> The fitness functions that nature comes up with are pretty arbitrary, and don't necessarily align with cultural ideas about merit, fitness or attractiveness.

nature's fitness is not arbitrary. it's about survival. culturally accepted fitness is arbitrary or linked to a particular evolution era. nature is constantly evolving, so what's fit in this era is not fit in the next.

> the millions of children who don't pointlessly die of infant diarrhea each year would probably push back a bit

I didn't say I don't like medicine. I do and do visit doctors. My main point was about freedom restrictions and how people should have free will to decide.