Drug-Centered Care and Quality of Life
The distinction between treatment and enhancement may not be very clear. Indeed, as John Harris remarks:
[t]he overwhelming moral imperative for both therapy and enhancement is to prevent harm and confer benefit. Bathed in that moral light it is unimportant whether the protection or benefit conferred is classified as enhancement or improvement, protection or therapy. (John Harris, quoted in Bostrom and Savulescu 2009: 7)
Looked at in this way, we might decide to focus on quality of life rather than health or enhancement as the relevant measure or status in determining whether a drug or other treatment is beneficial.
Healthcare providers cannot be charged with preventing harms and conferring benefits in all aspects of life; their duties are limited to addressing health-related harms and benefits. Clearly, however, there are health-related interventions that can promote quality of life. Some of these would count as healthcare under any view; others will be health-related only in the sense that they draw on skills characteristic of healthcare providers or affect functions that can also be affected in different ways by healthcare or by disease. Teeth whitening, removal of benign moles, and certain ways of enhancing cardiovascular fitness may be health-related quality of life interventions. As with enhancement, the availability of a drug to improve quality of life in one area may reasonably drive a decision to take that drug.