What Should We Fix and What Should We Leave Alone?

There's a though-provoking article over at Crooked Timber about the potential for mitigating the effects of Down's Syndrome and the accompanying discourse. Go, read it, come back.

Done? Good. So, Bérubé says

So yes, some things should be cured, and their cure would be an unambiguous species-wide good. Tay-Sachs disease, for example. Alzheimer’s. Perhaps Parkinson’s and Huntington’s, too. But Down syndrome and deafness aren’t anything like these.

It seems like his "cure/mitigate" and "don't cure/mitigate" buckets are pretty arbitrary. For example, both Down's syndrome and Alzheimer's deprive a person of their mental faculties and thus their autonomy¹. Deafness, on the other hand, leaves cognition intact; as Bérubé himself points out there are lots of situations where deafness is either irrelevant or an inconvenience. Frankly, and this is going to piss off a lot of people I'm sure, deafness is a lot more like cleft-palate than Down's. So, if we categorize diseases/syndrome/<insert your noun here> on the basis of the effect they have to the person, and regardless of whether or not we decide its appropriate to "fix" them, Alzheimer's and Down's should go in the same bucket.

What I'm getting at here is that it would help if Mr. Bérubé were more explicit in describing how he groups conditions together. It's pretty clear that he has some taxonomic principles in mind which guide not only which conditions are similar but also which, on a normative basis, should be remediated. His principles, however, are far from self-evident.

---

1 Recognizing that there's also a distinction between the two: Down's syndrome prevents the faculties from being developed whereas Alzheimer's degrades existing faculties. I don't see that distinction as being particularly relevant to the fix/don't fix debate, but I'm certainly willing to argue the point.