GPs implicitly treat their contact with patients as the meeting of conscious minds. What fewer may acknowledge is that this view may be rationally incompatible with notions of humans as products of a pure material evolution.
If Thomas Nagel, Professor of Philosophy and Law Emeritus at New York University, is correct then general practice, and the biological sciences in general, have been reading the story of life back to front. Nagel’s claim is that consciousness is an integral property of the universe, and the material nature of the universe is there to support this property. This claim, that sentience cannot be explained by substance and that evolution in some way contains a directional arrow, is not unique to Nagel, but it is an unusual assertion for an atheist.
Nagel puts his main concern on the front of the book: that explaining the mind purely in evolutionary terms is implausible. Nagel has absolutely no problem with the general facts of evolution and that humans are dependent on their material nature. His concern is that the failure of this process to adequately explain some critical aspects, particularly consciousness and reason, undermine the claim of evolution to be a general account of reality. His concerns are both philosophical and technical.
Philosophically, among other insights, Nagel refreshes Descartes’ observation that all knowledge, no matter how experienced or measured, is appreciated by the mind and this includes the specialised knowledge of science.
Technically Nagel examines some of the scientific difficulties of evolutionary progression, among these the suggestions that the timeframe for evolution is insufficient for the number of positive adaptive mutations to have occurred. He also expresses discomfort with the concept of emergence as a happenstance occurrence. Emergence, a widely accepted idea, suggests that complex systems like the nervous system throw up novel properties, such as consciousness, not belonging to the sum of their parts. However, Nagel observes that if something keeps cropping up it is unlikely to be either accidental or magical, and more likely due to a general property or tendency. In short, evolution of mind needs a more powerful explanation.
Nagel appeals to an examination of the facts that is driven neither by a need to establish a traditional theistic account of a created universe, nor to escape to a reductionist account that he feels is often driven by a desire to be ‘liberated from religion’. Nagel therefore rejects an entirely accidental and material Darwinian evolution of mind for philosophical and technical reasons, and a theist account for a mixture of personal and philosophical reasons before looking to see if there is another explanation.
Nagel believes the facts suggest evolution must be driven by some sort of directional force or ‘teleology’. In other words, evolution is not just going somewhere, it’s going somewhere specific. Nagel does not present his version of teleological evolution as a watertight case, but that he is compelled to find some alternative that is more likely than reductionist evolutionary or divine- creation alternatives.
Nagel uses long sentences and multiple negatives, and assumes a familiarity with contrasting analyses of evolution: Darwin and Dawkins, but also the alternative views of Alvin Plantinga and Sharon Street, and readers unfamiliar with these views may fail to appreciate Nagel’s starting point.
Does this matter to general practice? Nagel challenges natural science, but GPs may welcome his flexibility of thinking and lack of dogmatism in explaining the complexities of understanding conscious life.
Do we consider our patients to simply be driven by their genes to a series of complex survival strategies including seeking our help, or as someone sharing in the unique experience of being a conscious, reasoning being? Nagel gives us one possible viewpoint, not found in reductionist Darwinian accounts, from which that can be true.
- © British Journal of General Practice 2018