chapter  13
16 Pages

Professionalism in public health medicine and policy

The challenge of enhancement
ByAlex McKeown

Prevention aims to ensure ill-health does not occur, and these changes are likely to make it increasingly normal to receive care while still healthy. As a result, an increasing proportion of healthcare provision will be directed to optimising a healthy lifespan, rather than battling disease after it occurs. The changing nature of public health, therefore, may propagate an era in which enhancement plays a growing role, since the enhancement of normal health and functioning will deliver the goal of preventing illness and postponing death. Enhancement is often contraposed' to therapy, which has historically been a more pressing goal of public health. Although theoretical definitions of enhancement are numerous, they can be summarised broadly as meaning to go beyond normal' health and/or functioning. Understood simply, to enhance means to improve, and there is, therefore, an inescapable conceptual connection between the two.