Re: [asa] Medicine and Evolution

But again, Egnor's definition of "evolution" was specifically the entire
grand sweep of life from beginning to end. One can fully understand and
appreciate bacterial and viral drug resistance without understanding or
accepting the whole story of evolution. One could even draw an incorrect
distinction between "micro" and "macro" evolution and practice the
appropriate management of antibiotic and antiviral medicines while failing
to acknowledge that "goo to you" is just "micro"evolution writ large.

This is just a rhetorical effort to demonize ID people -- "they want to let
your kids die of bacterial infections!!" Just like all Democrats are "baby
killers," all Christians are "fundamentalists," all atheists are "nihlists,"
all evolutionists are "Nazis," all Muslims are "violent jihadists" .... same
old song.

> 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
>
>
>

-- 
David W. Opderbeck
Associate Professor of Law
Seton Hall University Law School
Gibbons Institute of Law, Science & Technology
To unsubscribe, send a message to majordomo@calvin.edu with
"unsubscribe asa" (no quotes) as the body of the message.