Darwinian Medicine Dawning in a Feminist Light

Abstract

One of the most exciting recent developments in evolutionary biology is the application of evolutionary theory to medicine, in a synthesis sometimes called “Darwinian medicine” (Deutsch, 1993; Ewald, 1994; Nesse and Williams, 1995; Westoby, 1994; Williams and Nesse, 1991). This research examines disease processes and physiological functions in an adaptive context, focusing on human diseases in part, because of the parallel tradition in conventional medicine. According to the Darwinian medical viewpoint, human host-pathogen interactions may be seen in the same way as other ecological relationships between antagonistic partners; the pathogen benefits by any actions that increase its reproduction, and the host benefits by decreasing the pathogen’s effects. The emphasis is on disease as a coevolutionary relationship, with outcomes depending on the particular biology of the partners, just as might be the case in a predator-prey or plant-pollinator interaction. This framework often generates predictions that run counter to conventional medical wisdom about, for example, the eventual benign relationships previously always expected to develop between humans and their parasites (Ewald, 1983, 1988, 1994). Any evolutionary biologist knows that antagonistic coevolutionary relationships are not always expected to evolve toward mutualism, but physicians and epidemiologists persist in believing that all diseases will eventually become less virulent in time (Ewald, 1983, 1988, 1994).