Gammelgaard A
Department of Medical Philosophy and Clinical Theory, Faculty of Health Sciences, University of Copenhagen.
Med Health Care Philos. 2000;3(2):109-16. doi: 10.1023/a:1009999502884.
In recent years, an increasing number of medical books and papers attempting to analyse the concepts of health and disease from the perspective of evolutionary biology have been published (Eaton et al., 1993; Ewald, 1993; Harrison, 1993; Nesse and Williams, 1995; Profet, 1991; Rose, 1991; Temple and Burkitt, 1994). This paper introduces the evolutionary approach to health and disease in an attempt to illuminate the premisses and the framework of Darwinian medicine. My primary aim is to analyse to what extent evolutionary theory provides for a biological definition of the concept of disease. This analysis reveals some important differences between functional explanations in the field of evolutionary biology and functional explanations in the field of medicine. Moreover, I shall argue that the biological functions relevant to the health of an organism cannot be determined on the basis of evolutionary theory. Accordingly, it seems that Darwinian medicine does not provide for the definition of a biological concept of disease. Still, Darwinian medicine may suggest why we are susceptible to certain diseases; it might also prove a suggestive heuristic on the basis of which new hypotheses concerning relevant treatments of various diseases might be advanced.
近年来，越来越多试图从进化生物学角度分析健康与疾病概念的医学书籍和论文得以出版（伊顿等人，1993年；埃瓦尔德，1993年；哈里森，1993年；内斯和威廉姆斯，1995年；普罗费特，1991年；罗斯，1991年；坦普尔和伯基特，1994年）。本文介绍健康与疾病的进化方法，旨在阐明达尔文医学的前提和框架。我的主要目的是分析进化理论在多大程度上为疾病概念提供了生物学定义。这一分析揭示了进化生物学领域的功能解释与医学领域的功能解释之间的一些重要差异。此外，我将论证与生物体健康相关的生物学功能无法基于进化理论来确定。因此，达尔文医学似乎并未提供疾病生物学概念的定义。尽管如此，达尔文医学或许能说明我们为何易患某些疾病；它也可能成为一种具有启发性的方法，据此可提出有关各种疾病相关治疗方法 的新假设。
