Drawing Lines between Extremes: Medical Enhancement and Eugenics

Mary B. Mahowald, University of Chicago

Many variables are ethically relevant to the assessment of medical interventions. While considering these variables in the context of genetics, it is helpful to distinguish between interventions that are clearly therapeutic and those that are clearly enhancing, and between "bad eugenics" and "good eugenics"—as descriptive of the outcome or intention of interventions. Both distinctions allow us to draw lines between clear extremes of permissibility and impermissibility. Examining how key features of the extreme positions relate to issues that lie between them facilitates resolution of conflicts that arise in human genetics. In this article, I identify these features and track their emergence in issues that arise between the extremes. Although this strategy cannot lead to definitive resolution of ethical disputes without agreement about the meanings of key terms and consideration of all of the morally relevant variables, it moves the analysis in that direction more effectively than other strategies.