This is a conundrum often discussed in media wrt to treatment of "ill" people, i.e. should doctors medicate people who refuse lifestyle changes. Should obese people get diabetes medication? Should fat people get cholesterol and BP medication? Should mentally ill people get psych drugs if they continue living in a destructive manner? Should a bandaid ever be used? We know metabolic and cardiovascular diseases are caused to a large degree by lifestyle. But MOST of the time a lifestyle change is not forthcoming.And a life of insulin should be a last resort for diabetes after someone has tried to change their lifestyle in my opinion. Diet, physical activity, the things we know and all have said many times cause health problems.
I don't have the answer. A lot of people think incorrigible people should be left to die off, they are natural born losers who will contribute nothing. Let fat people die, let the mentally ill die, let the junkies die. Perhaps even assist them in dying. Gas the severely mentally and physically handicapped. This is what Hitler did for a while, but it didn't fly with the German population and he reversed the policies.
Should ADHD children ever be medicated or should we accept that they are still within the spectrum of naturally occurring human variations and perhaps only help them find a place in society where they can somehow fit, but no drugs? In Switzerland and Holland etc they help people living in various types of irreversible states of pain to kill themselves. The ethics of this is constantly debated.
Anyway, these issues ARE discussed a lot but in my mind there's no easy solutions.