In basic terms, practicing medicine is the science of preserving health and life. Darwinism, on the other hand, is a death-driven worldview holding that life advances through survival of the fittest. When the two are joined, you have one of the biggest combinations of self-contradictory thought perpetrated in the last 50 years. But though “Darwinian medicine” is an oxymoron, it’s a very real approach advocated by people intent on having their worldview permeate every facet of life.
The faith-based foundation of Darwinian medicine was summed up in a book review for The Journal of the American Medical Association:
George Gaylord Simpson made the observation, nearly half a century ago, that “Man is the result of a purposeless and natural process that did not have him in mind. He was not planned.” The proponents of Darwinian medicine have taken this dictum to heart. They argue that by viewing the human form as a result of past episodes of natural selection, rather than purposeful design, one can develop new insights into the causes of illness and more effective preventions and treatments.1
Thus, the core belief of Darwinian medicine is that a mystical agent called natural selection molds living creatures in a way that looks designed—in lieu of God’s agency in actually designing them. This selectionism mentally projects selective capability onto environments and believes that nature can exercise agency to produce diverse creatures. Selectionism is a path that enables many scientists to essentially become worshippers of nature.2 Advocates of Darwinian medicine seek to guide their practice of medicine by following the routes they imagine nature took to produce life’s diversity.
However, the belief that human features were cobbled together through an imaginary history of evolution has, oddly enough, not improved medicine. Instead, much suffering happens when medical practitioners reject the purposeful design of anatomy and physiology.
Evolutionary Medicine: A Disaster for Patients
Darwinian medicine was pioneered by George Williams of State University of Stony Brook and Randolph Nesse of the University of Michigan Medical School. Early on, they complained:
Evolutionary biology, however, has not been emphasized in medical curricula. This is unfortunate, because new applications of evolutionary principles to medical problems show that advances would be even more rapid if medical professionals were as attuned to Darwin as they have been to Pasteur.3
Yet, medical history already shows the nonsense of Williams’ and Nesse’s claim that Darwin’s thinking would advance medicine to the same extent as Pasteur’s did. Importing the Darwinian worldview into medicine has proved extremely negative. A 2009 ICR article explained why Darwinian medicine is a prescription for failure.4 The track record showed thousands of needless surgical procedures to remove organs because Darwinists erroneously viewed them as useless “vestigial” evolutionary remnants. Medical research along multiple lines was hindered for years based on the prejudicial personification of natural selection as a klutzy “tinkerer.” A later ICR article documented the uselessness of evolution to medical education.5
Eugenics programs apply the concept of natural selection in government-run quests to improve a population’s genetic composition.6 Eugenicists hope to conserve the human gene pool by eliminating defects. They view the selective sterilization, abortion, or euthanization of “weaker” people as vital to humanity.
Historically, medical applications tried to mimic nature’s “selective” death or loss of reproduction. Yet, they constitute an abuse of medicine on par with the most abusive political regimes.7 The appalling legacy of eugenics-based thinking can be laid squarely on the concept of selectionism,6 as Randolph Nesse candidly admitted:
In the late nineteenth and early twentieth centuries, most applications were “medical Darwinism” that focused on the welfare of the species. In connection with eugenics, this led to moral and social disaster.8
When you analyze evolutionary literature, see if the words “Mother Nature” can be substituted for “natural selection.” If you can do it without making the explanation any more magical, then this reveals that an evolutionary “narrative gloss” has been applied to basic research.9
Likewise, Darwinian medicine is a narrative gloss that covers genuine medical research. Historically, we know that medically useful insights were derived apart from Darwinian thinking. Evolutionists claim credit by dragging the discoveries on a needless detour through selectionism.4 Over a decade ago, a proponent of evolutionary medicine conceded its lack of clinical value by saying, “Add to this [a tight curricular schedule] the fact that the field has failed so far to provide clinically useful findings and you see why medical schools lack interest” in providing evolutionary training.10
Darwinian Medicine Still Lacks Clinical Value
Are patients benefitting today from clinically useful findings through Darwinian medicine? In 2018, Oxford University Press began publishing the open-access journal Evolution, Medicine and Public Health. The journal’s “8 New Clinical Briefs” for 2019 should indicate if Darwin’s selectionism leads to unique and valuable medical contributions.11 For instance, physicians and patients know that gender differences need to be considered in treating illnesses. One EMPH clinical brief proposes an evolutionary scenario to better understand how these differences emerged:
Overall, stronger sexual selection in males in our early hominid ancestors together with constraints in the genetic architecture imposed by sexual conflict might explain the sex-bias and persistence of pathogenic phenotypes in contemporary human populations.12
Taking this insight from Darwinian medicine, the brief cautions doctors to recognize that “clinical approaches need to account for the ubiquitous sex differences in disease profiles and risk factors as well as in the effectiveness of therapies for both sexes.”12 But that elementary guideline is already taught in the early days of med school. Repeating what physicians already know in the context of an evolutionary narrative gloss does not make it a fresh insight.
Another brief addresses the observation that people in different cultures have different rates of obesity and, on average, different resting metabolic rates. This evolutionary account posits that:
Exposure to colder climates may have shaped human metabolism by positively selecting for a higher resting metabolic rate (RMR), at the expense of building lower adipose stores for times of food insecurity. This evolutionary trade-off has been supported by the fact that RMR varies between populations.13
Unfortunately, when researchers are content with an imaginary narrative gloss about “positive selection” producing “evolutionary trade-offs,” then inquiry into useful details about how RMR is internally regulated gets derailed. What clinical guidance was offered? Doctors should consider differences in RMR when treating for obesity—something that’s been happening already without Darwinian assistance.
The remaining briefs repeat the same ruse: take existing medical practices, freely coat them in imaginary evolutionary scenarios, and then portray them as profound new insights fresh from the practice of Darwinian medicine.
Darwinian Medicine Lacks Predictive Value
An online clearing house for issues related to Darwinian medicine recently posted this job availability: “The Laboratory for Evolutionary Medicine at Baylor University is searching for a postdoctoral fellow, with a generous contract renewable for multiple years, to work.”14 Interestingly, the posting said nothing about research conducted within the confines of evolutionary theory. Rather, areas for investigation were the same as normal medical research. This seems to indicate that, again, medical research won’t be guided by evolutionary theory but covered by a useless narrative gloss after the fact.
There is a scientific way to determine if Baylor’s Laboratory for Evolutionary Medicine can justify funding from donors. Given the long lead time to develop new drugs, a valuable contribution would be for these evolutionists to predict—based solely on their notions of human evolution—a new, presently unobserved disease for which pharmaceutical companies should start developing a treatment. So far, no such predictions have been forthcoming from any advocates of Darwinian medicine.
Where Eugenics and Medical Education May be Headed
A 1998 worldwide survey of over 2,900 genetics professionals found a strong association between eugenics-based thinking and current medical goals to detect and prevent genetic disease in society.15 Furthermore, this research revealed that “directiveness” in counseling, based on pessimistically biased information of persons with genetic disabilities, influences parental decisions after a prenatal diagnosis.
Yet, screening tests don’t prevent people with genetic diseases from entering society—abortion does. Today’s eugenics–abortion link is stronger than ever. One president of the American Board of Medical Genetics plainly affirmed:
I come now to the final question regarding prenatal diagnosis and eugenics—does prenatal diagnosis involve deprivation of life? The answer, in real terms, is certainly yes. Whatever the theory might be with regard to prenatal diagnosis as merely providing information, prenatal diagnosis and abortion are inextricably linked.16
Darwinian medicine isn’t the only medical education proposal with ethical implications. Another ominous change seeks to accommodate increasing demands for abnormal—indeed, perverse—medical interventions. Take, for example, a teenage girl who claims “Rapid-Onset Gender Dysphoria” after saturating her mind with online misinformation. Believing she is truly a male, she requests her physician prescribe testosterone to halt feminine sexual development and immediate referral to a surgeon to get “top surgery” (a double mastectomy). She informs her physician that the American Academy of Pediatrics endorses these actions as “equity in health care.”17 But, just like physicians who don’t categorize abortion as “health care,” he declines.
What is a government to do if the pool of physicians doesn’t include enough who are willing to perform abortions, or have surgeons who see this teenager’s request not as medicine but as mutilation? Should the government revoke medical licenses for a refusal to provide “standard health care” or allow freedom of conscience for doctors?
The government of Alberta, Canada, recently voted to reject a law protecting doctors. A related report noted that “a possible solution to prevent such debates from cropping up at all would be to screen out would-be doctors who say they would object to providing health care on conscience grounds before they even get to medical school.” A bioethicist with the Ontario Research Chair in Bioethics suggested, “Medical schools, pharmacy schools should go out of their way to basically eliminate applicants who they know already will not provide these services.”18
ICR’s Approach to Biology Fosters a Culture of Life
An adoption of Darwin’s survival-of-the-fittest selectionist worldview produced the eugenics disaster and millions of aborted children. ICR’s approach to biology disowns Darwin’s death-driven concept of natural selection in exchange for an undiluted culture of life. By rejecting notions that natural selection is God’s method to conserve the purity of a gene pool, the core tenet of Darwinian medicine would be excluded from any ICR approach to medical research or practice.
A sound way to do basic medical research is to methodically reverse-engineer living systems that can be framed in design-based models. ICR believes the astounding innate healing, repair, or regenerative capabilities of living creatures are not the “result of past episodes of natural selection” but were purposefully engineered by the Lord Jesus…for His glory.
- Rannala, B. 2003. Evolution, Illness. The Journal of the American Medical Association. 289 (11): 1442-1443.
- Guliuzza, R. J. 2020. Gaia and Selectionism’s Nature Worship. Acts & Facts. 49 (2): 17-19.
- Williams, G. C. and R. M. Nesse. 1991. The Dawn of Darwinian Medicine. The Quarterly Review of Biology. 66 (1): 2.
- Guliuzza, R. J. 2009. Darwinian Medicine: A Prescription for Failure. Acts & Facts. 38 (2): 32.
- Thomas, B. Does Medical School Need Courses in Evolution? Creation Science Update. Posted on icr.org December 8, 2010, accessed December 20, 2019.
- Guliuzza, R. J. 2020. Survival of the Fittest and Evolution’s Death Culture. Acts & Facts. 49 (1): 17-19.
- Weikart, R. 2004. From Darwin to Hitler: Evolutionary Ethics, Eugenics, and Racism in Germany. New York: Palgrave Macmillan.
- Nesse, R. M. 2012. Evolution: a basic science for medicine. In Pragmatic Evolution: Applications of Evolutionary Theory. Aldo Poiani, ed. New York: Cambridge University Press, 108.
- Coppedge, D. F. Darwinians Baffled that Students Refuse To Be Indoctrinated. Creation-Evolution Headlines. Posted on crev.info November 15, 2017, accessed December 24, 2019.
- Baker, M. Darwin in medical school. Stanford Medicine Magazine. Posted on stanford.edu summer 2006, accessed December 19, 2019.
- 8 New Clinical Briefs in EMPH 2019. Evolution & Medicine Review. Posted on evmedreview.com December 6, 2019.
- Janicke, T. and E. H. Morrow. 2019. Sexual selection. Evolution, Medicine, and Public Health. 2019 (1): 36.
- Salazar-Tortosa, D. and L. Fernandez-Rhodes. 2019. Obesity and climate adaptation. Evolution, Medicine, and Public Health. 2019 (1): 104-105.
- Postdoc position at Baylor. Evolution & Medicine Review. Posted on evmedreview.com September 18, 2019.
- Wertz, D. C. 1998. Eugenics Is Alive and Well: A Survey of Genetic Professionals around the World. Science in Context. 11 (3-4): 493-510.
- Epstein, C. J. 2003. Is modern genetics the new eugenics? Genetics in Medicine. 5 (6): 469-475.
- Rafferty, J. 2018. Ensuring Comprehensive Care and Support for Transgender and Gender Diverse Children and Adolescents. Pediatrics. 142 (4): e20182162.
- Browne, R. Medical schools should deny applicants who object to provide abortion, assisted death: bioethicist. Global News. Posted on globalnews.ca November 23, 2019, accessed December 18, 2019.
* Dr. Guliuzza is ICR’s National Representative. He earned his M.D. from the University of Minnesota, his Master of Public Health from Harvard University, and served in the U.S. Air Force as 28th Bomb Wing Flight Surgeon and Chief of Aerospace Medicine. Dr. Guliuzza is also a registered Professional Engineer.