The Human Body Under Criticism

"As a piece of machinery we humans are such a hodgepodge and makeshift that the real wonder resides in the fact that we get along as well as we do." — Wilton M. Krogman, Scientific American, 1951¹

"The anatomical revisions depicted on the pages that follow are fanciful and incomplete." — S. Jay Olshansky, Bruce A. Carnes and Robert N. Butler, 2001²

Summary

The parent article, Arguments from Bad Design, sets the test:  say what a part is for, say what limits it, and compare a real alternative.  This hub applies it to the complaints about the human body plan, in five systems:  the spine, childbirth, the shared passage for food and air, the urogenital layout, and the umbilical cord.  Each has a child article;  this page sets out the critics, the replies, and the number that matters most in each system.

• The critics argue history more than engineering. Wilton Krogman called the upright skeleton "scars of Nature's operations" in 1951.¹ Shubin, Coyne, Dawkins and Lents draw the same conclusion: the flaws "make sense only if they evolved from features of earlier ancestors."³ "Bad design" is their premise; common descent is their conclusion.
• Only one whole-body redesign exists, and its authors concede its costs. Olshansky, Carnes and Butler drew a longer-lasting human in Scientific American in 2001. They called it "fanciful and incomplete" and admitted that their knee would make standing hard and their separated airway "would disrupt breathing through the mouth and the ability to speak."²² No engineer or anatomist was found who has costed it.
• The test cuts both ways. A failure rate needs no redesign, but "no designer would have built this" is a comparison, and it needs a build that is better on every task at once.
• The design replies are strongest where they name functions and weakest where they refuse to test. Jerry Bergman lists what the shared throat does and concedes that only a comparison "of two groups" could prove a better design.⁴ Randy Guliuzza of the Institute for Creation Research writes that "There is no objective test for poor design."⁵ The first can be tested; the second cannot.
• The Fall answer covers wear and disease, not layout. Creation Ministries International and the engineer Stuart Burgess apply it to aging, disease and genetic decay.⁶⁷ The complaints here are about where the tubes run, which every human has from conception. Those must be defended as good design or shown to have changed.
• The five numbers. Low back pain affected 619 million people in 2020 and is the world's leading cause of years lived with disability.⁸⁸ English parish records give 10.5 to 5.0 maternal deaths per 1,000 live births between 1700 and 1850.⁹ An American's lifetime odds of dying from choking on food are 1 in 2,367.¹⁰ About 27% of men have an inguinal hernia repaired in their lifetime.¹¹ A cord around the neck occurs in 14.1% of births and does not raise perinatal mortality (0.5% against 0.6%).¹²

Verdict:  the whole-body complaint is mainly an argument for common descent, and it should be answered as one.  As an engineering claim it is unpriced.  Two of its entries, back pain and groin hernia, carry large, measured costs that the design side has not answered with numbers.  Two others, choking and the nuchal cord, carry small costs, and the only drawn fix for choking costs speech by its authors' own account.

Part 1: Who makes the complaint, and what each claims

Seven writers carry the whole-body version, and they claim different things.

Krogman, a physical anthropologist at the University of Pennsylvania, founded the genre.  He excluded vestiges on purpose:  "I am discussing the imperfect adaptations the human race has made in getting up from all fours."¹  He blamed slipped vertebrae, hernia, and "a narrower pelvis and a bigger head" on standing up.¹¹¹  He gave credit too:  on balancing the body over the hips, "Nature seems to have done a pretty good job."¹  He offered no numbers and no alternative.

Olshansky, Carnes and Butler made a narrower claim.  Their argument is about old age:  "we harbor flaws because natural selection ... does not aim for perfection or endless good health."²  Their redesigned human has a forward-tilting torso, a backward-bending knee, shorter stature, a separated food and air passage, and a urethra outside the prostate, among other changes.  A "simple rearrangement" would have fixed choking, they wrote, "albeit at the cost of severe trade-offs."²  On the prostate they allowed that "This configuration may have as yet unknown benefits."²  This is the most careful critique in the set, and it concedes more than its readers usually notice.

Shubin frames the body as a modified fish:  "In a perfectly designed world—one with no history—we would not have to suffer everything from hemorrhoids to cancer."¹³  His hernia chapter names the purpose of testicular descent, sperm cooling and signalling ("ample advantages"),¹³ names the cost, "a weak spot in the body wall,"¹³ and calls the result "a trade-off between our fish ancestry and our mammal present."¹³  That is this hub's own test, applied honestly.

Coyne states the logic most plainly:  "Imperfect design is the mark of evolution; in fact, it's precisely what we expect from evolution."³  He says of the testes' route through the inguinal canal, "No intelligent designer would have given us this tortuous testicular journey."³  He is the only critic in the set who proposes a specific human redesign:  "If you designed a human female, wouldn't you have rerouted the female reproductive tract so it exited through the lower abdomen instead of the pelvis?"³

Dawkins takes the vas deferens from George C. Williams.  It "takes a ridiculous detour around the ureter," and "If this were designed, nobody could seriously deny that the designer had made a bad error."¹⁴

Dunn, on Smithsonian.com, gives falling food "about a 50-50 chance of falling in the 'wrong tube'" when the epiglottis is slow.¹⁵  Nobody has measured that number.

Lents sorts human "design flaws" into three kinds:  features that evolved for a different world, "incomplete adaptation," and "the limits of evolution."¹⁶  On the throat, separate passages "would make much more sense," and with them choking "would never happen."¹⁶¹⁶  On the knee, "the issue isn't that evolution can't solve the problem but that it simply hasn't."¹⁶  On the spine, the disks sit in "an arrangement that is optimal for knuckle-draggers, not upright walkers."¹⁶

Two of Lents's factual claims are wrong or overstated.  He writes that "In other apes, the larynx is substantially lower in the neck than ours" and describes "the gradual elevation of the voice box."¹⁶  The mainstream account is the reverse.  Takeshi Nishimura of Kyoto University's Primate Research Institute writes that the human larynx starts "as high as in other mammals" and then descends after birth.¹⁷¹⁸  Lents also puts the historical maternal death rate at "1 to 2 percent" as "the lowest possible estimate."¹⁶  The English parish records give 0.5% for 1800 to 1850 and 0.75% for 1750 to 1800.⁹  Only the 1700 to 1750 figure, 1.05%, reaches his floor.

Part 2: What counts as a better build

The test

The parent article asks three questions of any complaint.  What is the part for?  What limits it?  Is there a feasible build that does better?¹⁹  Applied to anatomy, a better build has to beat the present one on every task the part performs, at the same time.  A throat that never chokes but cannot speak is not better.  It trades one loss for another, and the critic has to show the trade is worth it.

The parent article is right that critics "do not have to build a replacement organism that wins on every conceivable axis before identifying a defect."  A measured failure is evidence.  But the critics in Part 1 go further.  "No intelligent designer would have given us this" is a claim about what a designer could have built instead.  A claim about the alternatives needs an alternative.

So the complaint breaks into three claims, and they need different evidence:

1. The part fails often. This needs a rate. Part 4 gives one for each system.
2. A better build exists. This needs a redesign that works on every axis.
3. History explains the layout. This needs comparative and developmental evidence.

Most critics rest their conclusion on claim 3 and use claim 1 as support.  Claim 2 is asserted far more often than it is drawn.

Which redesigns have been priced

Five alternatives appear in the literature.  Only one has been tested with measurements, and the result did not support the cost the critics named.

• A wider pelvis. This is the textbook trade-off. Coyne states it: the pelvis "had to remain narrow to allow efficient bipedal (two-legged) walking."³ Holly Dunsworth and colleagues tested it and found that "There is no evidence that female pelvic morphology affects locomotor cost."²⁰ Nicole Grunstra and colleagues replied in 2023 with a different constraint: "the risk of pelvic floor disorders increases roughly linearly with pelvic canal size."²¹ The parent article covers this exchange. The walking cost that Coyne named has little support in the measurements so far; the constraint with better support is a different one.
• A separated airway. Olshansky and colleagues drew it and conceded that it would cost mouth breathing and speech.² David Menton pointed out that surgeons build this layout with a tracheotomy, and "you will be unable to talk after this procedure."²² Neither side has put numbers on it.
• An abdominal birth exit. Coyne proposed it without costing it. Shubin's hernia chapter supplies the cost in its own words. Women's abdominal walls are stronger than men's because no tube passes through them, and "This is a good thing when you think of the enormous stresses that female body walls go through during pregnancy and childbirth. A tube through the body wall just wouldn't do."¹³ Coyne's exit would put a far larger opening in the same wall.
• Olshansky's whole body. The authors conceded the knee themselves: "the absence of a locking mechanism would make it hard to stand."² A search of the creationist sites and the open web found no costing of the tilted torso, the shorter stature, or the rest by any engineer or anatomist.
• A straight vas deferens. The only creationist attempt at engineering numbers, E. van Niekerk's 2012 paper in the Journal of Creation, argues that a longer duct gives more pumping power and avoids kinking.²³ Its own caption says the force and time values "were realistically, but arbitrarily chosen," so "the values of the power output are also arbitrary."²³ With force and time held fixed, power rises with length by construction, so the result is assumed, not found.

No whole-body redesign has been priced by anyone, and no creationist has priced the present body against an alternative.  Both sides are arguing from drawings.

Part 3: The design replies, in their own words

The trade-off answer

Steve Laufmann, who leads the Discovery Institute's Engineering Research Group, gave the general form in 2018:  "Some bad design examples are simply the natural consequences of good design decisions made elsewhere.  All complex systems involve conflicting design requirements ... As a result, decisions that are optimal for the whole may appear suboptimal with respect to a given subsystem or component."²⁴  Lents answered that trade-offs are "one of the main points of my book."²⁵  Both sides agree that the body is full of trade-offs.  They disagree about what produced them.

Stuart Burgess, Professor of Engineering Design at Bristol, makes a much larger claim in Ultimate Engineering (2026):  biology shows "design at the limit of what is possible."⁷  He also accepts the critics' premise:  "I totally agree that bad design is what we should expect if evolutionary theory were true."⁷  Darwin denied only that selection yields perfection, as the parent article shows, and Behe denies that design entails the best possible build.  Burgess takes on a burden neither accepted, and every complaint in this hub becomes a test he has to pass.

Jerry Bergman, writing for Creation Ministries International, applies the trade-off answer to the throat.  "The pharynx serves as a single passage for three systems—the respiratory, digestive and communicative ... This can cause choking, but allows speech."⁴  He adds spare airways, mucus clearance and smell joined to taste, and states the test honestly:  "The only way to scientifically prove a system is better is to do a scientific comparison of two groups, one group that uses each system."⁴

David Menton, the anatomist, answers the birth complaint that "all other mammals also deliver their live birth through their pelvic birth canal."²²

The degeneration answer

Don Batten and Tas Walker of CMI state it directly:  "Degeneration with old age is not a design fault (prostate problems in some men are a case in question).  Nothing lasts forever.  Nor is malfunction due to disease (e.g., sinus problems).  None of these bad things were part of the original design but are a consequence of the Fall of man."⁶  Bergman applies it to choking:  "this is expected within the biblical model, as the Fall has produced degeneration."⁴  Burgess limits his claim in the same way:  "the human body and other organisms were initially made without these genetic flaws, and ... the flaws arose over time."⁷  On childbirth, Bergman and Menton both point to Genesis 3:16, where pain in childbirth is increased after the Fall.²⁶²²

That answer fits what it covers:  an enlarging prostate, a worn disc, a stroke that breaks the swallowing reflex.  It does not cover layout.  The urethra runs through the prostate in every man, the airway crosses the food path in every human, and the testes descend through the body wall in every male fetus.  None of the sources proposes that the Fall rerouted a tube.  For layout, the design side has two honest options:  defend the present layout as good, or reconstruct an earlier one and show that it changed.  No creationist source read for this hub attempts the second, and none proposes an anatomical change behind the pain of Genesis 3:16.

Where the replies answer a claim the critic did not make

• The knee. Bergman's review of Lents says "no evidence exists of knee evolution in the abundant fossil record."²⁶ Lents claimed the knee tears too easily, not that its fossil history is known. Bergman's other answer, that "Almost all knee problems are due to body abuse, overuse, injury, or disease," relabels the failure Lents describes rather than disputing it.²⁶
• The larynx. Batten and Walker reply that "if our larynx was lower in our neck we might be less prone to choke, but we could not talk."⁶ The adult human larynx is already the low one, and the low position is what the speech account credits.¹⁸ The reply accepted the critic's reversed premise instead of correcting it.
• The missing redesign. Bergman writes that critics "have not proposed the details or any evidence of a functional better design."⁴ Olshansky and colleagues had drawn one seven years earlier and conceded its costs, the best evidence for Bergman's side, which his reply left out.
• The pelvis. Menton adds that the pelvis "would only need to be less than two inches wider."²² He gives no source. If the number were true, it would say a better pelvis is a small change, which is the critic's point.

The weakest reply is the one that refuses the test.  Guliuzza writes that "There is absolutely no need from the outset to ever concede that anything on creatures is poorly designed."⁵  A skeptic reads that as a verdict reached before the evidence, and is right to.

Part 4: The five systems, and the number that matters in each

Each preview gives the likely verdict of its child article.  The child articles will test these verdicts and may reverse them.

The Spine and the Cost of Standing Up

The complaint is that a four-legged "bridge that walks" was stood on end.¹  The cost is not in doubt.  In 2020, 619 million people had low back pain, and it remains "the leading cause of YLDs globally."⁸⁸  Part of that burden comes from how the back is used:  38.8% of the years lived with disability were attributed to occupational strain, smoking and high body mass.⁸  Daniel Lieberman of Harvard, no creationist, puts it more strongly:  "many people sit in chairs all day, get no exercise, and thus have weak backs."²⁷  Likely verdict:  a real and large cost, partly from use.  No priced alternative exists, because Olshansky's tilted torso has never been tested.  The child has to compare the spines of apes that do not stand upright, and test Lents's claim about the disks.

The Spine and the Cost of Standing Up tests Olshansky's tilted torso against measured disc pressures and finds it worse, and weighs the wild-ape gap against the Tsimane and knee-arthritis data.

Childbirth and the Obstetrical Dilemma

The complaint is a big head through a narrow pelvis.  The number is the maternal death rate before modern obstetrics:  10.5, 7.5 and 5.0 deaths per 1,000 live births in 13 English parishes across 1700 to 1850, or about 1 birth in 95 falling to 1 in 200.⁹²⁸  What killed those women matters more than the rate.  Geoffrey Chamberlain names "The Four Horsemen of Death in maternal mortality" as "puerperal pyrexia, haemorrhage, convulsions and illegal abortion."⁹  None of the four is a head stuck in the pelvis.  Irvine Loudon concluded that "the main determinant of maternal mortality was the overall standard of maternal care provided by birth attendants."²⁹  Likely verdict:  a real, tight fit and a real trade-off, but the size of the historical death toll tracked care more than anatomy.  Coyne's abdominal exit is unpriced and would reopen the hernia problem.  Bergman's claim that difficult birth is "rarely a problem" does not survive the parish records.²⁶

Childbirth and the Obstetrical Dilemma shows that obstructed labour caused a small share of historical maternal deaths and that the pelvic floor, not walking, limits the canal.

One Passage for Food and Air

The complaint is that air and food cross in the throat, so people choke.  The number is the lifetime odds of dying from choking on food in the United States:  1 in 2,367, from 2024 data.¹⁰  Choking killed 5,553 Americans in 2022, and "rates of death rose rapidly at about age 71."³⁰  For scale, the same table gives 1 in 1,025 for drowning and 1 in 89 for falls.  Likely verdict:  a true trade-off in which both sides have named the costs.  Olshansky's group conceded that separating the passages costs mouth breathing and speech.  The risk is small and concentrated in old age and disease, which is where the degeneration answer does apply.  The child must also correct the reversed larynx claim that both Lents and CMI repeat.

One Passage for Food and Air shows that the crossing is common to all mammals, prices each separated route, and finds that speech did not strictly require the low larynx.

The Urogenital Layout

The complaint is the vas deferens looping over the ureter, the urethra running through the prostate, and the testes descending through the groin.  The number is the lifetime risk of inguinal hernia repair:  "27% for men and 3% for women" in the Oxford record linkage study of 1976 to 1986.¹¹  Olshansky's group adds that the prostate enlarges "in one of every two males."²  Likely verdict:  this is the critics' strongest system.  The cost is large and measured, and the layout follows a developmental route that the historical argument explains.  The purposes are real:  Shubin himself counts sperm cooling among the "ample advantages."¹³  The design reply so far is weak:  van Niekerk's arithmetic assumes its result.  A microbiologist's remark that the birth canal's nearness to the gut "is probably better design than what it initially looks" is a lead, not a measurement.³¹

The Urogenital Layout finds that the vas deferens loop has no known medical cost, as George Williams, who raised it, conceded, so the measured cost sits in the groin hernia that follows the testes' route.

The Umbilical Cord

The complaint is that the cord is long enough to wrap the neck.  The number comes from 243,682 deliveries at one Israeli hospital:  14.1% had a cord around the neck, and perinatal mortality was 0.5% with it against 0.6% without.¹²  A 2017 review puts the frequency at "about 10–29% of fetuses" and says most are "not associated with perinatal morbidity and mortality."³²  Likely verdict:  the complaint fails on its premise.  A loose nuchal cord does not measurably harm.  The review notes that a tight cord can, so the child must separate the two and weigh the risks of a short cord.

The Umbilical Cord shows, from 856,300 Norwegian births, that short and long cords both raise perinatal death, so cord length is a trade-off, and that no named scholar makes this complaint.

Objections and responses

1. "Critics do not need a redesign to show a flaw." True, and the parent article says so. A measured failure rate is evidence of a cost. But "a designer would not have done this" claims that a better option existed. That claim needs the option. Four of the five systems have no costed option.
2. "The Fall explains every defect." Only defects that could change over time. Batten, Walker and Burgess apply it to aging, disease and genetic decay. Layout present in every embryo needs either a defence as good design or evidence of an earlier layout. Stretching it to cover layout without evidence makes it untestable.
3. "Good design refutes evolution, because evolution predicts bad design." Burgess argues this, but Darwin did not predict bad design throughout. Good performance is compatible with selection. A discriminating argument needs an observation the two accounts expect differently.
4. "These failures come after reproduction, so they are not design failures." That is Olshansky's own argument turned around. A design argument cannot set aside old-age failures without saying what the body was built for, and for how long. Burgess counts aging as decay, a claim about the original design that needs support.
5. "Human machines have the same trade-offs, so none of this counts." A trade-off answers a complaint only when both costs are named and compared. The throat meets that standard, because both sides have named speech against choking. The spine does not yet meet it on either side.
6. "Then history wins by default." No. All mammals give birth through the pelvis, and every land vertebrate's airway crosses the food path. A shared plan is what both common descent and a common designer would produce. The discriminating evidence lies in the developmental routes, such as the descent of the testes, and the child articles must weigh it case by case.

Issues and unanswered questions

• Nobody has priced Olshansky's human, and this hub did not either. Until someone models it, both "better" and "worse" are opinions.
• No creationist reconstruction of an earlier human layout exists. The degeneration answer is left covering only wear and disease. If the young-earth side holds that the Fall changed anatomy as well as physiology, it owes a proposal and evidence. If it does not, it has to defend the prostate, the groin and the throat as they are.
• The groin is the hardest case for the design side. A 27% lifetime risk of surgery in men is a large, measured cost. Shubin's "ample advantages" name the purpose, but no source read here shows that the route through the body wall was the only way to meet it.
• The historical maternal figures are estimates. Chamberlain's parish rates come from 13 parishes, and the share of deaths from obstructed labour before 1850 is not given in the sources read here.
• Several sources were read as abstracts only. These are Loudon 2000, Primatesta and Goldacre 1996, Masad and colleagues 2020, and the Nishimura papers. The numbers quoted are in the abstracts, but the methods were not checked.
• Lents says maternal death in childbirth is "unheard of" in wild apes.¹⁶ That claim was not checked here and belongs to the Childbirth child.

Verdict

The whole-body complaint began in 1951 as an argument that the upright human carries "scars" of a four-legged past, and it remains mainly that.  The design side should answer it as an argument for common descent, one developmental route at a time, instead of answering an engineering claim the critics rarely support.

As engineering, the complaint is unpriced.  The only whole-body redesign is "fanciful and incomplete" by its authors' own account.  The one alternative that has been measured, a wider pelvis, did not show the walking cost the critics predicted, though it may cost the pelvic floor.

Sorted by what the evidence shows:

• Trade-offs any build would face: the crossing of food and air, with speech on the other side of the scale; the size of the birth canal, with the pelvic floor on the other side; and probably cord length, pending the child.
• Evidence of history: the descent of the testes and the loop of the vas deferens. This is where the critics' case is strongest, and it is a question of common descent more than of design quality.
• No priced alternative: the spine, the abdominal birth exit, and every whole-body redesign.
• Where the design reply is weakest: the refusal to concede any flaw; the Fall applied to layout without a reconstruction; the reversed larynx; van Niekerk's arithmetic; and "rarely a problem" said of historical childbirth.

The body carries real costs:  619 million people with back pain, and one man in four facing a hernia operation.  A defence of design that cannot say what those costs buy has not yet answered the critics.

Sources