Abstract
Many pharmaceuticals are available to patients only with a physician’s prescription. Although it is often not recognized as such, this is a classic example of paternalism in public policy. Pharmaceuticals are often perceived as carrying dangerous side effects. Access is restricted to protect patients from their own bad decisions. This chapter explores the moral justification for such paternalism and finds it wanting. It raises the question of whether there is adequate justification for this restriction (given that alcohol, tobacco, and guns are generally available on more or less libertarian grounds). Consistency requires that pharmaceuticals posing dangers primarily to the individual be available to competent consumers and that even moderate risks to third parties be tolerated. The chapter begins by arguing that all drug usage involves evaluative judgments about the relative benefits and harms of the agents and that physicians must make value judgments in deciding whether to prescribe.
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Notes
- 1.
See Tarasoff 1974.
References
Arras, J., and B. Steinbock (eds.). 1999. Ethical Issues in Modern Medicine, 5th ed. Mountain View: Mayfield Publishing Company.
Beauchamp, T. 1977. Paternalism and Bio-Behavioral Control. The Monist 60(1): 62–80.
Beauchamp, T.L., and J.F. Childress. 2013. Principles of Biomedical Ethics, 7th ed. New York: Oxford University Press.
Buchanan, A.E., and D.W. Brock. 1989. Deciding for Others: The Ethics of Surrogate Decision Making. Cambridge: Cambridge University Press.
Dworkin, G. 1972. Paternalism. In Morality and the Law, ed. R. Wasserstrom, 107–126. Belmont: Wadsworth.
———. 1988. The Theory and Practice of Autonomy. Cambridge: Cambridge University Press.
Emanuel, E.J., and L.L. Emanuel. 1992. Four Models of the Physician-Patient Relationship. Journal of American Medical Association 267(16): 2221–2226.
Faden R., and T.L. Beauchamp in collaboration with King NNP. 1986. A History and Theory of Informed Consent. New York: Oxford University Press.
Feifel H. et al. 1967. Physicians Consider Death. Proceedings of the American Psychological Association, 201–202.
Gert, B., and C.M. Culver. 1979. The Justification of Paternalism. Ethics 89: 199–210.
Goldman, A. 1999. The Refutation of Medical Paternalism. In Ethical Issues in Modern Medicine, 5th ed., ed. Arras et al. Mountain View: Mayfield Publishing Company.
In re Quinlan. 1976. 70 N.J. 10, 355 A. 2d 647, cert. denied sub nom., Garger v. New Jersey, 429 U.S. 922 (1976), overruled in part, In re Conroy, 98 NJ 321, 486 A.2d 1209 (1985).
Mill, J.S. 1956. On Liberty. New York: The Liberal Arts Press.
Scrimshaw, S.C., and B. Pasquariella. 1970. Obstacles to Sterilization in One Community. Family Planning Perspectives 2: 40–42.
Smith, D.H., and L.M. Bernstein, ed. 1987. No Rush to Judgment—Essays on Medical Ethics. Bloomington: The Poynter Center/Indiana University.
Tarasoff v. Regents of the University of California Supreme Court of California. 1974. 1974 13 Cal. 3d 177.
Veatch, R.M. 1972. Models for Ethical Medicine in a Revolutionary Age. The Hastings Center Report 2(3): 5–7.
———. 1978. The Hippocratic Ethic: Consequentialism, Individualisem and Paternalism. In No Rush to Judgment—Essays on Medical Ethics, ed. D.H. Smith and L.M. Bernstein. Bloomington: The Poynter Center/Indiana University.
———. 2009. Patient, Heal Thyself. New York: Oxford University Press.
———. 2012. Hippocratic, Religious, and Secular Medical Ethics: The Points of Conflict. Washington, DC: Georgetown University Press.
Wasserstrom, R., ed. 1978. Morality and the Law. Belmont: Wadsworth.
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Veatch, R.M. (2017). Prescription Paternalism: The Morality of Restricting Access to Pharmaceuticals. In: Ho, D. (eds) Philosophical Issues in Pharmaceutics. Philosophy and Medicine, vol 122. Springer, Dordrecht. https://doi.org/10.1007/978-94-024-0979-6_9
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