Genes are amazing! The amount of information they encode, processes and transmit is enormous.
There's a cell in the bone marrow that fractures itself and releases its parts into the blood flow and we call them platelets. Neurons can be as long as our extremities and deliver the materials from the core to the extremes using a very funny axoplasmic transportation at the incredible speed of a couple of centimeters/day, but the "electric system" runs at 100 mts/sec.
Going millions of years back in time we find that a primitive cell actually "ate" (phagocyte) a bacteria and made it "work" as the energy producer (the mitochondria), that has its own autonomous genome.
The process of evolution is really slow, the chances of error in the replication of the DNA is relatively low. But mutations do occur, and changes are visible (all forms of life follow the same basic rules, so far).
Eventually, homo sapiens appeared and with the ability to think and manipulate thing in an increasing complexity, stopped his own evolution (debateable). Through the discovery of diseases and treatments, humans are now able to continue living a relative "normal" life. Hypertension, cardiac diseases, diabetes, and many others, are "sustained" and passed down to the next generation. Actually, one of the most important questions a physician asks the patients is if they have a familiar history of one of the above.
The way I see it, humans have a couple of options:
1) Drugs: pharmacology (personally the most interesting thing in the universe) is advancing daily. Things that are coming and that we already have are pretty cool, the downside is the dependence that generates, and the power it gives to the pharmaceutic industry. I think this is the closest step, but there must be a way to assure that EVERYONE gets what he needs. Here I include the biological therapies, immunotherapy, and the use of monoclonal antibodies.
2) Stem cells: not approved yet, but they show potential. I don't think this would be a big problem.
3) Gene therapy: This is the one! In the near future, I'm pretty sure we're going to be able to change large portions of our own genome, targeting a specific group of cells (e.g. kidney, liver) or targeting germ cells (the whole organism). This opens the possibility to rearrange some physiological flaws, eradicate errors, incorporate functions and more. The cost might be the extinction of homo sapiens and the birth of multiple evolved species (e.g. tolerate changes in air, protection from radiation, infrared vision).
4) Deep Science-fiction.
So the questions are:
Should we do it?
And if the answer is yes, how could that achieve ethically?
In the future, I see myself studying mathematics to see if there is a way to put numbers to my physiologic concepts towards this end (suggestions, if any, are appreciated so I can start reading).