What Does Libertarian Medicine Look Like?

What does thorough-going libertarian medicine look like? Writing in the Journal of Medical Ethics, Jessica Flanigan, of the University of Richmond, Virginia, opens a window on the future. She says that it would abolish prescription drug laws because they “violate patients’ rights to self-medication”. “Patients have rights to self-medication for the same reasons they have rights to refuse medical treatment according to the doctrine of informed consent (DIC),” she argues.

Medical practice without prescriptions may sound troubling. But Flanigan points out that while all developed countries have a prescription drug system, many do not enforce it strictly, like Chile, Colombia, Ecuador, Mexico, Peru, Venezuela, Greece, Egypt, Hong Kong, Philippines, and Thailand. A 1987 study seemed to show that poisoning mortality did not increase in these countries. On the contrary, their mortality rates were significantly lower. “On-balance prohibitive pharmaceutical policies make patients medically worse off,” she says.

How would this regime work? Patients would be able to purchase drugs without a script. However, to ensure that patients truly give their informed consent, they would be required to discuss the potential risks and benefits with a pharmacist or a doctor.

What about dangerous drugs? Flanigan responds that patients are able to give informed consent to dangerous medical treatment, why not to dangerous pharmaceuticals? What about the danger of addiction and abuse? She admits that this is a danger, but she compares the situation with illegal drugs. If we have not been able to eliminate heroin and cocaine by declaring a war on drugs, a ban on ban on using medicinal drugs without a prescription will not work either.

The prescription drug system is paternalistic, Flanigan concludes. “Patients ought to be regarded as the ultimate authority when it comes to decisions about their own bodies. But patients’ authority doesn’t stop at their ability to refuse treatment. In order to truly respect patients’ rights, states must also abolish prescription drug requirements and recognise rights to self-medication.”

Michael Cook


Michael Cook likes bad puns, bushwalking and black coffee. He did a BA at Harvard University in the US where it was good for networking, but moved to Sydney where it wasn’t. He also did a PhD on an obscure corner of Australian literature. He has worked as a book editor and magazine editor and has published articles in magazines and newspapers in the US, the UK and Australia.

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  • Joe DeVet

    Part of a reform that Catholics can and should ally with.  The rest of the reform is to restore the whole medical field to the free market.  Government intervention sounds so promising but always creates more problems than it solves.  The most telling reason is that government intervention, as Obamacare to take an extreme example, sounds so much like getting something for free.  However, it always costs a lot, wastes a lot, creates harmful incentives, operates in part by political favoritism, and is subject to extreme corruption.

  • MaryK

    I can’t decide which part of your post disgusts me the most, so will not comment on specifics but address the whole.  Hogwash!  Your conclusions would only lead to one more step toward anarchy – no more would the few need concern for the many or the many for the few, but each one on his own.  And, the Libertarians have the audacity to call that “freedom”.

  • Victoria

    As a nurse, I find the concept of abolishing prescriptions terrifying. Physicians spend years learning about the side effects, interactions and actions of medications; they generally have some idea what they’re doing when they prescribe drugs. If patients could buy any medication they chose, everyone would be taking antibiotics for the common cold, for one example, (which is totally ineffective) which would quickly reduce the effectiveness of antibiotics when they are really needed. The mind boggles at some of the elderly patients I know picking their own meds, spurred on of course by TV ads.

  • MaryK

    Victoria-  Good reply.  I recently visitied a friend in an Alzheimer’s care center and was amused at some of the “Chair Games” the residents played.  I was sad for my friend that her active life was reduced to these levels, and of course, not a little afraid for my own future possibilities.  But after reading your post, i imagined a new game for the care center, “Musical Pills” – where residents could pick their own based on how the colors and shapes affected their minds – or refusing to play the game entirely, depriving themselves of any medicinal value contained in them. 

    I digressed to the ridiculous, but to restore medication to the free market without competent intervention would surely lead to such abuses, and worse.  And, why would anyone need to go to Medical School if everyone were allowed to diagnose and treat themselves.  All people would need is a High School equivalency test on the uses medicinal drugs from Aspirin to Viagra.

  • It’s also time to abolish the U.S. Food and Drug Administration which seems to have too much time on its hands, judging from news stories about raids on Amish farmers at gunpoint over the sale of fresh milk or censoring claims about the effects of dietary supplements. 

    As to drug safety, we would all be better off with an independent product safety certification organization like Underwriters Laboratories. Seroiusly, check out UL at wikipedia. It’s a remarkable outfit.

    The drug companies would pay for a “UL” label that the consumer could trust. Unlike the government monopolies like the FDA, such certifying organizations could actually BE trusted, because their reputation is all they have to sell.

    Randy England, http://www.freeisbeautiful.net

  • MaryK

    Hmmmm!  Could it be we have another Libertarian in the mix?  I can see it now – abolish the FDA and let China (and others) slink into the market undetected.  After all, liberty (according to the Libertarian platform)  means anyone can do anything at anytime.  They do put in a “caveat” that one person’s liberty cannot harm another person’s liberty, but just how can we imagine that outcome if there is no governing body to detect abuses or to determine just when a person is harmed by another’s liberty?

    I’m old enough to remember the John Birch Society when their similar platform would abolish public schools, Social Security, Medicare, the FDA . . . . . .  It didn’t work then for the JBS and it won’t work now for the Libertarians. 

    But – you are free to keep on a-talkin’.