Walter Block – August 14, 2022
The present system for pharmaceutical drugs requires a doctor’s prescription as a precondition for their sale to members of the public.
At first glance this seems like a reasonable plan. After all, most people simply lack the necessary information to determine whether they need or can benefit from drugs such as Penicillin, Vicodin, Albuterol, Lisinopril, Levothyroxine, Gabapentin, Metformin, Lipitor, Amlodipine, Tamsulosin, Finasteride, Digoxin, Metoprolol, Celecoxib to name but a tiny sample of those drugs covered by this rule. Moreover, even if people had that knowledge, which the average person most certainly does not, they would be totally lost as far as proper dosage is concerned.
However, all is not well under present institutional arrangements. For here we are not talking about advice and counsel from a physician to a patient. That is all well and good. Rather, the problem is that the horse is placed before the cart: the client must seek the permission of a person who is for all intents and purposes an employee of his, not an employer.
That should be the proper relationship between the two, and in the free society that is exactly what would occur. Instead, nowadays, the patient is not seeking, nor obtaining, information, knowledge, advice. Instead, he must appear on bended knee to beg for permission from his physician.
Imagine if this system were to be extrapolated to other fields of endeavor. Then, instead of the motorist telling the mechanic which of his services he requires, matters would be inverted: the former would have to gain the approval of the latter regarding the proper procedures to be followed. Instead of the customer telling the cab driver where to go, the former would have to seek approval from the latter regarding the destination deemed by him to be the most appropriate.
Similarly, the diner would have to ask the permission of the waiter as to what kind of meal to order; if the latter deemed the former’s choice to be in any way problematic, he would simply reject his request. Travelers would propose destinations to air carriers; the latter would say yea or nay. After all, doctors nowadays sometimes refuse to write prescriptions for patients if they deem those prescriptions harmful; they make the final determination to the request, not the order, of the patient.
Yes, yes, there are disanalogies here. Pharmaceuticals have life and death implications, certainly those for good health. Some, but not all of these examples are fully apropos. But this is a dramatic and accurate way of depicting exactly what is going on in the prescription system.
How should matters work, ideally? Architects give advice to builders. Mechanics give advice to automobile owners. That is exactly the relationship that should prevail between a doctor and a patient. The former should advise the latter as to proper medication. But the patient should be free to ignore what the physician says, to seek a second opinion, and to have access to whatever (legal) drug there is out there. (All drugs should be legal, but that is entirely a different matter.)
Lawyers know more than us about law; the same thing follows; they are our employees, not employers. Physicists, chemists, mathematicians, economists, musicians, plumbers, and electricians are also more knowledgeable about their own specialties than we laymen; still, this gives them not a shred of justification to boss us around.
Yes, doctors, too, know more than us, specifically about medicine. But that shouldn’t make them our bosses. Their brief should not be to permit, or to withhold permission. We, their clients, are not children. We should not be treated as such.
Originally published at Fee.org. Walter Edward Block is an American economist and anarcho-capitalist theorist who holds the Harold E. Wirth Eminent Scholar Endowed Chair in Economics at the J. A. Butt School of Business at Loyola University New Orleans. He is a member of the FEE Faculty Network.
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