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Commentary on ‘Three arguments against prescription requirements’
  1. Adrienne Martin
  1. Correspondence to Dr Adrienne Martin, Department of Philosophy, University of Pennsylvania, 429 s 36 st, Philadelphia, PA 19146, USA; adrm{at}

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Flanigan argues that the same arguments for a right to informed consent equally support a right to self-medicate,i and that prescription requirements violate the latter right. She proposes that, in order to respect the right to self-medicate, almost all prescription-grade drugs should be available over-the-counter (OTC) or behind-the-counter (BTC).1 On her proposal, consumers would be encouraged to consult with a physician or pharmacist but could waive the right to be informed about the potential benefits and risks of the drugs they purchase. There are two places a person uncomfortable with the full sweep of this proposal might look to dig in.

First, Flanigan's proposal has a number of potential harms and costs, some of which she mentions but dismisses fairly quickly, and some of which she does not consider. To name a few:

  1. Without enforced periodic consultations, we might see increases in uninformed and reckless drug use and thereby an increased risk of harm to people other than the self-medicating individual. An uninformed self-medicating individual is more likely to pose a direct physical threat to others, to accidentally or intentionally harm herself and thereby cause psychological and emotional harm those who care about her, and to incur the need for costly care that must be borne on society's shoulders.

  2. Although there are certain administrative costs that would decrease under the sort …

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  • Competing interests None.

  • Provenance and peer review Commissioned; internally peer reviewed.

  • Author footnote i Note an ambiguity in the concept of ‘self-medication.’ It ultimately appears Flanigan is arguing for a right to access and use prescription-grade drugs for medical or non-medical purposes—take the case of the student who wants to use Adderall not to treat a recognised medical condition but to be more competitive, or the analogy with elective cosmetic surgery. Her argument is, perhaps, really an argument for a right to access whatever resources are available for purposes of self-improvement—however one conceives of ‘improvement’ to oneself.

  • ii O'Neill, Onora, Autonomy and Trust in Bioethics, Cambridge, 2002.

  • iii Arguably, not all forms of suicide qualify as self-destruction in the relevant way.

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