• Approaching the problem of defining 'health' and 'disease' from the perspectives of evolutionary psychology and Darwinian medicine

      Lewis, Stephen J.; Chester College of Higher Education (2001-09)
      Concepts of 'health' and 'disease' are of fundamental importance to ethical considerations regarding medical provision. Yet the terms have no clearly agreed definitions. In fact, the difficulty of defining health has led to most attention being given to defining disease instead. Here, two schools of thought have arisen: the 'naturalist' which argues that disease is an objective entity in itself and the 'normativist' which gives emphasis to the subjective nature of disease experience differing between cultures and through history. Respectively, these two schools characterize quantitative (or functional) and qualitative (or evaluative) views of disease. Although both schools offer important insights, they are essentially at odds. This poster outlines an approach that seeks to find a basis for a meeting (if not a unification) of these schools by adopting ideas and approaches from evolutionary psychology and Darwinian medicine. From the perspective of reproductive fitness, the question of whether health and disease can be said to exist as biological entities is addressed and the idea that all that matters is reproductivity is considered. It is suggested that attitudes regarding certain biological entities, such as physical or physiological states, serve adaptive functions. The suggestion is then made that, although open to social and cultural influence, attitudes towards and qualitative definitions of health and disease also have biological bases. Thus, it may be argued that evaluative definitions of disease have functional (evolutionary) bases, thereby linking the naturalist and normativist schools of thought. Important in this linkage, however, is acceptance of ideas from evolutionary psychology. The only discipline that currently unites the study of health and disease with that of evolutionary biology (including evolutionary psychology) is Darwinian medicine. It is within this discipline that new theoretical and evidence-based understanding of 'health' and 'disease' is likely to prove fruitful – in particular, in giving 'health' appropriately weighted attention.
    • Even better by disease

      Lewis, Stephen J.; Chester College of Higher Education (1997-04-30)
    • On 'Kantian Experimentation' in the health sciences

      Lewis, Stephen J. (2002-05)
      This presentation dicusses various approaches to the definition of health and disease.
    • Questioning the role of Darwinian medicine

      Lewis, Stephen J.; Chester College of Higher Education (2001-09)
      Darwinian medicine as a distinct scientific discipline can be traced to George Williams' and Randolph Nesse's paper 'The Dawn of Darwinian Medicine' (Q Rev. Biol. 66: 1-22, 1991). Ten years on, at what is still the dawn of a new millennium, it is timely to review the current state of Darwinian medicine and to assess some of its still latent potentialities. Nesse remains the main protagonist of a Darwinian approach to medicine. Important work by others has appeared but his and Williams' 'Evolution and Healing' (Weidenfeld and Nicolson, 1995)†, although written for the popular press, remains the primary text of the whole discipline. Distinct lines of academic interest and inquiry are, however, emerging within Darwinian medicine and it has found inclusion in a number of undergraduate curricula. Sufficient interest exists to suggest that it will survive as a discipline. But as a discipline, Darwinian medicine needs more than a single protagonist – it needs serious critical attention. It is important, therefore, to ask in what form the discipline is to persist and into what new areas it might go. Fundamental to such questions is the relationship between Darwinian medicine (as a scientific discipline) and Western clinical medicine (as a profession). It is suggested that, rather than try to gain direct acceptance by the medical profession, Darwinian medicine might seek to establish itself more firmly within the academic disciplines of evolutionary and human biology. It is suggested that it give special attention to identifying and making its own distinctive voice heard as a biological science of health and disease distinct from medicine – a voice that clinical medicine, drawing as ever from allied sciences, cannot then afford to ignore. To this end, the question of what might be the “zeroth law” of Darwinian medicine is posited.
    • Solving the conundrum of health and disease

      Lewis, Stephen J.; Chester College of Higher Education (1997)