In "Darwinian Medicine and Proximate and Evolutionary Explanations," at Evolution News & Views (June 25, 2011), neurosurgeon Mike Egnor makes a critical distinction between proximate explanations and evolutionary explanations, as they apply to medicine:
Proximate explanations are the description of the process itself. A proximate explanation of type 1 diabetes is that it is caused by lack of insulin. A proximate explanation of Duchenne muscular dystrophy is that it is a recessive X-linked genetic disease that causes muscle degeneration, weakness and death. Males are affected, though females can be carriers. It is caused by a mutation in the dystrophin gene on the X chromosome (Xp21).
As you can see, proximate explanations are what medical researchers would call the scientific explanation for a disease. Proximate explanations are medical science and provide the foundation for all medical treatments.
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The difficulty with evolutionary explanations in medicine is:
1) All of the relevant pathophysiology is provided by the proximate explanations, which are the only explanations useful for treatment.
There are other difficulties but that one is the swish of Occam's Razor, as far as medicine is concerned.
Takin' it to the street: You tripped and sprained your ankle. What you need is a speculative history of the sprained ankle in vertebrates … not!
The principle question is, what is evolutionary medicine meant to do, given that it is no use in the normal sense?
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Denyse O'Leary is co-author of The Spiritual Brain.