Liberal Medicine

Abstract

I argue that citizens have rights of self-medication, and that prohibitive pharmaceutical regulations are therefore unjust. Pharmaceuticals are among the most important consumer goods we will ever purchase. Yet despite, or perhaps because of their importance, pharmaceuticals are heavily regulated in ways that other consumer goods are not: through premarket approval requirements and prescription drug systems.

I begin with a historical overview of pharmaceutical regulation (Ch. 1). I then show that prohibitive pharmaceutical polices cause death and suffering by discouraging innovation and by preventing patients from accessing beneficial and lifesaving drugs (Ch. 2). Indeed, adopting less prohibitive pharmaceutical policies is one way that a liberal society might promote public health. (Ch. 3) I then argue that liberal principles are often incompatible with pharmaceutical paternalism (Ch. 4). Further, seriously ill patients have rights of medical self-defense that entail rights to use unapproved drugs (Ch. 5). People also have rights to use drugs to end their lives even if they are not sick or disabled. (Ch. 6) Together, these arguments justify conditional rights of self-medication and call for extensive reforms to the current system of regulation. I then argue that the same principles of anti-paternalism that are used to justify the doctrine of informed consent also justify unconditional rights of self-medication (Ch. 7).

Governments that enforce prohibitive pharmaceutical regulations are morally culpable for the harms and wrongful deaths that are caused thereby (Ch. 8). Even though citizens overwhelmingly support prohibitive policies, prohibitions themselves do not serve the public interest (Ch. 9). To close, I propose several institutional reforms including the legalization of almost all pharmaceuticals and changes to medical practice (Ch. 10). I also discuss some circumstances where limits on self-medication are justified (Ch. 11).

More generally, this is an argument for more extensive rights against paternalistic interference in medicine, and a call to end deadly and ineffective pharmaceutical regulations. All governments are unjust insofar as they restrict patients' access to therapeutic medicine. Institutional protections for rights of self-medication aim to remedy this everyday injustice, and in so doing, save lives and empower patients.