Leeuwen, A.J. van
Darwinizing Disease. A philosophical analysis of the evolutionary etiology of disease research program; and the prospects of an evolutionary concept of disease
In 1991 George C. Williams (1926-2010), one of the twentieth century's leading evolutionary theorists, and Randolph Nesse, professor of psychiatry at the University of Michigan, published a paper entitled 'The Dawn of Darwinian medicine' in The Quarterly Review of Biology calling for the systematic study of the problems of medicine from an evolutionary perspective (under the banner of Darwinian or evolutionary medicine).
The rationale of evolutionary medicine is rooted in the distinction between two (complementary) kinds of biological explanations, known as proximate and evolutionary (or ultimate). The focus of the medical sciences is almost entirely on the proximate biology of health and disease, dealing with 'how?' questions. Evolutionary medicine, by contrast, is concerned with ‘why?’ questions, where 'why?' means “the historical ‘how come?’” (Mayr 1961: 1502); its explanations cite evolutionary-historical causes.
In this thesis I propose a distinction between a broad version of evolutionary medicine, which tries to cast an evolutionary light, wherever appropriate, on medically relevant biological phenomena, and a narrow version devoted to evolutionary explanations of vulnerability to disease. Here I concentrate on the latter, which I dub evolutionary etiology of disease (EED). EED asks why, from an evolutionary perspective, humans are vulnerable to specific diseases.
I critically discuss the standard view of disease vulnerability (implicit in modern medicine) to which EED provides an alternative. EED is then analysed as an explanatory research program within the framework of Lakatos' methodology of scientific research programs. Important explanatory models in EED are discussed. I proceed to evaluate EED along Lakatosian lines, which leads me to conclude that EED constitutes a progressive research program, exhibiting both theoretical and empirical progress.
Finally, I examine the prospects of an evolutionary concept of disease. Two naturalistic approaches to explicating the concept of disease are discussed: Boorse's (non-evolutionary) biostatistical theory and Wakefield's (evolutionary) harmful dysfunction approach. Evolution-based arguments for and against basing the concept of disease on the etiological concept of function are discussed.
|Laatst gewijzigd:||01 november 2013 14:11|