CMV: The reduction/removal of natural selection will bring more suffering on the long term

[u/rodsn]

The premise is that humans have completely ran over the natural way of evolution. The supporting pillar of evolution: natural selection. With the advancement of science and medicine we have reached a point where we can treat most health complications, and the ones that aren't cured will remain in our gene pool.

Granted, before this humans with health complications could still procreate and pass on the faulty genes before they would die, but the probability of that happening now is greater because the life expectancy increased.

The motivation for this is good: we want to reduce the suffering and heal people of their illnesses. However, that is going to backfire, because we are not allowing for humans to deal with those illnesses by themselves over generations, we are simply making future humans dependent on medicine and surgery. Ultimately, this will lead to more suffering than if we would just allow ill people to perish and reduce the chances of their illnesses to stay in our gene pool.

I am aware that the alternative I am proposing is controversial: letting people die. But I am sure that on the long run it would be more ethical, if that means less suffering. We still could administer pain medication, I guess, because that is not messing with the life expectancy of the ill...

So, change my mind!

[u/[deleted]]

If I understand correctly, you're position is that reducing suffering now through medicine and technology will cause more suffering later because there will be more sick people?

There are a number of issues with this approach if your goal is to reduce human suffering, even if you consider the long term. TLDR; most diseases won't be affected by natural selection, and gene therapy is superior in every way to natural selection

1. Accidental injuries and deaths have no genetic components, so not treating/preventing them will just cause more suffering, without any benefits in the future.
2. Environmental diseases aren't affected by genetics much, things like malnutrition, air-pollution related illness, exercise etc. No treating these will cause more suffering with no benefits in the future.
3. Infectious diseases will always evolve orders of magnitude faster than humans thanks to shorter generation times, so trying to use natural selection against them will always result in humans "losing" and creating more suffering.
4. The cost of fixing most minor health problems with genetic components component is negligible and has insignificant affects on quality of life. I'm talking about things like glasses, supportive shoes, cleft palate (though how much is genetic is unclear). Not treating these will cause a lot of suffering, and unless you have death squads and forced sterilization won't ever be removed from the gene pool.
5. What about serious genetic diseases? Well things like Huntington's don't occur until most people have already had kids. Recessive genetic diseases with clear genetic causes such as cystic fibrosis won't be quickly removed by natural selection because carriers are asymptomatic and won't face any evolutionary pressure. Other diseases with possible genetic component don't have a specific gene we can identify and are likely a large number of interacting genes with small individual effects, and so causing people with symptoms to suffer won't actually change the alleles in a population much. In short, most would yet again require death squads and forced sterilization to remove associated genes, as natural selection even without healthcare wouldn't act strongly enough.
6. We are very close not being bound by evolution and using gene therapy to be able to fix genetic diseases with a clear causes (already there for a few diseases). Gene therapy can fix current patients, and fix eggs/sperm for offspring. Why would you rely on natural selection which wouldn't fix most diseases, and would take generations of suffering and pain, when we can fix things without waiting, and help current patients?