Yet, ethicists say, churches are ill prepared to provide them. Disease in such a future would no longer be a problem that cuts across economic lines. Rather, like quality of schools and housing, its presence or absence would be, far more than at present, another criterion that defines economic groups. As a forerunner of the ambiguity that lies ahead, critics point to the relatively widespread use of a growth hormone. Initially developed as a treatment for dwarfism, a rare condition that afflicts some 7,000 children, critics contend that pharmaceutical companies have created a lucrative market by successfully promoting the drug as a muscle builder and, even more problematically, as a way of adding a couple of inches of height to children whose growth falls within the normal range.
Companies deny that they have inappropriately marketed the drug.
Yet, it has been prescribed for some 20,000 children, putting it among the nation's 50 best-selling drugs. In America, where height is statistically related to success, some ethicists worry that otherwise normal degrees of shortness are subtly being redefined as disease. The advent of genetically engineered characteristics and talents is almost sure to raise the ante on what parents might reasonably be expected to provide. What lies ahead, ethicists fear, is an increasingly fuzzy line between therapy and enhancement, and a search for medical solutions to social problems. Parens, who edited the book, is associate for philosophical studies at the Hastings Center.