TenForward: Where Every Vulcan Knows Your Name

The iron price, or gold (pressed latinum)?

The Federation is inherently plural, and we see several different attitudes toward disability by different people throughout the series.

Geordi is blind from birth. No one holds it against the guy. He wears a prosthetic vision device called a VISOR which is kind of the vision equivalent of a modern cochlear implant, there's an implant in his brain that an external sensor device hooks to. It's not a perfect solution, it gives him headaches, but it allows him to see and function like a sighted person, he can even see outside of the visual spectrum. Several times throughout the series we see him working with his doctor to maintain and adjust his implant when it gives him problems. Several times we see glimpses of possible futures where he has swapped his VISOR for alternative treatment methods, and the canonical future seen in the films has him using implants in his eyes, or even seeing with natural eyes because of that one fountain of youth planet. Throughout the show, people mention other treatments he could be using, but for the run of TNG he prefers his VISOR, which his doctor provides continuous care for. We see him go to Dr. Crusher to have his VISOR worked on repeatedly throughout the show.

Worf was paralyzed in an accident once. A heavy thing fell on him and broke his spine. Klingon culture is extremely ablest and he struggles to stand being seen by his friends or family in this condition, he wants to kill himself rather than live like this. He begrudgingly allows the doctors to try a treatment but quickly deems it unacceptable, so they INVENT SPINAL CORD REPLACEMENT SURGERY for him so that he can continue living his life on his terms. "There's nothing for it, we're just gonna have to grow a new backbone and central nervous system for the man."

Riva, the mediator/diplomat from the episode "Loud as a Whisper," is deaf. In his words, "Born, and hope to die." He has no intention of having his deafness cured or worked around, viewing it as a trait of his noble family and as a practical asset. He usually communicates through a trio of translators, but when they are killed, instead of attempting to cure his deafness via technology or medicine, Picard says "Okay it's time for US to learn sign language so we can talk to this man." and Data picks it up the fastest and takes on the role of interpreter. Riva's mission is to bring two warring factions to the negotiating table, so he decides to use sign language as an exercise in learning to communicate with each other. Fun fact: The actor who played Riva is deaf in real life. He asked the producers of Star Trek to make an episode about deaf people and had a lot of creative input on the episode.

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If there is a through-line to how the Federation treats people with disabilities, it is to prioritize the patient's decisions. Geordi receives continuous care for his prosthetic vision. They fly in civilization's leading expert to do an experimental surgery on Worf. The conversation with Riva goes "We can-" "No thank you." "Okay."

As for this:

| Geordi...is actually able to save the entire crew specifically because he’s blind.

As Data points out in A Measure of a Man, though it would measurably improve a crewmember's ability to function because he could see a wider range of the EM spectrum, the Federation does not force members of Starfleet to replace their natural eyes with cybernetic implants.

This is also set in a universe full of sentient aliens with all different kinds of physical abilities and senses. Several species are empathic or telepathic able to sense and/or transmit their own emotions and thoughts. No humans can do that. Again in Measure of a Man, Picard hand waves off a demonstration of Data bending an unbendable girder because "Several sentient alien species possess mega strength." There's one episode with aliens that have a kind of solar powered heat ray thing (the plot required the aliens to be able to take hostages and they needed a weapon that Lt. Yar couldn't confiscate). In a society made up of multiple sentient species that evolved with vastly different physical abilities, I think your whole concept of "handicapped" or "disabled" needs to shift.

In the episodes of TNG that look at their near future, Geordi has his eyes fixed, or at least has realistic implants that allow him to see normally. Why would he do it if there's no point? Is he stupid?

save the entire crew specifically because he’s blind

so you take away a persons autonomy to have the potential to be able to see and live a life with natural sight as you see a use for it.

You did a 360 there on the ethics and wandered into utilitarian territory reducing people to things.

You might not define it as a disability but it’s still taking autonomy from someone. They could just as well invent a tool to help save the crew. There is more than one option for things such as that rather than reducing a persons entire definition to their difference and how useful it is to you.

Human condition is more than their differences or their use to you.

A major Geordi character arc revolves around his eyesight. Yes, his prosthesis affords him additional abilities and allows him full function, but that says nothing of the otherness he has felt and psychological impact of being different throughout his whole childhood, and the challenges he faced for acceptance, even within StarFleet.

To dismiss his personal struggles while assuming that he's fulfilled and would OPT to not have regular eyes is incredibly arrogant and ablest, no? It is also deeply lacking in awareness and consideration of psychology, which is pretty bang-on for Boomers of the era that STTNG came out. "Oh, well looking at the END RESULT, he turned out fine, despite his massive trauma."

The likelihood is that he did not turn out fine, we just don't see the granular details of his psyche, on screen.

It doesn't really seem like in either situation I described that the treatment-enhancement gap has been breached.

There is no PGD, we are considering Star Trek levels of scanning technology. Both situations resulted from natural fertilisation, there was no group of potentials to select from.

The goal of eugenics, is unambiguously, to breed for some ideal. This resulted in some pretty dark times in the recent past.

Realistically, a lot of medical technology today is the antithesis of the eugenic ideal. Allowing those, who in the past, would have died from various causes to live. We at a species are the stronger for it.

I am aware of that sentiment and consequently find it selfish and ethically objectionable. While I understand that a special bond is formed this way, that happens anyway between halfway decent parents and their offspring because they love each other.

That is not a good enough reason to deny your child one of its senses.