Thursday, July 23, 2009

QJM Paper Now Published

My paper "Towards a more inclusive vision of the medical sciences" is now available in the August issue of QJM: An International Journal of Medicine. Here is the abstract:

Progress in the medical sciences is largely determined by two things: (i) the questions we ask, and (ii) how rigorously and vigorously we attempt to answer them. How do we know which questions are the right questions to ask, and thus the correct questions to spend our time and energies trying to answer? Such evaluative concerns bring into sharper focus the question—‘What is medicine for?’ The international study of rosuvastatin is important not simply because of the health benefits it may confer, but because it inspires a more robust and inclusive vision of the medical sciences. A vision which recognizes that the primary goal of medicine is to promote health, and that includes the health of ‘normal’ people as well as those with illness and disease. This inclusive vision of the medical sciences is a transformative one, it departs from the ‘disease-model’ approach which has dominated distinct areas of medical research for decades.

And a brief excerpt:

So what questions might we supplement the study of specific diseases with? If the delivery of health is our primary concern, and ageing threatens the health prospects of a population, then the obvious question is—what causes ageing? Evolutionary biology now provides scientists with new tools for understanding the ultimate, and not just proximate, cause of morbidity and mortality (as well as survival). Rather than invoke an overtly idealized concept of health—where health is equated with the absence of disease—evolutionary medicine incorporates the physiological constraints and ranges of plasticity well documented by the biological community.10 And this permits us to understand the role natural selection plays in survival and death and disease. By addressing the ultimate causes of phenotypes like disease and health, we begin to gain a better understanding of the things that threaten the health prospects of ageing populations.

....Like a diversified economy and economic prosperity,a diversified study of disease and health will best secure the goal of human flourishing. The reality is that the vast majority of ‘normal’ people are susceptible to the chronic illnesses of ageing (e.g. cancer and heart disease). To meet the health challenges of an ageing world we must adopt a more inclusive approach to preventative medicine, one that includes the drug development of interventions in the ageing process itself.17,18 Treating specific diseases and illness is of course important as well. But a truly inclusive vision of the medical sciences encourages us to adopt a more bold and imaginative conception of human flourishing and medicine. And humanity deserves nothing less than the best the medical sciences can deliver.