How an intervention is categorized largely determines how accessible it is to all who wish to use it. If an intervention is categorized as an enhancement, it will probably not be thought to satisfy the therapeutic goals of medicine and, hence, will not be a reimbursable service. There is an individual therapy-enhancement matter that each physician will decide for himself and herself, and the question is not limited to genetics. Each individual physician must interpret the goals of medicine and the appropriate use of his or her education and skills in fulfilling those goals. Either of these physician may, on the other hand, decide to prescribe growth hormone for a young boy who does not have growth hormone deficiency, but whose parents are both short and whose adult height will place him well below normal range for his sex.
Many factors enter into the decision.
If I don't do it someone else will. Every physician has entered into a covenant with society to apply his or her skills and judgment in the patient's best interest. If the physician and patient disagree, the physician must act as professional ethics and the profession's covenant with society direct. The specific issues are philosophical questions about which thinking people disagree. Professional judgment and integrity form the ethical framework for deliberating them.