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Arguments rely on premises preferably already accepted by an audience in order to establish a conclusion not previously accepted by them. Authors and commentators regularly rely on basic statements as premises---basic because they are presumed to need no further argumentation. Regardless of whether or why they actually (metaphysically) need no justification, it is the case that the audience's perception that they need no justification or explanation is sufficient to make them rhetorically basic.

If a person argues for immunizations, the claim that lives will be saved contains a basic presumption---that it is better to save lives than to lose them.

But some rhetorically basic statements are hardly as transparent as they appear. One such statement incorporates the goal of a healthier population; that is, the presumption that it is better to have a healthier population than not to have a healthier population.

For example, take the claim that prenatal screening and testing for, say, Down's Syndrome, helps to promote a healthier population. A healthier population is a good thing. So obviously prenatal screening for Down's Syndrome is a good thing.

The argument appears sound to a casual listener. It appears sound to the vast majority of people in the Western World.

But there is a problem with the "basic" claim that a healthier population is a good thing. The idea of a healthier population is unclear. Actually, it's quite clearly ambiguous, with at least two meanings, the confusion of which allows a horrific idea to appear morally laudable.

For casual listeners, "a healthier population" means simply that more people in the same population are healthy. If the original population is 100, and only 30 are originally healthy, the population becomes healthier if somewhere between 31 and 100 of the original 100 are healthy in the end. The conclusion that a public health action is morally laudable on the basis of a healthier population depends on this interpretation.

But there is an alternative interpretation. It is also possible to use the phrase "a healthier population" to refer strictly to an improvement in the percentage of healthy people in a population. Certainly the percentage of healthy people in the population example mentioned above improves. But so does the absolute number of healthy people. In the example above, there are more healthy people after the action than before. But in this case, where percentage alone is taken into account, the absolute number becomes unimportant.

What difference does that make? A profound one. Again, take the case of a population of 100 with only 30 healthy people originally. But in this case, simply eliminate any number of the unhealthy people in the population, while maintaining all the originally healthy people. By eliminating 40 of the originally unhealthy people from the population, the percentage of healthy people in the population improves by 20% or by 66%, depending on which statistical approach is used. Simply put, by eliminating 40 unhealthy people, circumstances arrive where 50% of the population is now healthy. Of course, there are only 60 people in the population now. And there are still only 30 healthy people---no more than before the action was taken to eliminate unhealthy people. But there is now a "healthier population."

Arguments will continue to be made that there should be more substantial Cystic Fibrosis screening, or more prenatal tests for Down's Syndrome, or more freely available abortion options. But no morally responsible audience should allow such an ambiguous use of a healthier population to stand as a basic premise in such arguments.

Eliminating children with Down's Syndrome before they are born does make for a healthier population---percentage-wise. But it makes no one in the population healthier.

If virtue is a healthy attribute in a population, then any population willing to accept such an "improvement" in its health is much sicker than it thinks it is.