acknowledgments

I would like to thank Lisa Lloyd and Steve Lawrie for their patient and illuminating comments on the paper. I would also like to thank Marilyn Valles, R.N. for providing valuable background information on neonatal clinical care. Finally, I am indebted to the anonymous reviewer for his or her helpful comments and suggestions. All errors, of course, are mine alone.

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  1. Lyman Briggs College and Department of Philosophy, Michigan State University, 25C West Holmes Hall, East Lansing, MI, 48825, USA

    Sean A. Valles

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  1. Sean A. Valles
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Correspondence to Sean A. Valles.

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Valles, S.A. Evolutionary medicine at twenty: rethinking adaptationism and disease. Biol Philos 27, 241–261 (2012). https://doi.org/10.1007/s10539-011-9305-z

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