But couldn't the same questions be asked about traditional medicine? If we successfully treat various types of cancer (which we do), could we be interfering with a larger beneficial process? We'll know when we know, right?

well it's difficult to say.

Generally speakin, cancer of any kind is seen to be lethal if untreated. And thus detrimental not only to the individual but to their children if they pass on these faulty genes.

But not all diseases are created equally. And not all diseases are as lethal as cancer nor inhibit reproduction or prosperity as much as cancer does.

What may reduce ones life expectancy today may very well encourage survival tomorrow when the environment/living conditions change.

For example, fair skin improves vitamin D synthesis but also increases melanoma risk. If the world were to get more hazy/cloudy or darker, then fair skin would be an advantage. However if the world were to get more exposed to UV, I don't know say maybe because of ozone depletion, then being light skinned would be detrimental.

In such cases, light skin may approach being a "disease state" if the majority of fair skinned people get melanoma. By mere risk or association of the 2 conditions.

Likewise dark skin could become more detrimental if there is a deficiency of vitamin D synthesis in a darker world.

Our diseases reflect the environment.
When the environment changes, so too does our consideration of what is disease = that which diminishes our survival in a given set of conditions
.

Genetic disease is an important topic, as is their control, so let's focus on genetically caused disease. Heliobacter pylori are bacteria, not a genetic disease. Cancer has a genetic component (certain types of breast cancer, for instance) but some cancers either do or may have environmental causes (viruses, chemicals, radiation, etc.) Cycle Cell Disease is a genetic disease. (It's not a sure-fire protection against malaria). Having fair skin isn't a disease either, and if Northern Europeans had stayed put (and not taken up residence as far south as Texas or even Minnesota) they wouldn't have sun-related problem.

Some genetic diseases of various kinds:

Down syndrome (Trisomy 21).
FragileX syndrome.
Klinefelter syndrome.
Triple-X syndrome.
Turner syndrome.
Late-onset Alzheimer’s disease.
Arthritis
Autism spectrum disorder, in most cases.
Coronary artery disease
Diabetes
Migraine headaches
Spina bifida
Isolated congenital heart defects
Cystic fibrosis
Deafness that’s present at birth (congenital)
Duchenne muscular dystrophy
Familial hypercholesterolemia, a type of high cholesterol disease
Hemochromatosis (iron overload)
Neurofibromatosis type 1 (NF1)
Sickle cell disease
Tay-Sachs disease

and more!

So, a lot of suffering is caused by genetic disease, for sure, just as genetics prevent some diseases -- a lot of people do not get cancer despite risk factors. Some, not a large number, are resistant to HIV thanks to a genetic variation that protected some northern Europeans from the Black Plague 600 years ago,

If we could, should we make genetic changes in the human genome to prevent these disease?

One big problem is that while the number of people suffering from serious genetic diseases isn't huge, the number of people who carry the genes which, in combination may cause genetic disease is very large -- about 1.6 billion people (20% of the population).

Genetic testing can identify some potential diseases that parents might pass on to children. how far do we go in preventing them from then having children anyway?

One thing I'd change is your opening question. Molecular biology, gene therapy, genetics and such aren't the same as Eugenics. I think this link goes over Eugenics well enough in differentiating between the racist social movement, and questions of bioethics.

For myself, I tend to believe in a non-hierarchical medical model. So a lot of these questions would be answered by informed consent. There wouldn't be a line to draw in the sand as much as everyone would have to draw their own line.

This topic reminds me of the skeptical theism response to the evidential problem of evil: "We're just not in a position to be able to say that what appears to be gratuitous suffering in fact is..." But that is all we ever do in medicine: to try to eliminate suffering without truly knowing that if in the long run we'll do more harm than good. What's the alternative? Not try to eliminate diseases?

We can either sit back and do nothing citing our lack of omniscience, or do things that we intend to have good consequences but can possibly have bad consequences, and learn as we go. I prefer the latter option.

A complicating issue is how 'we' distribute medical help. In practice there is already rationing by society and cost of types of treatment, and the technological advances enabling gene-based treatment are likely to be very costly per person. So at the one-to-one level 'we' may take each case on its merits, but in broader terms 'we' don't.

With gene manipulation just like there is a chance to cause undesired effects so is there a chance to cause desired ones.

Whether that's good or not then boils down to the study of the results.
The bigger "issue makers" are those taking ethics into the matter though rather than those postulating about positive or negative side effects.

How many diseases ought we medically challenge? And how many are covert beneficiaries to our future, which ones are merely adaptations that are becoming more advantageous with time? — Benj96

There is no way to know; no way to see that far down any road - assuming the road even continues beyond the next bend. We don't plan progress in any field of human endeavour; we respond to perceived present threats, current problems. We bandaid and fire-fight as best we can at any given moment. It's up to the future to take care of itself.

Most likely the law of supply and demand will dictate the future of medical research and treatment. Prudence would dictate extreme caution with respect to genetic modifications. But if the desire and dollars are there, research and treatment will probably be leaps and bounds ahead of regulation.

I think a start is to look at the costs to society for an individual with the disease. Autism at a lower spectrum could honestly just be considered a personality difference. But one can be autistic to the point of needing a constant care giver for basic needs. That's an immense cost to society where it takes two individuals to have the contribution of one.

Being born without basic functioning physical attributes creates unnecessary stress and cost to society. If one could prevent a child from being born blind, why not? A blind person is a higher cost which holds the full potential of an individual back.

Any time there is a defect of some sort, society bears the cost. Of course those with defects do their best to fit in and not be a burden on society, but its still a burden. It could be argued that people with these burden's can contribute to society in a unique way. Would Steven Hawking have been the brilliant man that he is without his impairment? Maybe, maybe not. All I know is there are lots of brilliant people walking around normally who didn't have to suffer like he did.

I'm a disgenicist. I acknowledge that entropy will sooner or later decay and breakdown even a population of good stock. A eugenicist is really an idealist who is just antagonized by imperfection, just as certain other types are antagonized by irrationality. Disgenics does not encourage the propogation of disease and disability, but just acknowledges in a laissez faire casualness that entropy is the nature of things, and that it has a useful function of provoking those who are triggered by degeneracy. A disgenecist is opposed to this type. If I envision two societies, a eugenic one that allows no disability and a disgenic one that allows it, I would imagine that both societies would have a large number of healthy people, but the disgenic realist society would be less likely to believe they are the masters and become domineering etc. in war/ conflict.

Interesting thoughts.

entropy is the nature of things, — introbert

Is it though? I mean, the continuity of life - "the living status" for the last 3.7 billion years begs to differ.
I understand that it operates within entropy in the sense it depends on the sun and the sun eventually decays.

But I mean for literally just over 1/4 of the entire existence of the universe, no small fraction at all. Life has consistently avoided total anhillation through at least 7 mass extinctions and shows no signs of being stopped going into the future.

As I see it, life is the very refusal to disassemble on command of surrounding chaos. It's one big middle finger to entropy, it's opponent, that has been around for at least 1/4th if time so far. And that's just life as we know it to be, not the spontaneous organisation of systems and chemistry that preceded it, that set the stage. That organisation process could go back much further.

If entropy is the diffusion/dispersal of energy, then what might we say if gravity which quite literally does the opposite, the aggregation and condensation of matter (also energy) into stable and orderly cycles. Pressure that insulates a planet and traps solar energy like a thermos, keeping available to the biosphere for as long as possible.

And knowing there are trillions of solar systems. Knowing that life may not always be organic, or so frail, knowing life as we know it is literally adapting to space conditions though technology, who is to say it doesn't spread outward like entropy does, to oppose it elsewhere, to not be limited by the lifespan of any one sun.

It could possibly fight entropy until the bitter end. Because at the end of the day. Things operate in opposites, dichotomies. And the opposite to chaos is creation. The opposite to disorder or order.

I think we need to reevaluate our relationship with entropy. No human has made a perpetual motion machine. But so far the most perpetual motion machine is 3.7 years old and going strong.

The "Eu-gene" of eugenics, the "good replicator" in that sense is the one that rallies the troops in the face of adversity. If life starts to struggle, the force vitale finds a way through change and adaptation to defer being destroyed. That is an intelligent dynamic, an awareness and response to the environment that permeates all of life.

How many diseases ought we medically challenge? And how many are covert beneficiaries to our future, which ones are merely adaptations that are becoming more advantageous with time? — Benj96

Some great people have risen out of harsh conditions of oppression and poverty. By combating these ills of society, we rob society of the great people these conditions would have developed. Seems similar, and in both cases - I think we should do what we can to help eliminate or reduce suffering. I could draw the line with disorders like autism, as you mention.

I rather live with someone who doesn't mind a little mess, than someone who is strict about keeping the room perfectly clean.

That was a little curt, but there is more to look at about eugenics than entropy. Eugenics is a pastoralism. It is a tendency of people with certain kinds of knowledge to try to control and improve the flock. The way it is controlled and the way it is improved is indeterminant in that there is no single way that it can be done. One pastoralist might want a flock of selfish individuals, another of other interested. Desiring machines of different kinds. A machine is a part as well as whole. If these are the only two desires to know self or to know others, both create a body with a kind of health and sickness. The eugenecist will try to make more eugenicist people who desire only fitness, functional parts of a schematic environment that determines what is fit. The disgenecist acknowledges the nature of decay, disorganization and conflict in the cosmos. It is a rational idealism thinking positive about a progressive plan against negativity. The negativity is a real aspect of the cosmos that will not change despite any scientific plans to the contrary. It is a complex area.

I rather live with someone who doesn't mind a little mess, than someone who is strict about keeping the room perfectly clean. — introbert

Haha well life does live with something a little messy - the universe. Life tries to cleans it up and tidy and this is reflected in the life's sustaining implementations of the body - all those little immune cells tireless munching on debris, killing off chaotic oopsies (cancers and other dysfunctional cells). Our body is a finely tuned society, conglomerate of cells. All cooperating. And when they cooperate in harmony, we are balanced and healthy individuals.

Even human society reflects this innate "housekeeping" or homeostasis - such as social health etiquette, hygiene, as well as laws, and policies regulations. And just like the body, it's a constant effort to uphold and mistakes invariably happen.

However life enjoys the benefits of a bit of chaos too. The accidental benefits, the happy mistakes/mutations. Societal innovation too often occurs though accidental discoveries.

. Eugenics is a pastoralism. It is a tendency of people with certain kinds of knowledge to try to control and improve the flock. — introbert

Eugenics has a bad rap for sure thanks to a certain German facist dictators ideals. However the ideal to foster a healthier population by itself is not inherently bad. What's bad is what one assumes and how they go about it.
Gene therapy and medical frontiers are also based on identifying bad genes and good genes alike but do not dangerously presuppose any ethnicity or variant of human condition is to blame, nor is superior to any other.

I agree with you that the natural chaos isnt going anywhere soon. We cannot erase and we shouldn't. But that doesn't mean one must sit around idly and let it happen to the greatest degree. That's a sit down and rot attitude. If that were the case, why bother with antibiotics or hygiene or medical interventions of any kind.

We are unique as a form of life in that we have knowledge that goes beyond simple survival instinct. We can innovate and we can revolutionise our place in nature. We know enough about how it works to do that and have been doing so since the advent of civilisation itself.

I see what you mean and I agree. There is certainly a balance to be had between the desire to control our circumstances and the trust/faith in the ecosystem already established to confer us with natural growth and resilience.

Trying to control things by being highly selective and rigid is exclusionary and suppresses diversity. On the other hand, excessive disorder and zero attempt at control undermines our ability to empower ourselves though knowledge and use that knowledge to adapt and benefit one another.

I'm just talking about eugenics. It's the slipperiest slope.

"eugenics has a bad rap due to a certain fascist dictator's ideals

There are certain constructions that set the postwar understanding of social-political phenonenon back on a gradual trajectory to rebuilding the failure of germanic idealism. Blaming individual for collective failures, conceptualuzing country borders as political reality when political reality is a pointilism of different colors that are borderless, for example yellow-red dots everywhere from germany to GB to canada and usa and south africa, denying words like 'reification' of ideology which a german would have easily understood: a car, or a person with racial logic ie an aryan. Denying the word allowed the project to continue. There is so much that was constructed and demolished that one has to suspect the laying of new cornerstones.

There is also the question of the well-being of the individual versus the well-being of the species. Diseases can also be the product of an interaction between a species population and an environment. In the case of severe overpopulation, diseases can proliferate. Have you considered the possibility that some disease may be instructive from this perspective, not so much to require a cure as a response?