Among other factors, domesticated rhubarb is less toxic than wild, and yes, the toxins are concentrated in the leaves. There are still residual amounts in the stalks which are (mostly) deactivated by cooking.
Bottom line: eating one raw stalk is unlikely to be a problem. Eating a lot of them could be, but virtually no one eats that much raw rhubarb.
Except Huntington’s does affect one’s reproductive success - those with the gene tend to have more children than those without. Type II diabetes doesn’t help you reproduce but if the traits that lead to that disease in our current environment can help you survive famine then, under those conditions, they might help you raise more children by surviving food shortages.
Another one is hemochromatosis, or genetic iron overload. Excessive iron levels damage vital organs like the liver and can lead to relatively early death (late 30’s or the 40’s). BUT - women with the gene almost never suffer negative effects until after menopause due to normal iron losses during menstruation and pregnancy. The trait might help women during their reproductive years, especially in areas where the diet is low in iron. And if they men die at 39? Well, that’s plenty of time to sire offspring, even if he’s not around to see them all the way to adulthood. By helping women survive their reproductive years the trait is not as negatively selected as you might assume.
A trait that impairs health but by one mechanism or another assists in reproductive success tends to persist.
At best IVF has a success rate of 30%. That’s not 30% per attempt, that’s 30% overall. Most couples need multiple attempts to get to the goal of a live birth. So fewer than 30,000 of those 100,000 attempts at IVF were successful. That’s a drop in the bucket compared to a world population of 7 billion. It’s not significant.
Now, if IVF became more successful/reliable/common that might become a problem but we’re a long, long, long way from that.
Given that at least some of those IVF attempts are done not to overcome infertility but to screen for genetic disorders and prevent the birth of people with them it’s arguably either neutral or a net positive (people of normal fertility who opt for IVF to avoid genetic problems tend to be more successful with fewer attempts, which probably shouldn’t be surprising as their issues aren’t fertility.)
Again - there has not been enough time with high technology civilization to make a difference in the human gene pool. It requires many many generations in an environment to cause the sort of problem you bring up.
And I’m not going to argue that we should abandon the sick - which is what you’re suggesting with “There’s the whole health care industry looking after people who are unhealthy, for example. Will that become even more of a drag on the economy?”. First of all, “chronic illness” is not incompatible with “employed”. A LOT of people with birth defects, amputations, permanent injuries, chronic disorders, and genetic flaws work for a living and are a net gain for society. It’s not a binary situation of either perfect health or helpless invalid. Second, all those people employed by the healthcare industry contribute to the economy, and if you eliminated healthcare they’d all have to do something else or else they’d be an unemployed drag on the economy.