Medical Practice Without Consent – Econlib

• In the realm of health care, informed consent and respect for personal autonomy are the guiding principles for patient-practitioner relationships. However, this philosophy seems to evaporate when it comes to government intervention in adults’ health choices. The government prescribes which health professionals individuals can consult, dictates the medicines they are permitted to purchase, and even restricts certain substances or activities deemed unhealthy—ignoring individual preferences for risk and benefit.

• I wish to highlight pathways toward a future where the government acknowledges and respects the autonomy and rights of all adults.

• –Jeffrey A. Singer, Your Body, Your Health Care, (pages 2-3)

Jeffrey A. Singer, a physician, advocates for a deregulated health care landscape that empowers individuals to make their own health decisions. His book’s title, Your Body, Your Health Care, deliberately or not, echoes the 1970 feminist landmark Our Bodies, Our Selves, which shifted the paradigm around women’s health, enabling them to understand, manage, and advocate for their own bodies and medical care.

Indeed, under most circumstances, we would find it unacceptable if a doctor dictated our treatment options. Dr. Singer shares this sentiment with equal fervor when it comes to governmental overreach in health treatment decisions.

In today’s world, we are accustomed to consuming only medications that the government has deemed acceptable—often requiring a physician’s prescription to do so. However, Singer envisions a system where individuals have the autonomy to make their own choices, with regulatory bodies like the Food and Drug Administration serving merely as advisers rather than gatekeepers. He asserts:

• If one endorses the principle of informed consent, then one must logically uphold the right to self-medicate. (page 13)

Yet, Singer also acknowledges the complexities and risks associated with modern pharmaceuticals, noting that the looming specter of tort liability would likely compel manufacturers to maintain many drugs as prescription-only. (page 60) This raises an interesting conundrum: while tort liability may impose costs, it doesn’t necessarily provide clear benefits, often leaving us yearning for better regulatory frameworks. I propose that the FDA should relinquish its monopoly on drug certification, perhaps allowing private entities to step in. Yet for these organizations to be effective, they might need government support to establish the necessary resources and incentives for thorough testing.

Singer is adamant that the government should not dictate whom we consult regarding our health.

• Ideally, states ought to abolish all health professional licensing laws. Such laws often fail to genuinely protect the public from inadequate care and instead act as barriers to innovation and new entrants in the health care field. States could authorize third-party certification organizations to fulfill the roles of licensing boards by assessing the qualifications, education, and real-world experience of applicants for various health care services. (page 39)

The challenge will lie in ensuring that consumers are represented in these certification organizations; otherwise, we risk perpetuating the current system, rife with provider rent-seeking behaviors.

Singer also takes a firm stand against the War on Drugs.

• If the government were to cease its war on drugs, individuals would have the freedom to purchase them from legitimate suppliers, enabling comparison shopping and instilling confidence regarding the drugs they buy, including dosage and purity. (page 151)

However, the legalization of marijuana raises questions about the efficacy of consumer protection in such a scenario. It seems that, in practice, consumers are not as well-informed or safeguarded as one might hope. In contrast, alcohol—a heavily regulated substance—offers consumers more reliability regarding purity and dosage.

For those who identify with libertarian ideals, drug addiction presents a unique dilemma. It embodies the conflict within the self: the part that is addicted and the part that desires freedom from that addiction. One potential remedy could involve empowering individuals to designate a trusted person with an equivalent of “power of attorney” regarding their access to addictive substances. This designated individual could intervene if necessary, serving as a safeguard against self-destructive choices.

Your Body, Your Health Care challenges the prevailing notions surrounding health care regulation. While I have my reservations about some of Dr. Singer’s suggestions, I wholeheartedly support re-evaluating public policies in these areas to enhance consumer autonomy.