If a competent adult refuses medical treatment, physicians and public officials must respect her decision. Coercive medical paternalism is a clear violation of the doctrine of informed consent, which protects patients' rights to make medical decisions even if a patient's choice endangers her health. The same reasons for rejecting medical paternalism in the doctor's office are also reasons to reject medical paternalism at the pharmacy, yet coercive medical paternalism persists in the form of premarket approval policies and prescription requirements for pharmaceuticals.
In Pharmaceutical Freedom Jessica Flanigan defends patients' rights of self-medication. Flanigan argues that public officials should certify drugs instead of enforcing prohibitive pharmaceutical policies that disrespect people's rights to make intimate medical decisions and prevent patients from accessing potentially beneficial new therapies. This argument has revisionary implications for important and timely debates about medical paternalism, recreational drug legalization, human enhancement, prescription drug prices, physician assisted suicide, and pharmaceutical marketing. The need for reform is especially urgent as medical treatment becomes increasingly personalized and patients advocate for the right to try. The doctrine of informed consent revolutionized medicine in the twentieth century by empowering patients to make treatment decisions. Rights of self-medication are the next step.
Fantastically and thoroughly argued, Jessica Flanigan is completely convincing in her argument for patients’ right to self medicate. Whether you are familiar with current pharmaceutical/medical policies or not, Pharmaceutical Freedom is a must read. Current government restrictions are costing people their lives, and this book is the beginning to righting this wrong.
“Though self-medication is sometimes dangerous, patients are able to consent to the dangers associated with pharmaceutical use and avoid the dangers if they choose. In contrast, no one can consent to the deadly system of existing regulations that violate patients rights and cause death and suffering. For this reason, even those who do not wish to use unapproved pharmaceuticals should nevertheless support reforms that empower all patients by respecting people’s right of self-medication.”
Flanigan provides a thorough, rights-based argument for self-medication and informed consent in Pharmaceutical Freedom. Given the seemingly endless array of issues surrounding public health paternalism, the FDA, the DEA, and medical ethics, Flanigan’s rule-consequentialist lens is not only unique in its kind (as others have noted in their reviews as well), but it is also the first and only philosophical attempt to just hash out what works and what doesn’t work with today’s system. For anyone that isn’t familiar with these issues, this book can be extremely informative. However, for anyone with more of an act-consequentialist perspective on life, or a more general disinterest in American political philosophy, then some of her arguments can seem a bit random and confusing at times. My Master’s thesis was on this book.
I cannot imagine there to be many books written on this topic, and especially from this angle - and in addition being so good and academical, investigating every angle - reading like a master thesis. It's not all for the good, because it can be slow to read sometimes and it does contain some reiterations and rephrasing of things, but all in all, I think this is a must-read if you want to think straight about making the argument of having the right to self-medicate.
I cannot say enough good things about this book. It deals with a topic that I have long viewed as a key part of my intellectual and activist agenda and which lies at the heart of the nexus of practices, institutions, and laws surrounding medical paternalism. Highly recommended.