Dissolving Distinctions: Is there a difference between gene editing for treatment and for enhancement?

In this paper, Tess Johnson makes a novel, thoroughgoing argument against the treatment/enhancement distinction in gene editing and its relatives, by framing human genome editing (HGE) (whether for treatment or enhancement purposes) as a public health intervention. The treatment/enhancement distinction is one of a number of arguments that commonly draw lines between what constitutes a morally permissible (or desirable) use of HGE—treating disease, and what constitutes morally impermissible (or undesirable) use—enhancing traits. The distinction is commonly objected to using counter-examples of interventions that we intuitively find permissible or desirable, but that constitute enhancement, such as coffee-drinking, education or vaccination. However, advocates of the distinction reject these counterexamples, or accept them only as exceptions to a general rule.

Tess Johnson argues that, although medical interventions are more limited to treatment purposes, interventions for public health rest on broad definitions of wellbeing and improvement that by no means draw a line between treatment and enhancement. If HGE is legitimately framed as a public health intervention, then it, too, should not be divided into im/permissible or un/desirable uses based on whether the editing is for treatment or enhancement purposes.

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