Reading Assignment and Guide for Phil & Animals (Future guides will be somewhat less detailed) WEDNESDAY, SEPTEMBER 8, 1999 Reading Assignment: Why We Get Sick: The New Science of Darwinian Medicine, pp. ix-12. Preface, pp. ix-xi. Who are the two authors? Why was Randolph Nesse frustrated in psychiatry? What significance did Nesse see in George Williams s evolutionary explanation of aging? In Paul Ewald s evolutionary treatment of infectious disease? How is the present book related to Nesse & Williams s 1991 joint article The Dawn of Darwinian Medicine ? Do Nesse & Williams think that Darwinian Medicine is a miscellany of unrelated ideas or a coherent new field? Does Darwinian Medicine promote health? Are their examples meant to be medical advice or authoritative analyses? Do Nesse & Williams reject conventional Western medicine? How are Darwinian and Western medicine related? Chapter 1: The Mystery of Disease, pp. 3-12. What is the baffling paradox with which the chapter opens? What diseases do we know a lot about why particular people get them, but fail altogether to understand why they occur at all? Give some examples. Formulate what Nesse & Williams call the great mystery of medicine. What bearing does it have on the theistic Argument from Design? Can an evolutionary approach help solve this mystery? Piecemeal or wholesale? Doesn t natural selection tend to produce organisms well adapted to their environments? Isn t it at least prima facie paradoxical, therefore, that natural selection hasn t eliminated the genes that make us susceptible to these diseases, especially when the diseases are very old? How well designed are our bones? Kidneys? Heart valves? Brains? Hormonal system? Sensorimotor system? How well designed is the crossover of the trachea and the esophagus? Our optical lenses? Our arteries? Our immune system? The course of pregnancy? The aging process? Our food cravings? Male & female sexuality? Our anxiety mechanism? Two Kinds of Causes (pp 6-7): How do evolutionary causes differ from proximate causes? How are they related? What do proximate explanations do? Evolutionary explanations? What kinds of questions does each type of explanation try to answer. Illustrate the difference between them by sketching explanations of the external ear and of taste buds. With which kind of explanation does Western medicine largely concern itself? Is physiology concerned with function and purpose? Biochemistry? Are these disciplines part of Darwinian medicine? Is Darwinian medicine mostly speculative? How does Margie Profet explain morning sickness? Is this a Darwinian account? Can evolutionary explanations make predictions about proximate mechanisms? Illustrate your answer by invoking the low iron levels found in patients with infections? Is this a case where Darwinian medicine makes a therapeutic recommendation? The Causes of Disease (pp. 8-11): Nesse & Williams propose the following six categories of evolutionary explanation as their formal framework for Darwinian medicine. Do they really constitute a formal framework for Darwinian medicine? 1. Defenses: Distinguish defects from defenses. Illustrate the distinction by invoking the signs of pneumonia. Is eliminating a defect usually a good idea? Ditto for defenses? 2. Infection: In what sense are bacteria and viruses sophisticated opponents? To what arms race are Nesse & Williams alluding? 3. Novel Environments: For what kind of environment(s) was our bodies shaped by natural selection? What bearing does environmental mismatch have on disease and epidemics? 4. Genes: Why are some genes perpetuated despite the fact that they cause disease? In your response, bring in genes with harmless quirks versus those with positive benefits. Are defective genes that result from mutation a serious health problem? What are outlaw genes? Do they pose a serious health problem? 5. Design Compromises: Are design flaws always mistakes or sometimes compromises? If the latter, do they have benefits, even if hidden? Give examples. 6. Evolutionary Legacies: Is evolution incremental or saltational? How does history constrain or encumber designers, natural selection included? What We Are Not Saying (pp. 11-12): Explain the connection between Darwinian medicine, eugenics, and Social Darwinism. How Darwinian is/was Social Darwinism? Does Darwinian medicine hold that disease, or at least some diseases, is good? What are the moral implications of Darwinian evolution?