New Scientist article: Evolution and intensive care

Darwinian medicine: Does intensive care kill or cure?

New Scientist, 11 August 2010 by Dan Jones

We’ve evolved ways to come back from the brink of death – and doctors’ efforts to help may just be getting in the way

NOTHING epitomises cutting-edge medicine so much as a modern intensive care unit. Among the serried ranks of shiny chrome and plastic surrounding each bed are machines to ventilate the lungs and keep failing kidneys functioning, devices to deliver drugs intravenously and supply sedatives, tubes to get food into a patient and waste out, and countless gizmos to monitor blood composition, heart rate, pulse and other physiological indicators.

This environment is home to Mervyn Singer, director of the Bloomsbury Institute Centre for Intensive Care Medicine at University College London. So you might expect him to wax lyrical about the wonders of medical technology. Instead, he has this to say: “Virtually all the advances in intensive care in the past 10 years have involved doing less to the patient.” And he goes further, arguing provocatively that modern critical care interferes with the body’s natural protective mechanisms- that patients often survive in spite of medical interventions rather than because of them.  Read more