Re: [asa] Medicine and Evolution

On Fri, May 30, 2008 at 10:30 AM, <drsyme@cablespeed.com> wrote:

> In my opinion, and it should probably count for something here, you are
> overreacting Rich, no question about it.
>
> First of all, your original post mentioned that Egnor said that darwinism
> was of no use in PRACTICING medicine. As a practicing physician I can
> attest to the truth of this. However, that is not the same thing as saying
> that there is no role of understanding Darwinism in the field of medicine.
>
> As Egnor alluded to, and which you seemed to have ignored, medicine is a
> very broad field, and involves physicians, microbiologists, etc. etc. What
> Egnor was referring to, I believe, when he was talking about the practice of
> medicine, is the direct interaction between a physician and a patient to
> diagnose and treat illness. This excludes research into mechanisms of
> disease, viral and antibiotic resistance, etc. etc.
>

Surgery is Egnor's speciality. Why does he *as a surgeon* need to understand
and study evolution? If he doesn't want his patients to die of an infection.

ScienceDaily (May 28, 2008) — The risk of contracting a Clostridium
> difficile infection following operations for which a "prophylactic"
> antibiotic is given to prevent infection is 21 times greater now than it was
> just a decade ago, according to researchers from the University of
> Sherbrooke in Canada.
>
> Surgical operations that have been associated with severe infections, such
> as open heart surgeries and prosthetic implants, are often accompanied by
> the simultaneous administration of antibiotics, a strategy which has
> successfully reduced the number of infections. A consequence of this
> antimicrobial therapy is a modification in normal flora of the human
> intestine. In this altered environment, a bacterium named Clostridium
> difficile can thrive. An infection with C. difficile can cause severe
> diarrhea, occasionally leading to death.
>
> Historically, the benefits of preventing surgical site infections have
> outweighed the relatively minor risk of C. difficile infections. However, in
> 2000 a hypervirulent strain of C. difficile emerged, leading to a dramatic
> increase in the number of infections and in the severity of those
> infections.
>
> Researchers from the University of Sherbrooke recently completed a study
> that calculated the risk of contracting a C. difficile infection when the
> sole antibiotic given was prophylaxis accompanying surgery and compared the
> current risk with the risk from a period before the emergence of the
> hypervirulent strain. They found a 21-fold increase in the risk, from 0.07
> percent of patients to 1.5 percent. Of the 40 patients who developed a C.
> difficile infection after peri-operative antibiotic prophylaxis, 5 either
> died or developed septic shock. Cefoxitin was most likely to be associated
> with the contraction of a C. difficile infection.
>
> Because the outcomes of C. difficile infections can be severe, the authors
> suggested that cases be individually evaluated and if the purpose of the
> antibiotic therapy is only to prevent infrequent or relatively benign
> infections, then the risks may outweigh benefits. This may be particularly
> important with elderly patients, who fare worse with C. difficile infections
> than do younger people.
>
> In addition, the study's lead author, Louis Valiquette, MD, MSc, suggested
> that surgical antibiotic prophylaxis should be used for the shortest
> duration possible to minimize the risk of C. difficile infection. This would
> also produce collateral benefits of decreasing cost, reducing
> microbial-related side effects, and slowing the development of bacterial
> resistance.

drsyme continues:

I think you are setting up a straw man, and attacking a point that is not
> what Egnor was getting at. What if he said, an engineer doesnt need to
> understand Einstein's theory of general relativity to design a bridge?
> Would that concern you as much? It shouldnt because the truth is that you
> dont need to understand relativity to design a bridge (unless it was a very
> very big one I suppose.) Similarly you dont need to understand evolution to
> practice medicine. *The theories and practice, and evidence for evolution
> are so far removed from the practice of medicine that it is essentially
> irrelevant.*
>

This is precisely why ID is called a science stopper. If there are problems
with evolutionary theory then you study it and fix them. I understand that
more moderate ID proponents don't like being associated with the deliberate
promotion of ignorance that Egnor is advancing. But, I don't see any of them
distancing themselves from him. All I hear is crickets.

The proper engineering analogy is that the engineer says he doesn't need the
engineering mechanics classes and that he can just eyeball it. The
historical novel "World Without End" shows how pre-scientific engineering
and medicine worked in the Middle Ages. The results were often terrifying
with churches collapsing and people dying from the plague. These attitudes
carry on to today. Like in the novel, some people oppose advances in
"dangerous" knowledge and people die because of it.

Now I am an engineer and even I need to be knowledgable about evolution.
While I am not a doctor I am a consumer of heath care. Evolutionary theory
tells me why it is important to finish my antibiotic course or why I need
another flu shot next year. So, I have educated myself from the primary
literature. Your last statement is so wrong I don't know where to begin. If
ID is strong enough to make it true then it is even a scarier statement.

Rich Blinne
Member ASA

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Received on Fri May 30 13:39:14 2008