Rapid Responses to:

NEWS: Balaji Ravichandran Morals, memes, and gerin oil BMJ 2006; 332: 1294-e [Full text]

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Rapid Responses published:

Evolution and Medicine.

Andy Wood   (2 June 2006)

Evolution in Medicine

Madhusree Singh   (2 June 2006)

Richard Dawkins' faith

Jonathan P Richards   (3 June 2006)

Facts, faith and Darwinian dogma

Richard J Roberts   (3 June 2006)

Medicine, evolution and extinction

Woody Caan   (4 June 2006)

The same mistakes.........

Andy Wood   (4 June 2006)

"Blind faith?"

Diana C Fortune   (4 June 2006)

Facts, faith and Darwinian dogma (2)

Richard J Roberts   (5 June 2006)

Re: Medicine, evolution and extinction

Michael Martin-Smith   (5 June 2006)

The God Delusion?

Lorna C. Nunn   (6 June 2006)

Zen and the Brain

Hywel B Lewis   (6 June 2006)

Creams buns and Sausages.

Andy Wood   (7 June 2006)

Pinker next

Barry P O'Muirithe, PL21 2QT   (7 June 2006)

Science and ethics

Trevor LP Watts   (7 June 2006)

Class: a struggle?

Alex May   (8 June 2006)

A Case For God

Colin J Rees   (8 June 2006)

Morals, Memes and gerin oil

Paul St.JohnSmith   (8 June 2006)

"Evil" religion and evidence

stephen black   (8 June 2006)

Dawkins, Hume, Evidence and Howls of outrage.

Andy Wood   (10 June 2006)

What does Darwinism have to do with caring for the weak?

Farr A. Curlin   (12 June 2006)

Those who cannot remember the past are condemned to repeat it.

Stevie M Gamble   (12 June 2006)

Is believing in creation rational and evidence based?

Richard J Roberts   (13 June 2006)

Medicine and Evolution.

Andy Wood   (13 June 2006)

Why antibiotic resistance is not evidence of evolution in action

Richard J Roberts   (19 June 2006)

Rational evidence......

Andy Wood   (19 June 2006)

Re: Doctors and Intelligent thought

Stevie M Gamble   (20 June 2006)

Cross eyed evolution.

Andy Wood   (20 June 2006)

Re: Cross eyed evolution

Richard J Roberts   (21 June 2006)

Common sense and Intelligent thought?

Andy Wood   (21 June 2006)

Perfection?

Assad Chaudhry   (21 June 2006)

Still cross-eyed!

Andy Wood   (22 June 2006)

Re:Evolving Intelligence on emerging pathogens

Stevie M Gamble   (27 June 2006)

Still seeing double.

Andy Wood   (28 June 2006)

Evolution and Medicine. 2 June 2006
Andy Wood, SHO Ophthalmology Glasgow Send response to journal: Re: Evolution and Medicine.	I can hear the howls of outrage from some quarters as I read your interview with Richard Dawkins. The BMJ rapid responses have previously seen a number of discussions regarding evolution and its relevance to medicine. At last you have responded in a manner fitting a world class journal such as the BMJ. Medicine and Evolution share common ancestry, without a full understanding of evolutionary biology and all its varied biological consequences, a full understanding of medicine is impossible. Not only was Darwin almost a Doctor, distressed by an operation without anaesthesia on a child he gave it up. The benefit to humanity of this decision is incalculable, but Huxley initially worked as a ships Surgeon on the Voyage of HMS Rattlesnake, Owen although disagreeing with Darwinism was a Doctor as I think were Hooker and Grant. What our predecessors would have made of the “culture gap” growing between Science and Medicine, especially with regard to such falsehoods as “Creation Science” I simply do not know. It is satisfying to see the BMJ address these issues. Significantly other international medical and science Journals have also taken a stance regarding science, evolution and education (1, 2, and 3). If I may adapt a phrase as others have done before (4), “nothing in medicine makes sense accept in the light of evolution”. 1. http://content.nejm.org/cgi/content/full/354/21/2277 2. http://biology.plosjournals.org/perlserv/?request=get- document&doi=10.1371/journal.pbio.0040167 3. http://www.jci.org/cgi/content/full/116/5/1134 4. Why We Get Sick R Neese and G Williams Competing interests: None declared
Evolution in Medicine 2 June 2006
Madhusree Singh, Outcomes Research Fellow Department of Health Policy, Thomas Jefferson University, Philadelphia, PA 19107 Send response to journal: Re: Evolution in Medicine	I agree with Dawkins' point of view. In the United States, the concept of evolution is definitely under threat from many quarters. For some historical reason, conventional religion in the US seems threatened by the thought of evolution. This suspicion of evolution seems to extend to Medicine as well. Training in evolutionary biology for future clinicians is essential to improve understanding of evolution.I agree with people who say that evolution is a basic science for Medicine.(1) I enjoyed the piece and I hope you will do more like these in future so that people may stop and think about these crucial concepts in science. Reference: (1) Nesse RM, Stearns SC, Omenn GS Medicine Needs Evolution Science Vol 311 24 Feb 2006 Competing interests: None declared
Richard Dawkins' faith 3 June 2006
Jonathan P Richards, Professor of Primary Care, University of Glamorgan Morlais Medical Practice, Berry Square, Merthyr Tydfil CF48 3AL Send response to journal: Re: Richard Dawkins' faith	I admire the writings of Richard Dawkins about evolution and he has deepened my understanding of science and the scientific foundation of my own work as a general practitioner. However I struggle with his attitudes to religion and his idea of memes. I was disappointed that the interviewer seemed to be in awe of him and did not challenge his ideas. His views on religion are entirely unscientific. He refuses to explore the evidence available about religion and spirituality using the scientific method and starts from his own conclusions and prejudices. (1,2) Please provide more information about the laboratories studying memes. Are they linked the the scientific departments investigating creation science? I have tried to learn more about them and have discovered that there is no evidence for them (2) and that, philosophically, the notion of memes is 'incoherent'.(3) Ravichandran concluded his piece with the comment: "Science is belief too, but it is based on verifiable evidence and is subject to change." Why is Dawkins lionised when he has unchanging, unverifiable beliefs about religion and memes? 1. Midgley M Evolution as a religion. London Routledge 1985 2. McGrath A Dawkins' God. Genes, memes, and the meaning of life. Oxford Blackwell 2005 3. Bennett M, Hacker PMS Philosophical foundations of neuroscience. Osford Blackwell 2003 Competing interests: None declared
Facts, faith and Darwinian dogma 3 June 2006
Richard J Roberts, Head, Vaccine Preventable Disease Programme National Public Health Service, Abton House, Wedal Road, Cardiff, CF14 3QX, UK Send response to journal: Re: Facts, faith and Darwinian dogma	The full page article given over to Richard Dawkins’ views and the promotion of his new book is not nearly critical enough. An injection of evidence-based reality, as usual, is missing from the Dawkins’ dogma. For example, his theoretical “meme”, unlike the gene, is not grounded in evidence based science – there is no means by which the concept can be verified or falsified (1). The lack of evidence to support the Darwinian theory of gradual change which Dawkins’ doggedly defends was acknowledged by Harvard professor and leading evolutionary biologist Stephen Jay Gould decades ago when arguing for alternative theories: “The extreme rarity of transitional forms in the fossil record persists as the trade secret of paleontology. The evolutionary trees that adorn our textbooks have data only at the tips and nodes of their branches; the rest is inference, however reasonable, not the evidence of fossils.” (2). Could it be that Dawkins’ Darwinism is an example of the dangerous “blind faith” he claims to deplore? As for his attack on belief in God being “blind faith” “in spite of…the lack of evidence”, this is simply Dawkins’ home grown reality-free definition of faith in God. In contrast, an objective definition of the Christian faith, for example, would include these elements: a reasonable response to an objective body of well attested historical evidence confirmed by personal experience. So Gould’s jibe at Dawkins as a Darwinian “fundamentalist” (one who holds an “intolerant philosophy with pretense of being the sole source of objective truth” (3)), seems justified, as Dawkins himself wrote that “science has no way to disprove the existence of a supreme being” (4). And what is the basis for asserting the importance of an “evolutionary perspective” for understanding medicine? There are plenty of doctors and scientists in medicine and related fields who find belief in God and creation and rejection of Darwinism perfectly compatible with scientific endeavour and medical practice at the highest level. I rejected Darwinism during my undergraduate years but this did not prevent me obtaining a Biochemistry degree while arguing against evolution in my BSc dissertation on chemical palaeogenetics (which led to some refreshingly candid discussion), nor it has not hindered my understanding of medicine, my effectiveness as a physician, or the acceptability of my scientific publications in journals such as the BMJ, NEJM, and the Lancet. In fact challenging evolutionary dogma teaches you to return to and question the evidence, which is the basis for advancing medical practice isn’t it? I would be delighted to see teaching on origins in the medical curriculum, but only if it distinguished fact from theory, promoted discussion not dogma, and did not unquestioningly accept an evolutionary theory which, as Professor Sir Ernst Chain, who won a Nobel prize for research into the curative properties of Penicillin, said “seems to me a hypothesis based on no evidence and irreconcilable with the facts.” (5). pop0nline@gmail.com References 1. McGrath A. Dawkins’ God: Genes, memes and the meaning of life. Oxford: Blackwell; 2005. 2. Gould SJ. Evolution's erratic pace. Natural History 1977;86(5):12- 16. 3. Wikipedia contributors. Fundamentalism [page on the Internet]. Wikipedia, The Free Encyclopedia 2006 [updated 2 Jun 2006, cited 3 June 2006]. Available from: http://en.wikipedia.org/w/index.php?title=Fundamentalism&oldid=56574054 4. Dawkins R. A Devil’s Chaplain. London: Weidenfeld & Nicolson; 2003. p. 149. 5. Perloff J. The case against Darwin [page on the Internet]. Medford: WorldnetDaily.com 2001 [updated 20 Feb 2001, cited 3 June 2006]. Available from: http://www.wnd.com/news/article.asp?ARTICLE_ID=21776 Competing interests: None declared
Medicine, evolution and extinction 4 June 2006
Woody Caan, Professor of public health Anglia Ruskin Un iversity, Chelmsford CM1 1SQ, UK. Send response to journal: Re: Medicine, evolution and extinction	The stimulating dialogue of Dawkins and Ravichandran [1] brought back memories of my late father (A.J.Z. Caan FRGS) patiently explaining the science of geological strata, marked by the successive proliferation and extinction of species after species. The unbroken lines of rock along the Channel coast show that nearly all the zoological species that once flourished, are with us no longer. A very few still have descendents, that adapted to change after change. Dawkins wisely urges us to see medicine 'in an evolutionary perspective'. [1] I think his belief that our own species is 'unique' is shared by most clinicians, devoted to the health of individuals during one human lifespan. But how should BMJ readers respond to a local or global threat of extinction? Within about 2 human lifespans, local extinctions of homo sapiens are highly likely [2]. The current 'species' of BMJ has continued for just over 150 years... unless the current generation of readers averts hostile global change, there may not be any humans to read this journal in another 150 years. The speciality of Public Health is trained to take a population perspective and to assess trends over time. 'Health Protection' is one of our core duties to our species, including those yet to be born. How will doctors and scientists alike answer Tolstoy's persistent question, 'What is to be done?' [3] [1] Dawkins R, Ravichandran B. Morals, memes, and gerin oil. BMJ 2006; 332: 1294. [2] BBC. Climate change is the biggest challenge facing the world, naturalist Sir David Attenborough has said. 24 May 2006. http://news.bbc.co.uk/1/hi/sci/tech/5012266.stm [3] Tolstoy L. Tak chto zhe nam delat? 1887, first translated in 1906 as 'What to do?'. Competing interests: Praying frequently, in the hope of a merciful God.
The same mistakes......... 4 June 2006
Andy Wood, SHO Ophthalmology Glasgow Send response to journal: Re: The same mistakes.........	You can always tell the direction of an argument, by the words used. Creationist have a lexicon all of their own, “Darwinism”, “Materialism”, “Naturalism” and the worst insult available “Evolutionist” whatever that means. Quote mining is a common technique also used by Creationists, in this case the late great Stephen Jay Gould is quoted. Of course this is the Professor Gould who was an unrepentent admirer of Darwin and constant critic of creationists, indeed his renowned co-worker Niles Eldridge recently confirmed his Darwinian credentials in a marvellous essay (1). I suspect many people would gain immensely from reading the literature surrounding memes, rather than accepting rather grand pronouncements upon their validity. (2). It is also worth remembering that one Gregor Mendal could not prove the existence of the gene, but could see their effects. Professor Chain is then invoked, I may be incorrect but I cannot help by pointing out that Dawkins is keen on evidence not opinion. The evidence for evolution is overwhelming; as usual I would direct those interested towards the more scientifically literate side of the web (3). Evolution is the basis for all biology, which is clearly important to medical practice. I think it was T H Huxley who when commenting on the publication of the book “Vestiges of the Natural History of Creation” in the nineteenth century, compared these views to “the inconvenient pertinacity of Banquo had upon Macbeth “time was, that when the brains were out, the man would die”. I’m afraid there is little dogma in science. Indeed I cannot but point out in the recent Dover trial Intelligent Design was described specifically non-scientific, and that it was incapable of uncoupling itself from its creationist and religious antecedents (4). This is hardly a firm basis for scientifically advancing medical practice nor more fully understanding the wonder and beauty of the world we live in. References. 1. http://www.vqronline.org/articles/2006/spring/eldredge-confessions -darwinist/ 2. The meme Machine. Blakemore S. 3. http://www.talkorigins.org/ 4. http://www.aclu.org/religion/intelligentdesign/index.html Competing interests: None declared
"Blind faith?" 4 June 2006
Diana C Fortune, Medicolegal London/Medway towns Send response to journal: Re: "Blind faith?"	Dear Sir, I am surprised at how insistent Professor Dawkins and the evolutionary camp are that religious people have ' blind faith', are ' delusional ' etc. Having looked into both sides of the argument for over a decade ( including obtaining a recent A star for astronomy GCSE) I find the creationist arguments actually require none of the blind faith Professor Dawkins mentions. Far from it. A particular favourite site of mine is www.creation.science.com, where the author, Walt Brown, a PHD in mechanical engineering, ex evolutionist,and army lecturer has 1. Downloaded the textbook ( free) that the Creation Science College uses ( with very satisfactory answers ranging from physics,maths,geology, dinosaurs, astronomy, biology etc) 2. Downloaded an interesting and simple 5 minute animation of the hydroplate theory,which explains frozen mammoths, ocean treanches, coal deposits etc 3. Downloaded an interesting and quite longstanding offer for a public debate with any evolutionist to go into print....with any agreed publisher then presenting both viewpoints for the public to access and decide for themselves. Interestingly,the evolutionary camp seem increasingly reticent about meeting the creationist science movement in open debate about the scientific issues,seemingly to prefer comment on personal character. Thank you, D Fortune MBBS BSc Competing interests: None declared
Facts, faith and Darwinian dogma (2) 5 June 2006
Richard J Roberts, Head, Vaccine Preventable Disease Programme National Public Health Service, Abton House, Wedal Road, Cardiff, CF14 3QX, UK Send response to journal: Re: Facts, faith and Darwinian dogma (2)	Dr Wood suggest my use of the term “Darwinism” comes from a “creationist.. lexicon”.  I would like to point out that this has long been a respectable scientific term; in fact Dawkins himself uses it in Ravichandran’s article.      He also describes my reference to part of a 1977 article by Gould as “quote mining”, clearly implying this misrepresents Gould’s views.  The facts are that a considerable portion of the life work of both Gould and Eldredge from around 1972 onwards was arguing that gradualism (Darwinism) should be replaced by a theory of rapid change they termed “punctuated equilibria”.  It is also worth noting that Eldredge was apparently reluctantly converted to this view while studying fossil trilobites for his PhD, because the absence of gradual change in the fossil record of did not fit the predictions of Darwinism.  Darwin was a careful scientist and realised this was a problem, supposing in 1859 “that the geological record is far more imperfect than most geologists believe” (1).  Almost 150 years on the fossil record is more complete than ever, and even more of a problem for Darwin’s theory than it ever was.    As to the assertion that “the evidence for evolution is overwhelming”, many clearly don’t agree.  A 2006 MORI survey of 2,112 random British adults found just 48% chose evolution as best describing their view of how life originated and developed, meaning that “more than half the British population is unconvinced by a theory that Dawkins would consider uncontestable” (2).  And 44% thought that creationism should be taught either instead of evolution or in addition.  In a country where Darwinian evolution has been required dogma in scientific education for decades, I find that amazing.    And finally, efforts by the Dover School Board in the US to include Intelligent Design (ID) in school science classes was unsuccessful not because the evidence did not warrant it - the judgement actually stated “..we find that while ID arguments may be true … ID is not science." (3, p.64.) - but because Judge John Jones defined science as the search for explanations about origins without reference to any supernatural causes - “ID fails to meet the essential ground rules that limit science to testable, natural explanations” (3, p.70, emphasis added).  Therefore, any reference to evidence for deliberate design, regardless of whether such evidence exists or not, is by definition now excluded from science teaching in Dover.  So in Dover you can have God or science but not both where origins are concerned.  However, despite the views of Judge Jones and the “scientific establishment”, it is encouraging to read Dawkins admit in Ravichandran’s article that such teaching in US schools is “proving somewhat successful”.  And no wonder - discussion and debate on origins are so much more educational than “just so” Darwinian theories.  And if readers want healthy debate, they should not confine themselves to one side of the argument (talkorigins) but might find an intellectual challenge looking at the views of the other side too (www.trueorigins.org).    pop0nline@gmail.com   1.       Darwin C. The Origin of Species (1859).  London: Penguin, 1968. p.439   2.       http://www.timesonline.co.uk/article/0,,1069-2038605,00.html   3.       Judge John Jones.  Full Judgement on Dover.  Pennsylvania: US District Court; 2005.  [updated 20 Dec 2005, cited 4 June 2006]  Available at: http://www.pamd.uscourts.gov/kitzmiller/kitzmiller_342.pdf   Competing interests: None declared
Re: Medicine, evolution and extinction 5 June 2006
Michael Martin-Smith, GP Principal Sydenham House , Boulevard,Hull HU3 2TA Send response to journal: Re: Re: Medicine, evolution and extinction	It is beyond doubt that Humanity, as present constituted, faces extinction from drastic natural changes engendered by local( ie terrestrial) factors or otherwise, with or without human causation. We have however tremendous powers of ingenuity, adaptability, and the sheer ability to see an opportunity and make it work for us! At the end of the last Ice Age for example we were faced with the relatively rapid loss of our chief source of food - the larger mammals- and so went on to agriculture - leading on to cities, government, astronomy and civilisation. Faced with a new global crisis, we should encourage the spread of new sources of energy( of which there are plenty) and develop the ecological techniques to live in more dispersed environments. Diaspora is a proven survival strategy, both in History and Biology. The last 50 years have shown us several dozen moons, thousands of asteroids, and millions of comets; the last decade, over 180 new planets beyond our own solar system. Furthermore, the whole Earth intercepts less than one billionth of the prodigious solar output at our present orbit...surely we can do better than this? The trajectory of evolution is clear -we are to become to the wider Universe what our distant marine ancestors became to dry land some 370 million years ago. It is this vast evolutionary task which is laid upon our shoulders - fail it, and we shall not only not survive - but we would lose any reason to do so! In practical terms, biology, chemistry, nanotechnology, and medicine can contribute by addressing and solving the problems of living in microgravity, building closed loop life support systems, and using extraterrestrial resources in situ for construction and consumables alike. Meanwhile our engineers and economists need to reduce the costs of access to Space and generate new spaceborne industries, for instance clean solar power generating satellites, to name but one. Such an enormous switch of high tech endeavour would, alone, provide adequate conversion from the ever growing industries of armaments and warfare which now engulf us "Swords into Ploughshares" has a less modern ring than "Missiles into Spaceships"- but has the same meaning. Either,in coming generations, we are going to strangle ourselves in an ever tightening mess of unproductive and futile regulation and introspection or we are going to spread beyond the confines of our one small planetary basket. Both courses will be costly and even dangerous, but only one will enhance the Evolution of Life and Mind! In the words of Konstantin Tsiolkovski,"Earth is the Cradle of Mind, but one does not live in the Cradle forever!" Competing interests: None declared
The God Delusion? 6 June 2006
Lorna C. Nunn, GP Edinburgh Send response to journal: Re: The God Delusion?	I was saddened to read the article 'Morals, memes and gerin oil', where Richard Dawkins suggests that scientific truth and faith in a supernatural being are irreconcilable. There are many doctors around the world who see no such tension. As a Christian doctor, people may ask me 'Why do you believe in God?' There are several possible answers. To me, the idea that there is no intelligence involved in the natural world is odd; there is no possibility of my house having been built by a random, purposeless process, far less the natural world existing in the same fashion. Secondly, there are those, like myself, who have had experiences which one may call 'supernatural.' However, the main reason I believe in the existence of a supernatural being is as a result of examining the claims of Jesus Christ - the historical evidence of his life, works, death and resurrection. As barmy as the above may sound to many, we each need to consider the evidence and re-evaluate the confident assertion that 'there is no god.' Competing interests: None declared
Zen and the Brain 6 June 2006
Hywel B Lewis, Locum General Practitioner Swansea SA5 9DE Send response to journal: Re: Zen and the Brain	Following reading the article 'Morals, memes, and gerin oil in the B.M.J.dated 03/jUNE 2006 by Balaji Ravichandran about Richard Dawkins, for those looking for a means of increasing inner peace and outer compassion I would recommend as a path that is consistent with science and does not require any dogma a book called 'Zen and the Brain' by James H. Austin and its sequel 'Zen-Brain Reflectios'. Read and try the recommended Way Competing interests: None declared
Creams buns and Sausages. 7 June 2006
Andy Wood, SHO Ophthalmology Glasgow Send response to journal: Re: Creams buns and Sausages.	Darwinism and the other words I outlined are regularly used by creationists in a pejorative manner, that is simply the point I wished to make. As I stated with no hesitation previously the howls of outrage are easily heard. Gould and Eldridge did create the theory of punctuated equilibrium. Unfortunately both were/are unrepentant admirers of Darwin. How does one square that circle? Simply put the arguments are regarding the rate and tempo of evolution, not the purposeful and deliberate misrepresentation of creationists about whether evolution has taken place. When one zooms in on a punctuation event it becomes gradual. Indeed sadly for your correspondent Darwin himself noted that Evolution may occur in spurts. I cannot help but point out that Darwin, a genius if ever there was one, did not and would not have claimed to have the whole picture; rather his theory has been modified and will be in the future. Hardly dogma at all. Misrepresenting the picture of the modern fossil record by quoting Darwin from the nineteenth century would I suspect, confirm for anyone blatant “misrepresentation” of the facts, indeed the purpose of quote mining. I’m afraid the BMJ is a medical journal and I doubt a discussion of paleontology is appropriate; I only point the readers toward the talk origins archive for a fuller appreciation of the facts. Of course Dawkins does I suspect see evolution providing a frame work for his atheism, but I’m glad to see the Archbishop of Canterbury does not. I’m sure that provides comfort for many, who share a similar dichotomy of views. I doubt very much whether the general populous of GB spend much time fretting over the evidence for evolution, nor reading dusty scientific papers. I do doubt the relevance to the discussion of the poll so quoted. It and its results do not answer in any-way my point about the evidence for evolution being overwhelming, rather represent peoples views of the same. The two are clearly not congruent. Creationist misrepresentation perhaps? The last paragraph really takes the biscuit, when one defines science as science; well creationism which is not science is excluded. Err yes; when one wishes to define a cream bun, one excludes sausages, no matter how appetizing they look. Obviously unfair on the sausage I would have thought! Competing interests: None declared
Pinker next 7 June 2006
Barry P O'Muirithe, Locum Consultant Psychiatrist Bodmin Hospital, PL21 2QT Send response to journal: Re: Pinker next	Re- Morals, memes, and gerin oil’-BMJ 2006; 332: 1294-e Balaji Ravichandran. Stephen Pinker’s work on the sociological implications of our scientific knowledge of genetics might prove as relevant to medics as Professor Dawkins’ opinions. Pinker examines the need of certain type of feminism to hold the ‘unscientific’ belief in the Blank Slate. He calls this ‘gender feminism’. One claim of ‘gender feminism is that the differences between men and women have nothing to do with genetics and are completely the result of social constructs (1). He contrasts this from of feminism to ‘equity feminism’ which is a moral doctrine. The issues of sex and gender are unavoidable in medical policy and practice (2), (3) and I would value an introduction to Pinker’s work in the BMJ (followed by the lively feedback from the rapid responses). (1) Pinker, Steven (2002). Gender. In The Blank Slate: The Modern Denial of Human Nature (337-371). New York: Viking Penguin The future of men and their health (2) Siegfried Meryn and Alejandro R Jadad BMJ 2001 323: 1013-1014. (3) Sex, gender, and health: the need for a new approach Lesley Doyal BMJ 2001 323: 1061-1063. Barry O'Muirithe Competing interests: None declared
Science and ethics 7 June 2006
Trevor LP Watts, Senior Lecturer and Honorary Consultant in Periodontology King's College London Dental Institute at Guy's, King's and St Thomas' Hospitals, SE1 9RT, UK. Send response to journal: Re: Science and ethics	I have looked with interest at this article and the ensuing correspondence. As a Christian, I agree very much with a scientific approach to the universe we live in. After all, it was the Puritans (especially those in the Royal Society) who laid the foundations for modern experimental science in contrast to ancient Greek rationalism where manual work (experiments included) was considered fit only for slaves (1). Truth is one matter, but ethics is quite another. I tackled this question in my Presidential Address to the British Society of Periodontology (also at the Royal Society!) last September. You can read it on the BSP website (2) at the appropriate heading (3) on the left of the home page. It seems to me that the only ethic science has ever produced is “Survival of the Fittest”, and I consider Hitler and Mao to be exponents of this. Of course, acceptance of their ethic requires a faith in its truth. Any other ethic needs another faith. Going beyond my address, my faith is based on something for which I think there is good evidence. Its basis is that as God has created us and communicated with us to let us know his views, we owe him our obedience. (1) Hooykaas R (1972) Religion and the Rise of Modern Science. Edinburgh, Scottish Academic Press. (2) http://www.bsperio.org/ (3) Nov 2005 Newsletter Competing interests: I became a Christian at the age of 16, from a background of science and humanism.
Class: a struggle? 8 June 2006
Alex May, NIBHI Research Fellow University of Manchester, Manchester M13 9PT, UK Send response to journal: Re: Class: a struggle?	So, Richard Dawkins was born to “an upper middle class family” – whatever that is. It is ironic that in the same issue the letter from Agyemang highlights the need for use of accurate, well-defined definitions of race and ethnicity in medical research (1). If social class is a useful construct, its operational definition should be explicit, too – “upper middle” or not. (1) Agyemang C. Ethnic misclassifications hamper progress in research. BMJ 2006; 332: 1335. (3 June.) Competing interests: None declared
A Case For God 8 June 2006
Colin J Rees, Consultant Gastroenterologist South Tyneside NHS Foundation Trust, Harton Lane, South Tyneside, NE34 0PL Send response to journal: Re: A Case For God	The Editor BMJ Dear Editor I write in response to the ‘News’1 item in June 3rd BMJ featuring an interview with Professor Richard Dawkins. I begin by asking quite what this article has to do with medicine and why it featured in the BMJ ? It’s appearance did, however, manage to provoke a reaction in me. I shall endeavour to be clear and non politically correct in my response given Mr Dawkins’ aversion to ambiguity. I trust that in the interest of fairness the BMJ will print responses from what Mr Dawkins describes as ‘undereducated doctors’. Mr Dawkins opinions symbolise much of what is pernicious (to use his word) about the arrogance of some modern day scientific opinion. Atheism is a belief system just as reliant upon faith as religion. When Mr Dawkins can empirically disprove the existence of God perhaps his arrogance may have foundation. I am a firm believer in evidence-based practice and whilst my religious beliefs do require a degree of faith, that faith is based upon analysis of the available evidence. I am intellectually convinced regarding the birth, life, death and resurrection of a man called Jesus who lived 2000 years ago. I cannot categorically prove these events by scientific experiment but there is certainly far more historical evidence for these events than for many historical events that are universally accepted as proven. I certainly base my beliefs on more substance than attributing ailments of human pregnancy as ‘parent- offspring conflict in the womb’. Much of the most meaningful of human experience such as love, hope, joy, grief cannot be scientifically measured however I suspect that Mr Dawkins does not deny the existence of these emotions. I suggest that such an aggressive view about religion as his arises out of a realisation that human intellect cannot explain everything or perhaps a deep-seated fear that God may exist after all. Fortunately many of the last two millennia’s greatest minds had the intellect to accept the finite nature of human understanding and realise that the mind of the Creator is greater than that of the created. Yours faithfully Dr Colin Rees FRCP Consultant Gastroenterologist 1. B Ravichandran. Morals, memes, and gerinoil. BMJ 2006;332:1294. Competing interests: None declared
Morals, Memes and gerin oil 8 June 2006
Paul St.JohnSmith, Consultant Psychiatrist Cranborne CMHT Mutton Lane Potters Bar Herts EN6 3AA Send response to journal: Re: Morals, Memes and gerin oil	I was pleased to see the debate about Religion and science brought up in this article.I am secular and I hope a scientist. I agree with Dawkins on Evolution and science. However,as a psychiatrist I am dismayed that Dawkins persists with his false belief that Religious belief(s) is a delusion. This is terminologically inexact.If Dawkins wants to be clear and truthful he should call Religion something else. A false belief is not by itself proof that it is delusional otherwise he could be said to be delusional too. There are religious delusions but they are usually bizarre and held out of keeping with the cultural context and are part of mental illness. All Religious people are not mentally ill however at odds with science and evidence they may be. As an exampleof this fallacy is that chilren are taught that Columbus discovered America in 1492.Taking into account Native Americans, Vikings and J.S.Cabot, he apparently only found the Bahamas. Believing Columbus discovered America is not proof someone is deluded, just lacking in knowledge. My point is that I am concerned he will bring not only his own views into disrepute but also discredit biological sciences and scientists as being equally fundamentalist and closed. I have written to him at both the Royal Society and at Oxford and he has not replied to my concerns. I would like someone to clear up this important psychiatric point with him before he is shown to be deluded too using his idiosyncratic use of the word. Competing interests: None declared
"Evil" religion and evidence 8 June 2006
stephen black, management consultant london sw1w 9sr Send response to journal: Re: "Evil" religion and evidence	It is always great to see a new controversy kicked off by Richard Dawkins: he is a great writer and communicator. But his dedication to the belief that religion is a dangerous delusion (and "the root of all evil") is itself delusional on any superficial view of the evidence. He believes, if I understand him correctly, that the world would be a better place if we could abolish religious ideology and there would be less death and fewer conflicts. Statistically speaking, however, the three biggest killers of the last century--Stalin, Hitler and Mao--were secular ideologues not religious ones. It looks as though a propensity to kill others for ideological reasons is part of human nature. Religions have probably done as much to mitigate this as they have to exacerbate it. Doing away with religion does not seem like the way to improve things. Competing interests: None declared
Dawkins, Hume, Evidence and Howls of outrage. 10 June 2006
Andy Wood, SHO Ophthalmology Glasgow Send response to journal: Re: Dawkins, Hume, Evidence and Howls of outrage.	I see that the Howling continues. I wonder what Professor Dawkins makes of it all? I suspect he will recognise the standard arguments put forth by those who perceive a threat to their faith or simply disagree with rational thought. The arguments put forth regarding the actions of well known despots fail when one applies the rigorous rational approach which Dawkins advocates. Irrational thought is not restricted to religion, undoubtedly a major part of theism is the acceptance of fallacious arguments, but other fields of human endeavour are hardly immune. Indeed science is not immune although the questioning nature of science acts as a self correcting mechanism to limit any damage. Sadly such mechanisms are lacking in the more dogmatic beliefs of this world. Fallacious arguments are common, indeed so far we have had, Appeal to the people, Appeal to Unqualified Authority, Argument from popularity, Quoting out of context, Ad Hominem, scare tactics and scapegoating to name but a few. I doubt this is a secure evidence base. I cannot but point out that the beliefs of Mao and Stalin were irrational and not based on “evolutionism”. Indeed I cannot but point out that whatever Hitler was, he wasn’t an atheist. Of course he was born and baptised a Catholic, indeed confirming his adherence to the Catholic faith throughout his life. He persecuted Catholics, Jews, homosexuals and atheists whilst quoting extensively from the bible in his speeches and including Pagan imagery in his deranged politics. I doubt this is a direct result of sweet-pea genetics, rather the result of a warped and repugnant political ideology. The same type of irrationalism which Dawkins I think would disagree with. I have no doubt that an Ethics based on “Survival of the fittest” would be repugnant, but simply put anyone who follows such a notion has fallen into the Naturalistic Fallacy so outlined by Hume and Moore. Irrationality rears its ugly head again. Although I understand that peoples adherence to a religious faith provides a foundation for their lives, it is sadly not based on reliable evidence. A reading of Hume’s Dialogues reveals the historical record of miracles to be inadequate and always will be. As the great infidel himself said, “There is not to be found, in all history, any miracle attested by a sufficient number of men, of such unquestioned good sense, education and learning, as to secure us against all delusion in themselves” The belief in any supernatural entity always rests on as Kierkegaard put it, “a leap of faith”, sadly when one leaps without looking; one never knows where one will land. Commonly it appears the end result of such intellectual gymnastics is the "overheated minds" of those falsely perceived to be the result of exclusive theistic Creation. Competing interests: None declared
What does Darwinism have to do with caring for the weak? 12 June 2006
Farr A. Curlin, Assistant Professor of Medicine The University of Chicago, Chicago, IL Send response to journal: Re: What does Darwinism have to do with caring for the weak?	I always find it curious to read that medicine's future is imperiled to the extent that Darwin's theory is doubted. If Darwinism is questioned, the story goes, soon there will be no more science, no more intelligent thought, no more new drugs. Progress will come to an end. The commentator Andy Wood sums it up with, "Nothing in medicine makes sense except in the light of evolution." Perhaps he, or Mr. Dawkins, or someone else can present us with one example of a part of medicine that does not make sense in light of creation (antibiotic resistance as a consequence of natural selection will not suffice). Since nothing makes sense except in light of evolution, they shouldn't have far to look. After that, I would be pleased to hear someone explain how medicine, as a moral practice, makes any sense in light of the Darwinism of Mr. Dawkins. Why should we spend vast resources caring for the sick, the crippled, the maimed, the weak, the mentally retarded, the old, and the helpless. Those are resources that could be turned to helping the strongest and brightest to reproduce. If we look around at our fellow products of eons of evolution (the other animal species), do we see any of them going so far to sustain the members of their species that are weak and sick? In his other writings (1), Mr. Dawkins makes a strange turn here by describing himself as a strict Darwinist with respect to the facts of our ontology, but a committed non-Darwinist with regard to ethics (2). Mr. Wood wants to credit Mr. Dawkins for avoiding G.E. Moore's naturalist fallacy, but the naturalist fallacy has nothing to do with the question. The question is, why should the Dawkinses of the world be so exercised by the purported irrationality of those whose science and ethics both begin with God as a premise, while they themselves insist on living as if what they claim to be true were false? We can only hope that the deeper rationality that leads the Dawkinses among physicians to a non-Darwinian ethic will catch up to and convert their rationalizing commitment to atheism. Then, they will have sound reason for caring for those who are ill. 1. Dawkins R. A Devil’s Chaplain. London: Weidenfeld & Nicolson; 2003 2. Barr SM. The Devil’s Chaplain Confounded. First Things 2004; 145: 25-31. Competing interests: None declared
Those who cannot remember the past are condemned to repeat it. 12 June 2006
Stevie M Gamble, retired HMIT EC2Y 8BL Send response to journal: Re: Those who cannot remember the past are condemned to repeat it.	Andy Wood states that: "I have no doubt that an Ethics based on “Survival of the fittest” would be repugnant" as if this were a possibility which might come true at some point in future time. Had he followed Santayana rather than Hume and bothered to acquaint himself with the past, he would have realised that Spencer's catchy little summary of Darwin's work has already provided the raison d'etre of two world wars, several rather smaller ones, and widespread domestic programmes in numerous countries in a number of continents, all dedicated to eliminating the unfit from the face of the earth. The casualties run to well over a hundred million; a bloodbath which far outdoes the total killed in all of the wars of religion in recorded history put together. From the concentration camps of the Boer War, to the killing fields of the Somme, and the gas chambers of the Third Reich, the butchers justified their butchery by asserting that they were simply eliminating the unfit in accordance with Darwin's precepts. That and defending themselves. Darwin's belief that the flora and fauna of one period 'would certainly be beaten and exterminated' by the flora and fauna of a later period was central not only to the vision of evolution as progress, but also to the slaughter that followed; exterminate or be exterminated, there was no other possible choice. As Spencer, Darwin's most ardent advocate, put it: 'We have unmistakeable proof that throughout all past time, there has been a ceaseless devouring of the weak by the strong'. Who could possibly argue with unmistakeable proof? And who would choose to be devoured rather than devouring? And so for a century and a half we have butchered away secure in the scientific knowledge that we have no choice. Ethnic cleansing, that euphemism for murder, continues to plague the world; people are persecuted for the colour of their skin, their sex, their religion, and the principles of eugenics still underpin many of the arguments which turn up regularly in the BMJ's correspondence columns, and slightly less regularly in its articles. All in all, not the sort of scenario to justify asserting the superiority of the scientific world-view. I suspect Hume would have agreed. Stevie M Gamble Competing interests: None declared
Is believing in creation rational and evidence based? 13 June 2006
Richard J Roberts, Head, Vaccine Preventable Disease Programme National Public Health Service, Abton House, Wedal Road, Cardiff, CF14 3QX, UK Send response to journal: Re: Is believing in creation rational and evidence based?	Despite what Dawkins, Ravichandran, and others may say, it is perfectly rational to argue, from scientific data, for either creation or evolution as an explanation of the origin of life. Douglas Futuyma, a distinguished Professor of Ecology and Evolution, wrote: “Creation and evolution, between them, exhaust the possible explanations for the origin of living things. Organisms either appeared on the earth fully developed or they did not. If they did not, they must have developed from preexisting species by some process of modification. If they did appear in a fully developed state, they must indeed have been created by some omnipotent intelligence” (1).   The relevance of the fossil record to this discussion has been questioned. However, its importance is fundamental because a) it is the only observable evidence that life existed in the past, and b) biological and genetic mechanisms must fit the pattern observed. So what do the data from palaeontology show? Contrary to what most of us have been brought up to believe, the fossil record does not show animal life slowly appearing or species gradually changing as we ascend the geological column. The oldest rocks (Cambrian) in which multi-cellular organisms are found contain, fully formed, all but one of the more than 30 major animal types (phyla) which exist today (2). Their supposed evolutionary ancestors are not found. The significance of this “Cambrian Explosion” was described like this by Simon Conway Morris, Professor of Evolutionary Palaeobiology at Cambridge on BBC Radio 4 in 2005: “[the Cambrian explosion is] really talking about the origin of species which in the end is the origin of everything ...what we have here is a whole world which has been just radically transformed” (3). In the rocks laid down over these, most species enter the record fully formed and remain the same as you move from older to younger rocks i.e. they do not exhibit gradual change. Harvard professor and leading evolutionary biologist Stephen Jay Gould: “The history of most fossil species includes two features particularly inconsistent with gradualism: 1. Stasis. Most species exhibit no directional change during their tenure on earth. They appear in the fossil record looking much the same as when they disappear; morphological change is usually limited and directionless. 2. Sudden appearance. In any local area, a species does not arise gradually by the steady transformation of its ancestors; it appears all at once and `fully formed.'”(4). Therefore, following the logic of Futuyma’s argument, the data point towards creation.    When you turn to look for genetic evolutionary explanations for such data, no adequate explanations exist either for the original source of the genetic code or for a mechanism to generate the vast quantity and diversity of genetic information necessary to achieve such a “sudden explosion of complicated animals” (see 3) [the whole 45 minutes is worth a listen]. The organism with the smallest genome of any self-replicating prokaryote known to us, Mycoplasma genitalium, has a genome size of 580 kilobases, close to the theoretical minimum for a fully functional organism (5). The probability that this amount of genetic information (leaving aside necessary proteins and cellular structures) arose by chance is similar to the probability that a textbook of around 250 pages could be generated by random hits on a keyboard – it might happen, but I wouldn’t bet my life on it – and most people would call it a miracle. And the human genome, 5000 times larger at 3.1 billion base pairs, is awe inspiring. No wonder Dr Francis Collins, Head of the US Human Genome Project (6) is now “convinced miracles are real” (7) and says his research has deepened his belief in God.   Engagement with the hard data on the origin of life leads even hardened exponents of evolutionary theory to wonder at its order and complexity. Simon Conway Morris (who rejects creationist views) said on BBC Radio 4 in 2003: “[Science] allows us to see the world… as an extraordinarily well organised place in all sots of respects […] There’s no reason why you can’t take an entirely secular view of what’s going on there, but I think you have to still stand back, and when you look at the whole set up… it turns out in fact that... the ways you can do it are extraordinarily limited, and that could all be by accident, it could all be just the way the world is... or you might just have a sort of thing at the back of your mind and say ‘Hang on a moment, all this is just a little too odd, the whole thing is just..well..lets think about this a bit further’.” (6). He believes such thoughts take us away from science, but others would disagree.   Those who believe God exists are free to choose either creation or evolution.  More and more well qualified scientists are willing to challenge, on the basis of the evidence itself, the current scientific paradigm that the observable natural properties of inanimate matter alone can explain evolution of life from molecules to minds (7). When they do this, many find the observed scientific data fit comfortably with their belief that in the beginning God created.   References 1.      DJ Futuyma. Science on Trial: The case for evolution. New York: Pantheon Books, 1983. p. 197. 2.      Nash JM. When Life Exploded. Time Magazine, December 4, 1995, p74. Available at: http://www.time.com/time/archive/preview/0,10987,983789,00.html. 3.      Simon Conway Morris speaking on: In Our Time “The Cambrian Explosion” 17 Feb 2005 BBC Radio 4 (time 37:00). Available at: http://www.bbc.co.uk/radio4/history/inourtime/inourtime_20050217.shtml 4.      Gould SJ. Evolution's Erratic Pace. Natural History 1977;86(5):14 5.      Taylor-Robinson D, Tully JG. Mycoplasmas, Ureoplasmas, Spiroplasmas and Related Organisms. In: Balows A, Duerden BI editors. Topley and Wilson’s Microbiology and Microbial Infections (9th Ed). Vol 2. London: Arnold; 1998. p. 813-814 6.      http://www.genome.gov/10000779  7.      Swinford S. I’ve found God, says man who cracked the genome. London: Sunday Times, 11 June 2006. p12. Available at: http://www.timesonline.co.uk/newspaper/0,,176-2220484,00.html 8.      Simon Conway Morris speaking on: In Our Time. “Chance and Design” BBC Radio 4, 13 Feb 2003 (time 39:50). Available at: http://www.bbc.co.uk/radio4/history/inourtime/inourtime_20030213.shtml 9.      John Ashton. In Six Days: Why Fifty Scientists Choose to Believe in Creation. Green Forest: Monarch Books, 2001   Competing interests: None declared
Medicine and Evolution. 13 June 2006
Andy Wood, SHO Ophthalmology Glasgow Send response to journal: Re: Medicine and Evolution.	I don’t think that anyone has said “If Darwinism is questioned, the story goes, soon there will be no more science, no more intelligent thought, no more new drugs. Progress will come to an end” This is an irrational argument referred to as a “straw-man”. Simply put no one has said anything of the sort. I cannot understand why the observation of natural selection of bacteria under the action of antibiotics will not suffice as an example of evolutions relevance to medicine; I believe that is the fallacious argument of groundless assertion. I can only direct your correspondent towards the article concerning A Letter to God, for an answer to his query about the failure of creation to provide an adequate framework for medicine. Evolution amply explains these design faults. I can only reply to the next point with slight wry smile and suggest that anyone who has read and most importantly understood Dawkins work will know that he specifically points out that a society based on “Survival of the fittest” would be repugnant. And that we are unique in being able to “rebel against our genes”. The naturalistic fallacy has everything to do with that. Of course this is assuming there is no evolutionary benefit to caring for the sick and elderly when there probably is, humans evolved as other great apes have as group living primates. Traits which cause us to look after the sick and the elderly may have been beneficial and prospered. Science provides rational considered answers based on reproducible evidence to pertinent questions, regretfully other magisteria, overlapping or not, do not. Indeed one only has to read the above responses to see ample evidence of this. Your correspondents last point is simply not worthy of comment other than to note it is another fallacious argument namely Ad Hominem mixed with a False dilemma. I am quite well acquainted with the past; I cannot remember Hitler or Stalin justifying their actions, by quoting finch evolution. I doubt that the Somme will be remembered as a battle based on fossil Megatherium or indeed shall we remember Fugian involvement with the Boar war. I see all my history books attributing the World Wars to rampant expansionist nationalism need to be rewritten to include Captain Fitzroy and The Beagle. It would appear that Basil Fawlty was incorrect; it wasn’t started by the invasion of Poland! The problem here is that your correspondent is not distinguishing accurately between rational and irrational thought. Science is not immune to irrational thought, although as I have previously stated it does have a self correcting mechanism inherent in its methods. Spencerism is now seen to be a rather crude interpretation of evolutionary thought and has mostly been discarded. Indeed I suggest he becomes acquainted with the present and accepts that society’s views on eugenics have moved on considerably since the nineteenth century. He is also failing to appreciate those societies views of wars and races were quite different, independent of any supposed evolutionist reasoning. I suggest he joins Von Ranke and sees history "wie es eigentlich gewesen" not as he wishes it to be. He is also unfortunately attributing causation to events on little evidence. Indeed if I may borrow from Dawkins again, I note that both Hitler and Stalin had moustaches, which is obviously a direct cause of the Second World War (1). I doubt that the Church in Rome or the Archbishop of Canterbury would accept that evolution is the reason for these conflicts. Indeed both have accepted to different degrees evolution as “more than a theory”. For some the acceptance of evolution provides a basis for their atheism, evidently that is not the case for others. I did go to some lengths to make in my last contribution to outline the fallacious arguments sadly utilised by those who simply should have a better knowledge of the term “Evidence”. Indeed I think we have added Appeal to emotion/Argument from outrage mixed in with a potent slippery slope, topped off with the usual loaded language. I doubt very much whether Hume would have given such a diatribe more than a moment’s consideration. 1. God’s just too small. THES 2004. Competing interests: None declared
Why antibiotic resistance is not evidence of evolution in action 19 June 2006
Richard J Roberts, Head, Vaccine Preventable Disease Programme National Public Health Service, Abton House, Wedal Road, Cardiff, CF14 3QX, UK Send response to journal: Re: Why antibiotic resistance is not evidence of evolution in action	Dr Wood states he “cannot understand why the observation of natural selection of bacteria under the action of antibiotics will not suffice as an example of evolutions relevance to medicine”.  The confusion is unsurprising as this is often offered and interpreted uncritically as a textbook example of evolution in action.  However, natural selection and evolution are fundamentally different:    natural selection — an observed phenomenon in which environment interacts with phenotypic variation with the result that organisms which produce more offspring increase as a proportion of a defined population (agreed on by all scientist whatever their view of the origin of life). evolution — a theory to explain the unobserved origin of life and biological diversity which assumes the properties of inanimate matter alone gave rise to the first living organism and from it, by descent with modification, to all the observed features of past and present diverse and complex life (which by definition must include human ethics and morality).   A key difference between the two is information.  Observable natural selection, including among bacteria, does not result in any increase in genetic information in a population (if this is disputed please provide an example of increased genetic information from the literature).  By contrast zero-to-hero evolution requires increased genetic complexity following the origin of the hypothetical first self-replicating genome.   Although in textbook discussions on bacterial diversity evolution is everywhere assumed (1), it is nowhere necessary for medical practice. This is because systematics and biological classification is based on currently observed differences, and whether these are attributed to common ancestry (evolution) or common function (creation) is irrelevant to the usefulness of the observed data.  It is also interesting to note that when assuming phylogenetic (evolutionary) relationships among eubacteria the “inability to resolve the branching order suggests that there was a rapid radiation of the lines, resembling the Cambrian explosion in animals” (2); therefore among eubacteria evolutionary theory has yet another “explosion of life” to explain.    Antibiotic resistance arises in different ways.  Point mutations result in loss or decreased efficiency of a pre-existing function. Horizontal gene transfer is simply spread of existing information.  Though beneficial in terms of survival, neither process represents an observable net increase in genetic information among bacteria, as required for neo-Darwinian evolutionary theory (3).  This is why bacterial resistance is an example of natural selection, but not of evolution.   An analogy may help.  The belief that random mutation acted on by natural selection leads to an increase in information is analogous to believing that introducing random typographical errors into individual copies of the BMJ would improve the articles (no cheap jokes please!) - i.e. would increase the amount of information contained in it - if all the readers were allowed to select and re-cycle favourable changes in each random iteration (this analogy is not wholly accurate, as readers can make reasoned choices, whereas natural selection is a passive probabilistic process). Reason, observation and experiment (i.e. the normal methods of scientific investigation) do not support such a belief.  Expressed in conventional Darwinian terms, natural selection explains why the finch’s beak varies by habitat; it cannot explain how the finch got its beak.    Those who critically analyse scientific publications on evolution will recognise this as a fundamental problem in evolutionary theory – one for which no satisfactory answers currently exists. Evolution requires an increase in genetic information; random DNA mutation and natural selection do not provide a mechanism.    For further reading there are two books I would recommend, both by well qualified authors and generally available e.g. from Amazon (4, 5).   pop0nline@gmail.com   References 1.      Zinder SH. Bacterial Diversity. In: Balows A, Duerden BI [Editors]. Topley and Wilson’s Microbiology and Microbial Infections (9th Ed). Vol 2. London: Arnold; 1998. p. 125-147 2.      ibid., p. 129 3.      Dr Kevin Anderson.  Is Bacterial Resistance to Antibiotics an Appropriate Example of Evolutionary Change? Internet page at http://www.trueorigin.org/bacteria01.asp 4.      Dr L Spetner. Not by chance. New York: Judaica Press, 1997. 5.      Dr John C. Sanford. Genetic Entropy and the Mystery of the Genome. Ivan Press, 2005. Competing interests: None declared
Rational evidence...... 19 June 2006
Andy Wood, SHO Ophthalmology Glasgow Send response to journal: Re: Rational evidence......	It is a good idea to repeat the sentence “opinion is not evidence” whenever tackling a difficult question. I don’t think anyone has questioned the relevance of the fossil record, rather that in a high class medical journal such as this, it may be a little obtuse to fully discuss such a concept. Now extinct examples of life are found in the fossil record, regretfully it records very little, it is incomplete and sadly if you are wishing a complete record, inadequate. The Cambrian explosion does contain the record of a fauna of organisms from around 540 Mya; alas this is not the first record of complex life. Multicellular life has been discovered in China at 560-590 Mya. Fossil micro-organisms have been found at 3480 Mya. The explosion itself is thought to have taken between 5-10 Million years (some claim 40My). Spurred possibly by the co evolution of predators and prey. To suggest that the Cambrian explosion represent creation ex nihilo is simply incorrect, at the very least one can assume it took far longer than six days. There are few scientific discoveries which are more prone to being mangled in the Creationist mill than the work of Gould and Elderidge. Neither doubts that evolution has taken place, both are admirers of Darwin. Yet somehow there work is still misrepresented as a “problem” for evolution. Punctuated equilibrium is not a saltationist theory of evolution, neither is it mutually exclusive of gradualism. Rather it is pointing out that the rate and tempo of evolution as recorded in the fossil record may be described as periods of rapid change followed by stasis. It is not a reason to assume that evolution has not taken place. When one “zooms” in on a period of rapid change it becomes gradual. I don’t think there is a single evolutionary biologist on the planet who believes that an organism such as Mycoplasma genitalium was created fully formed by “chance”. Rather that natural selection, a process which selects the “fittest” genome, acting on the random variation inherent in any population is responsible for the eventual production an organism’s genotype. I have no doubt that engagement with evidence leads one to wonder at the complexity of life, I have no doubt that a number of scientists are free to choose to believe in Creationism, they are equally free to disbelieve in the theory of rain, gravity or indeed sunlight. Popularity or authority and has little to do with whether one is correct or not. Such arguments are neither rational or evidence based. Competing interests: None declared
Re: Doctors and Intelligent thought 20 June 2006
Stevie M Gamble, retired HMIT EC2Y 8BL Send response to journal: Re: Re: Doctors and Intelligent thought	Both Andy Wood and Richard J Roberts, in their Rapid Responses of 19th June, 2006, at least appear to agree on the application of natural selection to bacteria. Unfortunately, most current medical problems with bacteria spring from unnatural selection, and distinctly unintelligent creation, both by human beings. Admittedly it is now axiomatic that pseudomonas aeruginosa, like those colonising my lungs, behave in a way contrary to classical Darwinian theory.(1) However, both classical Darwinism and Creationism are entirely irrelevant to the question of how best to deal with the clinical problem of something which appears to behave as a group entity, made up of many millions of pathogenic bacteria, behaving co-operatively, in a patient's lungs. It would, of course, be a great deal easier if the bacteria behaved as they are supposed to in the competition and extermination model, but they don't. Doctors deal with what is happening, not with what should theoretically be happening. That is not to say that these questions are irrelevant to medicine generally; scientific models can blind scientists to facts like quorum sensing. Bacteria have been around for a very long time, so in the 'evolution as improvement' paradigm they were perceived as crude, simplistic organisms. Naturally, crude simplistic organisms must lack sophisticated communication abilities; equally naturally crude organisms must behave archetypally as exterminators or the exterminated. Since the theory dictated this, who would waste time looking for non-existent facts to contradict it? Fortunately, many scientists do look for facts, even when the theory tells them they can't exist. I do not accept Creationism, or Intelligent Design. I do, however, recognise the dangers of adhering to any theory at the expense of intelligent thought. Stevie Gamble (1) Cooperation and competition in pathogenic bacteria Griffin, West & Buckling Nature 430, 1024 - 1027 (26 August 2004); doi:10.1038/nature02744 Competing interests: None declared
Cross eyed evolution. 20 June 2006
Andy Wood, SHO Ophthalmology Glasgow Send response to journal: Re: Cross eyed evolution.	It’s a little difficult at times to not to find oneself cross-eyed at the arguments put forth by Creationists. It would appear when one is in danger of conceding a goal; the time is ripe to move the goal posts. Having disposed of the fossil record, now evolution does not lead to an increase in “information” whatever that is. Natural selection has nothing to do with evolution? Well I wonder what Darwin would have thought of that? Darwin did not invent the idea of evolution; rather he did outline the predominant mechanism namely natural selection contemporaneously with Wallace. Evolution is a simple concept, it may be defined as “a change in the genome over time” this occurs via a number of processes namely natural selection, sexual selection genetic drift or possibly endosymbiosis. I’m afraid the origin of life is usually referred to as abiogenesis although a related field it’s not really relevant here. It is equally difficult to see how someone can come to the conclusion that natural selection cannot increase information however that is defined, indeed that is exactly what it does. “ Any arrangement implies information; the information is how the arrangement is described. If a new arrangement occurs, whether spontaneously or from the outside, new information is assembled in the process. Even if the arrangement consists of shattering a glass into tiny pieces, that means assembling new information.” (1). The exposure of bacterial populations to antibiotics results in the selection of resistant bacteria, it results in a change in the populations genome or if you wish a change in allele frequency of that population. This change no matter how it comes about is a change in information, transferred from a selective environment. If it is not then I can only suggest that nothing about information is relevant to evolution. The vast proportion of mutations are silent, some are harmful and some are beneficial. Mutations in junk DNA are usually silent; mutations in promoter regions may alter gene expression. Point mutations, deletions, chromosomal duplications, breakage and realignment, retroviruses, plasmids, transposons and symbiotic transfer all are relevant. For example, the duplication of a gene with subsequent independent mutation of the two copies will increase the information in the genome. Duplication of whole chromosomes will do likewise. Indeed gene duplication is how the complement system and blood-clotting cascade evolved One may of course be contrary about what information is, but when strictly defined evolution is not found lacking (2). Indeed biological complexity seems to be due to the processes so outlined (3). Bacteria are still evolving they are still becoming resistant to antibiotics, the methods of evolutionary biology are relevant to this situation. Bacteria evolved, they do not represent common design, unless a designer specifically acted to make the differences found at the genome level look as if the organisms had evolved. Alas I think you will find that reason, observation and experiment show that the analogy given is deeply flawed (4 and 5). 1. www.talkorigins.org 2. Evolution of biological complexity. Adami C http://www.pnas.org/cgi/content/full/97/9/4463 2.Protein family expansions and biological complexity. Vogel C, Chothia C, http://compbiol.plosjournals.org/perlserv/?request=get- document&doi=10.1371/journal.pcbi.0020048 3.http://www.zachriel.com/mutagenation/ 4.http://www.zachriel.com/phrasenation/ Competing interests: None declared
Re: Cross eyed evolution 21 June 2006
Richard J Roberts, Head, Vaccine Preventable Disease Programme National Public Health Service, Abton House, Wedal Road, Cardiff, CF14 3QX, UK Send response to journal: Re: Re: Cross eyed evolution	As I said “Those who critically analyse scientific publications on evolution will recognise [reconciling evolution with genetics] as a fundamental problem in evolutionary theory” (emphasis added) (1).  If you don’t think this is a problem, then you should know that the two leading British evolutionists (not creationists) Professors Simon Conway Morris and Steve Jones do think it’s a problem.  Will you disagree with them too? And let me say finally, “evolutionist” is not the “worst insult available” (2), it’s the term Prof Steve Jones uses for those who share his point of view.  Which apparently you don’t, and neither do I. Harmony at last. I would love to discuss longer but face to face would be easier – I might look you up when I’m next in Glasgow.   pop0nline@hotmail.com   1.      Roberts RJ. Why antibiotic resistance is not evidence of evolution in action. http://bmj.bmjjournals.com/cgi/eletters/332/7553/1294-e#135914 2.      Wood A. The same mistakes….  http://bmj.bmjjournals.com/cgi/eletters/332/7553/1294-e#134949 Competing interests: None declared
Common sense and Intelligent thought? 21 June 2006
Andy Wood, SHO Ophthalmology Glasgow Send response to journal: Re: Common sense and Intelligent thought?	It would appear that there is much confusion about evolutionary biology. The production of bacterial resistance is due to natural selection. Bacterial origins and relations are a consequence of natural selection. A full understanding of this process and its manipulation does provide therapeutic benefits (1). The paper so quoted regarding Pseudomonas infection does not in anyway contradict Darwinian processes. The paper itself is one of three which represent the application of social evolution theory to predict the damage to a host from parasite infection. This work concentrates on the exploitation of a host by related parasites and the effects on virulence of parasite relatedness. Indeed it amply shows that bacteria can behave in a cooperative and competitive model in accordance with neo-Darwinian theory. I cannot help but think that these papers represent an excellent example of the application of evolutionary biology to medicine (2, 3 & 4). With regard to adherence to a theory, it would appear that intelligent thought is not as common as common sense would presuppose. References. 1. Predicting the emergence of antibiotic resistance by directed evolution and structural analysis. Orencia M C et al Nat Struct Biol. 2001 Mar;8(3):238-42. 2. Cooperation and competition in pathogenic bacteria. Griffin AS West SA, Buckling A Nature, 2004 Aug 26;430(7003):1024-7. 3. Bacteriocins, spite and virulence. Gardner A, West SA, Buckling A Proc Biol Sci. 2004 Jul 22;271(1547):1529-35. 4. Cooperation, virulence and siderophore production in bacterial parasites. West SA, Buckling A Proc Biol Sci. 2003 Jan 7;270(1510):37-44. Competing interests: None declared
Perfection? 21 June 2006
Assad Chaudhry, Studying LLM in Leagal Aspects of Medical Practice LE2 5TJ Send response to journal: Re: Perfection?	Comming from a non medical point of view, has anyone ever thought that maybe we as human beings were not designed to live forever, or to even last that long. The problem with this article is that it assumes that living long or living forever is the sign of a perfect creation, but is it? Imagine the implications if all human beings were always in good health, there would be 1) no need for any doctors 2) there would be a population problem for all countries 3) this would lead to massive economic problems such as employment etc This would just be a few. Thus with the points above it must be logically concluded that human beings were designed to die and if this is one of our purpose then there can be no argument that we are a flawed creation. Thank you Assad Chaudhry LLB Hons, LAMP student, Cardiff Competing interests: None declared
Still cross-eyed! 22 June 2006
Andy Wood, SHO Ophthalmology Glasgow Send response to journal: Re: Still cross-eyed!	I may be incorrect but I do seem to remember saying that creationist use certain terms in a pejorative manner, that is simply the point I was making. To the right wing of American evangelical creationists “evolutionist” is one of the worst insults available. Here we go again with the argument from authority! As far as I am aware Prof Jones is a distinguished geneticist, indeed he has published extensively regarding his views on creationism (1). Prof Conway Morris is a distinguished palaeontologist and again has little regard for creationist fancy although he is I think a committed Christian (2). Indeed the volume so quoted goes someway to reconciling his views on evolution and his deeply held faith. It is also wonderfully written. The last time I looked, the Archbishop of Canterbury also regards creationism as less than worthy. I believe the Pope’s own astronomer takes the view that creationism is a type of Paganism. I must point out that a common error running through some of these posts is the notion that a problem for evolution (as an aside I cannot think of any) is necessarily one in the bag for creationism. That simply isn’t so. Indeed there is little or no positive evidence for creationism, whichever brand you choose. Medicine is important, far too important to be left in the scientific doldrums by a failed theory; indeed it is only a theory, namely creationism. It would appear that those in the know about God’s wishes tend to agree with me. 1. The single helix. A Turn Around the World of Science. Jones S. 2. Life’s solution. Inevitable Humans in a Lonely Universe. Conway- Morris S. Competing interests: None declared
Re:Evolving Intelligence on emerging pathogens 27 June 2006
Stevie M Gamble, retired HMIT EC2Y 8BL Send response to journal: Re: Re:Evolving Intelligence on emerging pathogens	Andy Woods, in his Rapid Response of 21st June, claims that research into evolutionary theory would 'provide therapeutic benefits'. Alas, the papers he cites do no such thing. For example, what Orencia et al (1) actually say is: 'Our results demonstrate that directed evolution coupled with structural analysis can be used to predict future mutations that lead to increased antibiotic resistance.' As any hospital infection nurse would tell him, it's extremely easy to create highly resistant bacteria; we do it all the time. We're actually looking for something in precisely the opposite direction… Contrast that with the research now going on world wide into quorum sensing as a target for the development of novel anti-infective agents. The important original scientific discoveries made about quorum sensing in pathogenic bacteria were kick-started 15 years ago in a 'quite by chance finding' (2). They were genuinely new, and had absolutely nothing to do with ''the application of social evolution theory to predict the damage to a host from parasite infection'. I am beginning to agree with the paleontologist, David Raup, who noted: 'On the creation-evolution debate, I foresee continued conflict. Both sides will continue to lie, cheat, and steal to make their points.' (3) Unfortunately, we are probably running out of time for this squabbling; as Mark Woolhouse noted at this years's American Association for the Advancement of Science conference: “The rate of accumulation we are seeing now is too fast to be supported over an evolutionary timescale. We would be overrun with pathogens. Either many of these pathogens will not persist in humans, or there is something very unusual about the present time. The most obvious explanation is the pace and scale of change in the ways humans interact with their environment, providing new opportunities for humans to be exposed to and to transmit novel pathogens.” (4) And Robert Swanepoel yesterday predicted that Ebola and Marburg viruses are likely to reach London in the near future as the bush meat trade accelerates. (5) We have dug ourselves into a very deep hole; if we are going to get out of it then we need all the competent scientists we can get. Harassing people for their religious beliefs is not a good way of going about it. Stevie Gamble (1) Predicting the emergence of antibiotic resistance by directed evolution and structural analysis. Orencia M C et al Nat Struct Biol. 2001 Mar;8(3):238-42. (2) Obituary for Gordon Stuart, Professor of Applied Molecular Biology in the School of Pharmaceutical Sciences, University of Nottingham, http://www.nottingham.ac.uk/quorum/stewart.htm (3) http://www.geocities.com/CapeCanaveral/Galaxy/8152/davidraup.html (4) http://www.timesonline.co.uk/article/0,,3-2049697,00.html (5) http://news.independent.co.uk/uk/health_medical/article1095837.ece Competing interests: None declared
Still seeing double. 28 June 2006
Andy Wood, SHO Ophthalmology Glasgow Send response to journal: Re: Still seeing double.	Honesty is an essential part of scientific endeavor.Indeed it is the assumption at the heart of science. Unfortunately it seems it is not universal. A little like intelligence in that respect. The production of resistant bacteria is simple, although knowing how they become resistant at a molecular level is not. Therapeutic interventions rely on knowing this hence the point of the paper by Orencia et al. Not all scientific discoveries are predicted and the world is still large enough for chance discoveries to rear their welcoming heads. It would seem that chance, or at least Malaria had a hand to play in the discovery of natural selection by Alfred Russel Wallace. The papers previously quoted do address social evolution theory and it application to pathogen host relationships. Indeed the above sentence comes directly from the authors your correspondent initially referenced. It seems peculiar that he references papers claiming they provide evidence of therapeutic thinking without resorting to Darwinism. Yet when looked at closely they are concerned with Darwinian processes and therapeutic thinking. As for the rest, when will some see that opinion is not and never has been evidence? I would agree that harassing religious people is to be deplored, in much the same way as slack thinking which is regretfully much in evidence here. Thankfully it would seem that the Royal Society, full of competent scientists to a (Wo)man deplores such thinking as well (1). References. 1. http://www.royalsoc.ac.uk/news.asp?id=4298 Competing interests: None declared