Disease and Doctors
If life is intelligently designed, with forethought, planning, purposeful, meaningful, are diseases intelligently designed, planned, purposeful too? Do we need more or less religion? Do we need more or fewer doctors?
by Jack Hoehn | 17 April 2024 |
There are many things that attack and end life. Here are 20, plus a few more, of the World Health Organization (WHO) top world causes of death in 2019 before the COVID pandemic. The rank of cause in the USA is in the left column.
Large charts like this can be overwhelming, but there are several things to be noted, with a little time spent on it. Look back at the chart and note the things in orange. First, the causes of USA deaths are in a different order than world deaths. The most obvious conclusion is that some diseases are caused or greatly worsened by poverty (orange).
Now, note the left column listing the number of USA causes of death versus the rest of the world causes of death in the second column. We could decide that some diseases are caused by politics and policies—for example, deaths by murder are much higher in countries that have few or no policies to control weapons of mass destruction—(Murder and Assault deaths are not even in the top 20 in the world, but are the 8th cause in the USA).
Hidden Risks
Tobacco smoking and pollution are a major cause of lung deaths both from chronic obstructive pulmonary disease (COPD) and lung cancers in all countries. The far right column shows a cigarette where tobacco is the major cause, and a cocktail glass shows when alcohol is a major contributor to this cause of death. This is not obvious at first reading of these problems. Alcoholism and “cirrhosis” is the 12th most common cause of death in the world, and the 16th cause in the USA. But look at for how many other diseases alcohol is a major contributor to the problem but is hidden under a diagnosis that does not make you think of alcohol at first reading (green with cocktail glass).
The relation of alcohol to many diseases is well established by scientific facts, but is hidden from its significance under other diagnoses’ names. People are usually aware that most cirrhosis of the liver is alcohol-related. The alcohol industry has widely promulgated and constantly repeated those few studies that suggest a mild decrease in heart attacks in light drinkers. But the actual total cause of mortality and morbidity from the use of alcohol is hidden in the statistics.
Alcohol is a hidden cause of many diseases.
There is absolutely no total health benefit from the use of alcohol—none beyond the mild benefit of reducing heart attacks from a very light use of alcohol (10 to 15 ml of absolute alcohol a day—much less than most people drink in all usual servings of beverage alcohol). I live with chronic atrial fibrillation from a leaky mitral heart valve, and have never used alcohol, but the major cause of atrial fibrillation in the USA is from alcohol use. In fact, the WHO has listed 28 diseases with scientific proof of worsening with alcohol use, and the British Institute of Alcohol Studies has documented 61 diseases caused or worsened by alcohol use in men.
Choices
None of these statistics prove that disease is or is not caused by an intelligent designer or by an intelligent disease designer. But it does show that the frequency of disease is influenced by choices made by intelligent people and their governments. It is not possible to blame God if you get lung cancer and you are a smoker. And if you are killed by an AR-15 assault rifle while attending a kindergarten, watching a movie, or shopping for groceries, it is not God’s fault that weapons of mass destruction are permitted by governments and their policies to be ubiquitous. That children still die of diarrhea, and live in conditions permitting cholera, tuberculosis, typhoid, and malaria is a failure of global economic policies permitting huge gaps between the top 1% of earth’s population and the rest.
Policies
Governmental decisions and personal decisions are not God’s fault. In democracies, they are our fault. In autocracies, they are the tyrants’ fault. If we elect officials who make budgets and collect taxes, we approve of how the facts fall out on earth, not in heaven. Just look at these statistics and let them remind us how much choice is in human hands, votes, decisions.
2019: CDC Cancer Prevention budget $ 0.4 billion
2019: National Cancer Institute budget $ 6.6 billion
2019: National Health Institute budget $ 42.9 billion
2019: Alcohol bought, US $ 252.0 billion
(2019: Alcohol taxes, US $ 9.9 billion)
2019 US defense budget $ 686.1 billion
All of these numbers could be changed. Fewer alcohol purchases, higher alcohol taxes, more health and fewer weapons, etc., etc., etc., etc. These are things in human control, not heaven control.
More Doctors?
Doctors are very useful. There is no remedy for a ruptured appendix except for a good surgeon and a good hospital. But there are interesting statistics that show for general health of a population it makes a big difference what kind of doctors a state or country has.
“A series of articles published this year in JAMA Internal Medicine has substantially added to the empirical literature showing that access to and use of primary care medicine in the US is associated with higher value care and better health outcomes than care that is more specialist-oriented.” Or as an early article put it, “A greater supply of specialty physicians was associated with higher mortality.”
This does not mean specialists are killing people; this must mean that for general total health, a good primary care physician (family doctor, pediatrician, general internist, OB/GYN physician) is more important than a lot of skilled brain surgeons.
Again, economic policy is not heaven’s decision on health; it is our decision. Doctors, like all people, respond to incentives. If you are spending half a million dollars on your education, you would like to get out of debt as soon as you can after medical school. If we want more primary care physicians than specialists, then we have to pay them more. Or subsidize the cost of their education if they agree to a primary care practice. Here is what we presently reward doctors with:
I know specialists deserve to be paid well, but I also know that we need more family doctors. So if we want more, then this physician compensation chart should be inverted. And that is a choice we humans can make. I don’t mean family doctors need to have their salaries tripled. But we do need to incentivize family physicians with subsidized educations, and increased remuneration during their working lives, even at the expense of the top-paid specialists.
What if we paid all physicians well, and about the same with variations for productivity? Oh, “socialism?”
- “Socialism.” What if it meant everyone had access to a good primary care physician who had low educational debt loads and adequate incomes?
- And our populations had less disease and later deaths?
- And our specialists were all busy and well paid, but there were fewer of them sitting around waiting for things to do?
- And what if everyone had health care insurance…but now we are really getting radical! What do you think this is, Canada? Norway? Sweden? Israel? Ireland? Scotland? England? Germany? France? Italy? Korea? Japan? Lithuania? These things are a choice, a decision by us and our elected representatives, dear fellow Americans, not by God.
So life is intentional, purposeful, and appears designed; diseases also appear intentional, purposeful, designed. So perhaps we can criticize God for not designing a disease-free universe. But that is not a scientific argument against intelligent design. That is a theological argument. And a trick often used to escape the scientific evidence of design. The argument “What kind of God would have designed…?” is not a scientific argument against intelligent design, even if spoken by a scientist.
The science showing that our infinitely large, infinitely small, and infinitely complex universe appears to be intentional, purposeful, created with complex specified information and foresight stands by itself apart from theological issues. It should open the door to serious theological discussions, about “what kind of God…?”
But theology or religions or holy books should not and do not falsify facts of science. Nor should atheism be able to falsify the evidence for intelligent design by sneaking in a theological argument.
This is #8 in a series on worship guided by science. #1 is here. Jack is also known as Dr. John Byron Hoehn, MD, CCFP (Canada), DTM&H (London). His book Adventist Tomorrow—Fresh Ideas While Waiting for Jesus in its second edition continues to be the most popular book Adventist Today has published. Jack’s wife, Deanne, has published a delightful new book called Loving You—I Went to Africa, about their 13 years as medical missionaries. These books are available at SHOP in the menu at the top of the page. All sales go to support Adventist Today.
