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Evolution: medicine’s most basic science 

Evolution: medicine’s most basic science

Evolution: medicine’s most basic science

Randolph M. Nesse

and Richard Dawkins



June 2014—this chapter has been re-evaluated and remains up to date; new website links of relevance have been added.

Updated on 28 Aug 2014. The previous version of this content can be found here.
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date: 24 April 2017

The role of evolutionary biology as a basic science for medicine has been expanding rapidly. Some evolutionary methods are already widely applied in medicine, such as population genetics and methods for analysing phylogenetic trees. Newer applications come from seeking evolutionary as well as proximate explanations for disease. Traditional medical research has been restricted to proximate studies of the body’s mechanism. However, separate evolutionary explanations are also needed for why natural selection has left many aspects of the body vulnerable to disease. There are six main possibilities: mismatch, infection, constraints, trade-offs, reproduction at the cost of health, and adaptive defences. Like other basic sciences, evolutionary biology has limited direct clinical implications, but it provides essential research methods, it encourages asking new questions that foster a deeper understanding of disease, and it provides a framework that organizes the facts of medicine. Physicians who understand evolution recognize that bodies are not designed machines, but jury-rigged products of millions of years of natural selection that work remarkably well, given that no trait can be perfect, and that selection maximizes reproduction, not health.

Acknowledgement. Thanks to the Berlin Institute for Advanced Study for providing a fellowship to RMN that made preparation of this chapter possible.

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