Man Without Qualities

Sunday, February 09, 2003

Medical Science

The Man Without Qualities recalls when one of his brighter friends - at the time a biochemistry doctoral student at Rockefeller University in New York, from which he eventually obtained his degree and went on to great things and another story - expostulated in frustration: "Medical doctors just don't do science ... they don't do scientific research. They say they do it ... but they just don't." He had just returned from a joint project team meeting between his group and some University medical researchers. It took several margaritas and some excellent duck at Zarella's, then our favorite Mexican restaurant, to calm him down. In the process he emitted many unflattering words in the direction of what he termed "so-called medical research." "Cargo cult" and "Potemkin village" and the like were heard frequently that evening.

Since that dinner I have listened to more than a few biochemists, biologists and even physicists complain that medical doctors and medical researchers don't do or really understand science. This contempt is usually heaped up along with the counsel: "But don't ever say that to them - it just enrages them!" Yes, I am told, medical doctors and medical researchers use science, but so do municipal engineers - but engineers don't annoyingly claim to be scientists. And, yes, I am also told, medical doctors and medical researchers sometimes get repeatable results - but so do political consultants. And while they claim a lot of absurd things, Dick Morris (for example) does not claim that his craft is "science." So by this analysis, both engineers and political consultants are more bearable than medical doctors and medical researchers.

Having listened to so many such complaints over many years, it is really pretty funny to read the web site of the now notorious Professor Dini (who, by the way, is not a medical doctor but a biology Ph.D., according to his website), which includes the following passage:

The central, unifying principle of biology is the theory of evolution, which includes both micro- and macro-evolution, and which extends to ALL species. How can someone who does not accept the most important theory in biology expect to properly practice in a field that is so heavily based on biology? How can someone who does not accept the most important theory in biology expect to properly practice in a field that is so heavily based on biology? It is hard to imagine how this can be so, but it is easy to imagine how physicians who ignore or neglect the Darwinian aspects of medicine or the evolutionary origin of humans can make bad clinical decisions. The current crisis in antibiotic resistance is the result of such decisions.

It is certainly true that most modern evolution theories are "synthetic" - meaning that they attempt to integrate micro-evolution and macro-evolution.

But Professor Dini's comments are odd, because it doesn't seem to be necessary to appeal to evolutionary forces to explain the ongoing creation of antibiotic-resistant bacterial strains ("superbugs"). Whatever other necessary components there may or may not be to "evolution," both natural selection and mutation are clearly central today. But the "superbug" bacteria that medicine is dealing with (or, worse, not dealing with) today are the results of only natural selection. Pre-existing resistent minority strains and bacterial conjugation seem to be what most experts think is going on. Mutations (and "evolution") is not needed. That is not the same as saying that mutations cannot occur - or be induced by radiation or chemical mutagens - which cause bacteria to become resistant to antibiotics. But such mutations are not widely believed to be the source of the "superbugs."

Further, it's worth noting that many of the "superbugs" seem to be arising out of massive, deliberate, almost continuous, knowing overuse of antibiotics - most notoriously among the prostitutes in Bangkok, which has been the source of several of the recent "superbugs." That is, while it is true that "the current crisis in antibiotic resistance is the result of ... decisions" to disregard natural selection effects in administering antibiotics, it is also true that those decisions are largely made by people who fully believe in evolution and know perfectly well what they are doing is creating "superbugs" - and don't care.

The HIV virus and other viruses do mutate a great deal, creating major natural selection effects. Those facts are widely viewed as essential to understanding how viruses work. So by some definitions of "evolution" understanding some fairly basic concepts about viruses does require accepting "evolution" as some people define it.

But it does not seem to require accepting "evolution" as other people define it. For example, some people who are very serious skeptics about "evolution" think that "evolution" (as they define it as the object to their skepticism) is more than just mutation plus natural selection - they define it in terms of complexity and information content. Such people don't agree that the HIV virus or other viruses "evolve" when they just mutate because they don't think mutation (even mutation that brings propagation success to the organism) alone means that that the virus becomes more "complex" or contains more "information". Personally, I haven't found many biologists (although there certainly are some) or any medical doctors who have a clear understanding of information theory. [Steve Verdon points out to me by e-mail that some 'intelligent design" proponents have a nasty habit of moving the goal in this area, which seems almost inevitable given the informal defintions that seem to proliferate in this set of arguments.]

In the above discussion I have linked to two articles written by a fairly serious skeptic of evolution. I do not mean to suggest that I agree with those articles - certainly not that I agree with everything in those articles. My point here is to note what seems to be a recurring feature of the "evolution" debate: absence of rigorous, agreed upon definitions.

It constantly surprises me how intense this body of arguments routinely becomes without the principals seeing the need to rigorously define their terms.

MORE: It is worth noting that the wonderful "Pitfalls of Information Theory" web page maintained by Thomas D. Schneider, a research biologist (apparently not an MD) who runs a lab focusing on Molecular Information Theory within the National Cancer Institute Laboratory of Experimental and Computational Biology, points out (among an almost unbelievable selection of other fantastic things):

Information theory and molecular biology touch on a huge number of topics... As a result there are many ways that one can get into intellectual trouble and many of these are widely repeated in the literature. ... Not everything that is in the literature is correct!

The very first "pitfall" listed by Doctor Schneider - is using ambiguous or poor terminology - and one of his first examples of poor terminology is the term "complexity," a term used extensively in the "intelligent design" debates. Dr. Schneider also describes some fairly serious technical mistakes made by William Dembski - a chief proponent of "intelligent design" theory - in the book No Free Lunch.

Dr. Schneider also points out that his computer simulation does suggest that "information" as mathematically defined by Claude Shannon can be generated by Darwinian evolution (that is, replication plus mutation plus selection). Here's more.

Steve Verdon has a very interesting list of related materials.

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