For citing purposes, please use the final version of this article: E. Malmqvist, "Reproductive choice, enhancement, and the moral continuum argument," Journal of Medicine and Philosophy 2014;39: 41-54.
Abstract:It is often argued that it does not matter morally whether biomedical interventions treat or prevent diseases or enhance non-disease traits; what matters is whether and how much they promote wellbeing. Therapy and enhancement both promote wellbeing, the argument goes, so they are not morally distinct but instead continuous. I provide three reasons why this argument should be rejected when it is applied to choices concerning the genetic make-up of future people. First, it rests on too simple a conception of the badness of disease. Second, it wrongly assumes that diseaseavoidance and enhancement can proceed with similar accuracy. Third, it overlooks that disease-avoidance tends to be more urgent than enhancement from the point of view of distributive justice. While none of these reasons establishes a firm therapy-enhancement distinction, they show that a continuum model is not an attractive alternative.