The concept of ‘normalcy’ has tremendous power in the domain of medicine: both in theoretical discourse over health, health care & ethical analyses of biomedical technology, and in health care practice and policy decisions over what treatments should be provided and prioritised. For example, in discussions of human enhancement technologies, the putative distinction between therapy (often thought of as restoring a ‘normal’ state of health) and enhancement (increasing function beyond the ‘normal’) has assumed a perhaps-disproportionate moral significance. This same supposed benchmark of normalcy plays a key role in definitions of disease / disability that are used to create a hierarchy of value in determining which treatments are most worthwhile. But ought this to be the case? The consequences of importing, wholesale, a particular account of normalcy as a source of normativity into our ethical assessments of biotechnology and health care provision can be positively unethical.

This paper seeks to undertake a critical analysis of the influence of this ‘healthism’ on the ethical discourse surrounding health care and new biotechnologies. Considering a number of examples, I argue that the often-unquestioned normativity of health imposes constraints on access to medical technologies that are frequently unwarranted, and should be explicitly revealed and challenged.