ABSTRACT: Determining the correct goals of medicine plays an important role in many healthcare debates. For example, some argue that genetic enhancement is a justified goal of medicine, while others claim that health care should focus on therapeutic treatments only. On my account, autonomy gets priority over other goals. This means that, for patients who have capacity, the primary goal of medicine is to promote their values. I defend this view, first, by showing that physicians already perform many forms of treatment that align with this account, and, since these treatments are defensible, consistency demands treating other cases the same. Second, I argue that the most plausible version of the welfare condition—which poses the biggest threat to giving priority to autonomy—is either otiose or collapses into the autonomy condition. I then explain how this account gives guidance in controversial cases. On this view, enhancement is ethically permissible, but there are restrictions.

BIO: Eric Mathison is a postdoctoral fellow at Baylor College of Medicine, where he is a researcher and clinical ethics consultant. He has a PhD in philosophy from the University of Toronto.

RESPONDENT: Shirley Tilghman, President of the University, Emeritus; Professor of Molecular Biology and Public Affairs