Bioethics Discussion Blog: The Authentic Right to Health Care: Treating Yourself as You Desire

REMINDER: I AM POSTING A NEW TOPIC ABOUT ONCE A WEEK OR PERHAPS TWICE A WEEK. HOWEVER, IF YOU DON'T FIND A NEW TOPIC POSTED, THERE ARE AS OF MARCH 2013 OVER 900 TOPIC THREADS TO WHICH YOU CAN READ AND WRITE COMMENTS. I WILL BE AWARE OF EACH COMMENTARY AND MAY COME BACK WITH A REPLY.

TO FIND A TOPIC OF INTEREST TO YOU ON THIS BLOG, SIMPLY TYPE IN THE NAME OR WORDS RELATED TO THE TOPIC IN THE FIELD IN THE LEFT HAND SIDE AT TOP OF THE PAGE AND THEN CLICK ON “SEARCH BLOG”. WITH WELL OVER 900 TOPICS, MOST ABOUT GENERAL OR SPECIFIC ETHICAL ISSUES BUT NOT NECESSARILY RELATED TO ANY SPECIFIC DATE OR EVENT, YOU SHOULD BE ABLE TO FIND WHAT YOU WANT. IF YOU DON’T PLEASE WRITE TO ME ON THE FEEDBACK THREAD OR BY E-MAIL DoktorMo@aol.com

IMPORTANT REQUEST TO ALL WHO COMMENT ON THIS BLOG: ALL COMMENTERS WHO WISH TO SIGN ON AS ANONYMOUS NEVERTHELESS PLEASE SIGN OFF AT THE END OF YOUR COMMENTS WITH A CONSISTENT PSEUDONYM NAME OR SOME INITIALS TO HELP MAINTAIN CONTINUITY AND NOT REQUIRE RESPONDERS TO LOOK UP THE DATE AND TIME OF THE POSTING TO DEFINE WHICH ANONYMOUS SAID WHAT. Thanks. ..Maurice

FEEDBACK,FEEDBACK,FEEDBACK! WRITE YOUR FEEDBACK ABOUT THIS BLOG, WHAT IS GOOD, POOR AND CONSTRUCTIVE SUGGESTIONS FOR IMPROVEMENT TO THIS FEEDBACK THREAD

Wednesday, December 20, 2006

The Authentic Right to Health Care: Treating Yourself as You Desire

There is a philosophy of healthcare in this country and elsewhere that there should be total freedom for people to select how they want to be treated for their illnesses. If that happened, it is believed that medical costs would drop and everyone could obtain healthcare. The freedom would include treating themselves with whatever medications they understand will be helpful without any prescriptions and/or go to any person they want for medical attention who need not have gone to a medical school or be licensed to practice medicine. Those persons who offered themselves as practitioners and didn’t practice effective medicine would be eliminated by attrition. What do you think about this right and whether, in the end, it would take the politics and laws out of medicine and make medical care more affordable to everyone? Is there any merit to this philosophy?

The following article is from the self-described “raw data for raw nerves” website totse.com by Sheldon Richman, representing the libertarian organization The Future of Freedom Foundation, who presents a discussion about this “authentic right”. ..Maurice.


The
Right to Self-Treatment

by Sheldon Richman, January 1995

_________________________________________________________________


Over the last year or so, much has been said about the right to health care. The advocates of government management of the health-care system believe that everyone should be able to obtain the services of doctors and related practitioners regardless of ability to pay. That is what has fueled the push by the Clinton Administration and others for so-called universal coverage.

Truth be told, there is no right to health care as the advocates of socialized medicine conceive it. In their view, anyone who needs medical attention ought to be able to count on the government to force others to provide or pay for it. But no one can have a right to the services or money of unwilling providers. One has a right to buy services from willing providers. One has a right to request free services or financial donations. But one has no right to use the threat of physical force--directly or indirectly (i.e., through the state)--to obtain those things. The right to health care in that sense is a counterfeit right.

There is, however, an authentic right to health care, which was recognized in the United States until 1914. It is typical of our age that while nearly everyone embraces the counterfeit right, almost no one accepts the authentic right. Even worse, few realize they are denied an important freedom. That authentic right may be called, as the noted psychiatrist Thomas S. Szasz has called it, the right to self-medication. It is the right to care for one's own health without prior permission from the state.

At first glance, many people will believe we already have that right. They are wrong. For example, one may not seek treatment from a practitioner who is not licensed by the state. Although one may be perfectly content with the treatment provided by an unlicensed practitioner, the state will prohibit that therapeutic relationship; it will even jail the practitioner if it wishes. True, it will not jail the patient. It will merely prevent a consenting adult from engaging in the medical acts of his choice.

Another way that the government interferes with the authentic right to health care is through the system of prescription medicines. Citizens of this theoretically free country may not use certain medicines without the written permission of an officer of the state. Yes, doctors are officers of the state by virtue of their having been
deputized by the state to grant, or withhold, such permission. That was not true before 1914. Until then, adult citizens could enter a pharmacy and buy any drug they wished, from headache powders to opium. They needed no one's permission. They were, in a phrase, pharmacologically free.

That freedom was abolished as the paternalist ethic gained currency. People had to be protected from their own unwise choices. For their own good, they could not be allowed to prescribe medicines for themselves. At least, that is what they were told. In fact, we know otherwise. When Americans were pharmacologically free, they managed not to kill themselves with overdoses or inappropriate medicines. When they felt it necessary, they sought advice from physicians or others who had greater experience than themselves. Americans somehow knew not to swallow purported medicines without wondering about the consequences. (We know this because population and life expectancy grew all during the period.)

Then they lost this right. They were told they were no longer able to make those kinds of decisions. For some unfathomable reason, they surrendered their authentic right to health care without a bloody struggle.

They were lied to, of course. The doctors and the politicians did not really believe that Americans had suddenly become too benighted to medicate themselves. No, the doctors and politicians wanted power. The prescription law was just one piece of a larger conspiracy against the public. At about this time, the United States got its first laws to license doctors and accredit medical schools. The same paternalistic rationalizations were fed to the public. But the minutes of the medical societies' meetings tell another story. Historian Ronald Hamowy has documented what was really on the minds of the doctors: income. They were concerned that free entry, and hence unrestricted competition, into the medical profession was driving down fees. Only government regulation could keep the doctors living in the manner to which they had become accustomed.

That regulation took several forms. Accreditation of medical schools regulated how many doctors would graduate each year. Licensing similarly metered the number of practitioners and prohibited competitors,such as nurses and paramedics, from performing services they were perfectly capable of performing. Finally, prescription laws guaranteed that people would have to see a doctor to obtain medicines they had previously been able to get on their own. The doctors and politicians succeeded in supporting the medical profession's income; they also contributed to the infantilization of the American people. We have never recovered.

The same laws have also subverted the medical profession, since doctors can be--and have been--prosecuted for prescribing drugs "in amounts that exceed a legitimate medical purpose." In some states, doctors must send a copy of prescriptions for certain drugs to a government bureaucracy. Government thus reserves the power to decide what is legitimate.

Some will say, things were simpler before 1914. Surely in our complex age, people cannot be expected to make those decisions for themselves. This is fallacious. Despite all the purported protection against self-treatment, the one thing that is supposed to activate the system for the individual is left entirely to his own discretion: the visit to the doctor. What protects a person against his decision not to see a doctor? Even the most extreme proponents of socialized medicine donot advocate compelling people to see a doctor against their will. The freedom to do without medical care, at least, is respected. If the paternalists were truly consistent, they would call for protecting us from that dangerous freedom by requiring periodic visits to the doctor. But perhaps that would bare their totalitarian talons a little too much.

However, if we can be trusted to make such a basic decision, why can't we be trusted with other decision-making related to health care? The reason cannot be that people are ignorant in these matters. We are ignorant in lots of matters in which the consequences of unwise decisions can be great. Most of us know little about automobiles. An improperly serviced auto can be dangerous to others. Yet, there is no law against my servicing my own auto. The law does not stop me from working on my own furnace, though a mistake could kill me and others. If I am spiritually distressed, I am free to console myself or seek comfort from a bartender, friend, or anyone else. If I can work on my car, my furnace, and my mind, why can't I work on my own body?

But surely no medicine should be allowed on the market before it is approved by the government, right? Wrong. The right to self-treatment means just that--the right to choose and administer (or have administered) any treatment. Each individual should be free to determine his own level of confidence about a medicine. A desperately sick person quite reasonably may be willing to seize on a new, untested drug. He may not survive the years of testing required by the Food and Drug Administration. (That systemic delay kills thousands of people each year.) Someone less ill or more risk averse may be more selective. A third person may only want medicines that have stood the test of time. The key question is, who should decide one's level of confidence? Should the government impose one level on everyone? Or should each decide for himself? In a free society, there can be only one answer.

It is certainly wise to know what one is doing before treating oneself. And that is why the free market provides an abundance of medical information to the layman. It would provide even more in a free medical marketplace. Sources of information would include doctors, medical societies, insurance companies, Prevention magazine, Consumer Reports, newspapers, and more. Competition and the civil law against fraud and malpractice are the best assurances of quality in both information and services. But in the end, people must have the right to enter into any mutually agreed-on contracts for medical services that they choose. Anything less makes a mockery of the idea that we are free.


Permission is granted to reprint this article, provided appropriate
credit is given. Please send two copies of the reprint to The Future
of Freedom Foundation

_________________________________________________________________

Sheldon Richman is senior editor at the Cato Institute in Washington,
D.C., and the author of The Future of Freedom Foundation.

2 Comments:

At Saturday, December 30, 2006 3:39:00 PM, Anonymous Moof said...

Dr. Bernstein, through this post, you have exposed my "soft underbelly," so to speak.

My own thoughts are very close the thoughts expressed by those in the article you reproduced.

I believe in personal freedom - with the exception of when my freedoms impact the freedoms of another person. I also believe in personal responsibility - which includes a responsibility toward my fellow man.

I also believe that there should be rules and regulations ... and some sort of oversight of those who claim to be able to provide a product that has particular uses (like a medication) ... but I'm not sure that the government should be holding the reins.

Perhaps it's true that citizens are no longer able to "do for themselves" ... they've had decisions made for them for so many years! They've been taught to no longer think for themselves - hence we have a population of people who are credulous to the point of making sending spam a profitable enterprise!

You have touched upon one of my "pet peeves." I try very hard to not get into this subject, because it's one of the few in which I don't seem to be able to maintain an objective attitude.

The trend in the west seems to be toward a nanny society ... which is sad. Thinking adults who come into line in a nanny society end up needing one.

 
At Tuesday, January 23, 2007 9:08:00 AM, Blogger isabella mori said...

thank you for posting this thought-provoking article. i am writing from canada, who has a few more (and different) layers of bureaucracy shrouding our healthcare. i am also an immigrant to canada, and have worked with a lot of immigrants. this has definitely shown me the reality of the protectionism in all professions, and particularly medicine. also, our bureaucrazy [that was a typo but i think i'll leave it misspelled] is literally strangling our healthcare. the irony is that we recently had someone from hungary stay with us, and he was appalled at our health care system.

maybe making health care a total free-for-all is not quite the answer but there is absolutely no question in my mind that we have cut the ties to the nanny.

 

Post a Comment

<< Home