D&D 5E Disease immunity etcetera vs. non-communicable disease

[Nevvur]

Most fantasy settings assume an earth-like setting except where explicitly mentioned, and Earth has a huge variety of genetic diseases. It stands to reason, then, that most fantasy settings have these conditions, too, even if they don't come up in the narrative often.

Aside from the choice of word 'disease,' and in some cases specific symptoms, there's not a lot in common between inherited and communicable diseases. To point, I think they're generally classified as "genetic disorders" rather than "genetic diseases" these days, though some still wear the word (e.g. Tay-Sachs disease).

For spells and feature which cure disease or provide immunity to it, I feel the RAI is to only affect communicable disease. Still, an argument could be made to include inherited disorders.

1) What's your take? Personally, I'm comfortable omitting them from the types of conditions those spells/features affect, but I also see the potential for interesting story elements the other way. For example, a character that comes from a long family line of paladins whose forebear started the tradition in part to combat his sickle cell anemia.

2) Assuming you don't allow disease immunity/lesser restoration to remove genetic disorders, is there any magic that can (short of Wish, which I assume most DMs would approve). How about Heal? It's a 6th level spell, techincally more powerful than bringing a person back to life! Surely it can fix a few errant chromosomes? Could the beneficiary of such an effect change in appearance if their disorder caused obvious physical abnormalities (Down's Syndrome)?

 

[The Crimson Binome]

My go-to cure-all for all types of corporeal maladies is Reincarnation. It even cures old age!

 

[Cap'n Kobold]

Since genetic disorders aren't actually diseases caused by outside corruption, but are a function of a person's natural body, I would generally say that spells such as cure disease or effects like disease immunity wouldn't affect them.
I'd represent them by a character's ability scores: for example a low Constitution, rather than by the disease mechanics in the DMG.

It may well be worth pointing out that at the tech level of most D&D settings, there will be less genetic disorders around than today, since they'll be more likely to be edited out of the gene pool.

 

[LordEntrails]

There is already precedence of some diseases not being healed by lesser restoration etc. Why not just go with specific exceptions and say certain "diseases" require heal, or a special ritual or whatever?

Also, it's kind of a given that Player Characters don't have anything "wrong" with them without player approval (at least in 5E). Since genetic diseases are not obtained via an infection, it would be up to the player to say "My character has this genetic disorder and magic doesn't cure it."

So, imo, communicable diseases are the only ones that matter in terms of RAW.

 

[Sunseeker]

I think putting these things in the game adds a level of science D&D is not equipped to handle. And it's worth pointing out that many genetic disorders are incredibly debilitating and in a psuedo-medieval society usually lead to someone not living a long life.

 

[Nevvur]

So, imo, communicable diseases are the only ones that matter in terms of RAW.

For PCs sure, but NPCs? It would be inconvenient if, for instance, a plot point evolved around an NPC's genetic disorder, and the level 3 cleric just casts Lesser Restoration on him.

 

[jaelis]

My first thought was, why would you bother to make a character with something like Down syndrome just to turn around and cure it. But then, maybe if your life has been affected by Down syndrome, that might seem rather cool. So I’d say go for it.

 

[Nevvur]

I think putting these things in the game adds a level of science D&D is not equipped to handle. And it's worth pointing out that many genetic disorders are incredibly debilitating and in a psuedo-medieval society usually lead to someone not living a long life.

If one gets down to the level of actual genetics/DNA as part of justifying their answer, I basically agree. However, magic doesn't really need explanation. Either it can or cannot cure genetic disorders and we can leave it at that.

--

To restate from my reply to LordEntrails, I am looking at this mostly from the perspective of healthy PCs encountering NPCs with genetic disorders. There's a lot of wish fulfillment going on in D&D, and the ability to treat a(n imaginary) person with a debilitating genetic disorder could feel quite rewarding.

If people want to discuss how to handle genetic disorders for PCs, have at it. I think that discussion could be mined for some interesting perspectives as well. Not what I really had in mind, but hey, public forums.

 

[LordEntrails]

For PCs sure, but NPCs? It would be inconvenient if, for instance, a plot point evolved around an NPC's genetic disorder, and the level 3 cleric just casts Lesser Restoration on him.

You kind of ignored the first part of my post;

There is already precedence of some diseases not being healed by lesser restoration etc. Why not just go with specific exceptions and say certain "diseases" require heal, or a special ritual or whatever?

...
To restate from my reply to LordEntrails, I am looking at this mostly from the perspective of healthy PCs encountering NPCs with genetic disorders. There's a lot of wish fulfillment going on in D&D, and the ability to treat a(n imaginary) person with a debilitating genetic disorder could feel quite rewarding.

So, if it's for an NPC, then simple - what do you want the plot device to be? As I've said, their is precedence for making things that don't follow the regular rules.

Do you want the PC's to go find some magical do-dad that can cure it? Clear out the hags that inhibit the magical healing spring? Collect rare ingredients needed for the healing ritual?

I don't see any point in trying to come up with a standard set of mechanics or rules for NPC diseases. Because the only time a NPC will have such a disease is when the DM has given that disease as part of a plot. So what's that plot? Make that disease whatever it needs to be for that plot. Don't worry about justifying it with a set of rules.

 

[Sunseeker]

If one gets down to the level of actual genetics/DNA as part of justifying their answer, I basically agree. However, magic doesn't really need explanation. Either it can or cannot cure genetic disorders and we can leave it at that.

--

To restate from my reply to LordEntrails, I am looking at this mostly from the perspective of healthy PCs encountering NPCs with genetic disorders. There's a lot of wish fulfillment going on in D&D, and the ability to treat a(n imaginary) person with a debilitating genetic disorder could feel quite rewarding.

If people want to discuss how to handle genetic disorders for PCs, have at it. I think that discussion could be mined for some interesting perspectives as well. Not what I really had in mind, but hey, public forums.

I would argue that no, Cure Disease is not intended to cure genetic disorders. I would however argue that magic should be able to cure genetic diseases. Perhaps a "Greater Cure Disease" is needed or "Cure Disability" (Restoration maybe?). Though I wouldn't place it higher than Reincarnate. Now, there's nothing saying that Reincarnate creates a healthy body, but neither does it say that it does not, that's some fluff room left up to the style of DMing and the theme of the campaign IMO, IE: In Ravenloft, Reincarnate and other forms of resurrection may not create healthy bodies.