An important part of the orientation for those new to thinking about enhancement ethics is the ways in which current debates are shaped by the history of earlier efforts at perfecting people. At one level, perfectionist and meliorist impulses have deep roots in Western philosophical and religious thinking, which both modern science and medicine have inherited (Keenan 1999; Comfort 2012). Most advocates and critics of biomedical enhancement share these cultural commitments, but have disagreeing visions of the ideal (Roduit, Baumann, and Heilinger 2013; Parens, 2005).  Other scholars, recalling the historical imposition of hegemonic religious and political visions of salvation and citizenship, fear the elevation of any canonical account of existing human virtues, in favor of visions that prize people’s capacity to shape their own ideals through reason, autonomy, and democratic deliberation (Sparrow, 2014; Buchanan 2011). Others, pointing to the consequences of modern individualism for the common good (Persson and Savelescu 2012), feel confident about being able to name the constellation of existing human traits that should either be preserved (Kass 1997; Annas 1998; Agar, 2013) or enhanced (Bostrom 2003). However, almost no one in this literature eschews the development and use of new medical tools for healing purposes (Kamm 2005; Kass 2003). Because of this, a first step in our discussion is to scrutinize the distinction between treatment and enhancement, to see if it can help demarcate where different melioristic ideals diverge.