Abstract

Pre-natal genetic tests prompt questions about when, if ever, it is legitimate to choose against a potential life. Philip Kitcher has argued that test-based decisions should turn not on whether a potential life would have a disease (understood as dysfunction), but whether that life would be of low quality. I draw attention to difficulties with both parts of this argument, showing, first, that Kitcher ignores distinctions upon which the case for disease as dysfunction depends; and, second, that his analysis of quality of life tacitly, and controversially, links high quality to normal functioning. Kitcher's chief complaint about disease considerations-that they inappropriately privilege the functional goals of the body over the personal goals of the individual-turns out to bear much more directly upon quality-of-life considerations than disease considerations.