[Mrs. Don-o]

My point is that the ethical practice of medicine is to restore (or attempt to restore, or promote) optimal health. That means, to heal injuries, to cure diseases, to strengthen weakened functions, etc.

Fatigue and pain are suboptimal states; they signal a degree of exhaustion or a reaction to damage. That's why using painkillers, etc. is ethical. Fertility, on the other hand, is an aspect of normal sexual health. It is not legitimate to deliberately attack or vitiate a healthy system. Whatever else that may be, it's not healthcare.

[steve-b]

Nope. Your use of "suboptimal" makes your argument circular.