Nature's Destiny By Michael J. Denton (review)

or parts for whole, we are liable to end up with an incomplete and mean-spirited medicine that suits the best aspirations of neither health professionals nor patients. For example, an overemphasis on cost reduction by outcomes researchers may skew policymakers' perceptions in such a manner that we end up with a doctor-patient relationship built on the model of an commercial negotiation. If one approaches outcomes assessment with the attitude that contemporary medicine is rife with ignorance , wasteful spending, and the exploitation ofpatients, then it is natural to lunge at outcomes data with open arms and nary a question, indiscriminately gobbling up whatever morsels fall from its table. On the other hand, if one sees much in contemporary medicine that is good and worth preserving, then it is natural to regard outcomes assessment with a certain degree of skepticism, not out of inertia and blind loyalty to the past, but out of a desire to ensure that the outcomes of outcomes research are as beneficial as possible to the health professions and the patients they serve. Richard Gunderman Indiana University Nature's Destiny. By Michael J. Denton. Free Press, 1998. Pp. 454. $27.50. The argument from design is perhaps the most venerable of the evidences for the existence of God. From Aristotle to Aquinas, many formidable intellects of the pre-modern worldjudged that certain features of nature were purposely arranged to permit life. The persuasiveness of the design argument, however, unlike that of purely philosophical proofs for a divinity, depends unpredictably on changes in our knowledge of nature. With their limited understanding of the natural world, the pre-moderns could point only to easily observed features, such as the passage of the seasons or the arrangement of animal limbs, as evidence of design. However, as biology advanced in the 17th and 18th centuries, the design argument advanced with it. The discovery of a gaggle of well-adapted biological features seemed to put design beyond doubt, and the argument reached its zenith in the writings ofWilliam Paley. Suddenly everything changed. With the publication of The Origin ofSpecies, those well-adapted features were assigned another explanation, and the design argument became a target for ridicule. Nonetheless, the argument depends on our understanding of nature, which continues to advance, and the fortunes of the design argument are brightening once again. A harbinger of the argument's re-birth was the discovery in the 1920s of the expanding universe—a precursor of the Big Bang theory—which raised the specter of something outside of nature as the universe's cause. Later, in the mid-1970s, the physicist Brandon Carter published "Large number coincidences and the anthropic principle in cosmology," first pointing out that the universe is suspiciously suited to foster life [I]. Now, at the close of the 20th century, a straw in the wind showing the resurgence of the design argument can be found in New Scientist, a British popular-science magazine, which recently ran an article on physicists who postulate the existence ofmultiple cosmos [2] . In the course of discussing the "finetuning " of our universe, the article offhandedly remarks: "This fine-tuning has two Perspectives in Biology and Medicine, 43, 1 ¦ Autumn 1999 151 possible explanations. Either the Universe was designed specifically for us by a creator or there is a multitude of universes." New Scientist can hardly be considered an apologist for religious ideas, and its writers are attuned to the most current science . Yet it counts the design argument as one of just "two possible explanations" for the viability of the cosmos, whose only rival is a highly speculative, probably untestable hypothesis about universes beyond our own. From laughingstock to contender , the argument from design has made a remarkable comeback. Before Darwin, proponents of the design argument used mainly biological examples . In our own time, however, the illustrations have generally been drawn from physics and astronomy. But the heavy reliance on physics is changing, as shown by Michael Denton's Nature's Destiny. Denton, the author of a previous critique of Darwinism, Evolution: A Theory in Crisis, is a physician and geneticist at the University of Otago in New Zealand. In his new book he sets out to...