On the other hand, disease-based accounts also face at least two major difficulties. The first is one they share with the Professional Domain account: the problem of biomedicine’s infamous nosological elasticity. It is not hard to coin new maladies for the purposes of justifying the use of enhancement interventions (Carey, Melvin and Ranney 2008). Unless some specific (and usually contentious) theory of disease is employed to give this approach its teeth, it puts the power for drawing the boundary back into the profession’s hands, and raises the same worries about the social consequences of medicalization (Parens 2013).