Tracing consequences both seen and unseen.
Wirkman VirkkalaThe Logic of Self-Medication
Posted at 3:25 am on April 5, 2010, by Wirkman Virkkala

I may disapprove of what you take, but I’ll defend till your death your right to take it.

The same sort of values and reasoning that support the right of free speech supports, also, the right of self-medication.

Because we have had free speech rights, but have lacked the right to self-medicate, the two rights seem (to many) the most distant of cousins, if not warring foes. To most folk, the idea of self-medication? Heaven (or the state) forbid: We must always be guided by doctors, who know better!

But, in a free society, it is each person’s own responsibility to decide what to do with his or her body. In families, spouses and parents and siblings and even children can assist. But, unless a person is addled or unconscious, the responsibility for decision making is his or her own.

It’s this way regarding belief and speech. We have a right to believe and say as we wish. But the responsibility to refine those wishes for our own betterment? That’s ours, too. The right and the responsibility. The right gives us freedom to choose a wide array of thoughts. The responsibility means that we can’t blame others for our silly notions or foolish talk. And decisions.

So it is with medicine. And by this we must mean psychoactive drugs as well as drugs for acid reflux, blood pressure, or what-have-you. When I mentioned this to a friend, he was aghast at the thought. “We don’t have a right to self-medicate for pleasure!” I asked why not. He was on the fence about a right to self-medicate to avoid pain or repair physical maladies, but for just pleasure? Of course not! The idea had never crossed his mind. And yet he, like me, knows many people who are prescribed Paxil-related drugs, drugs that are designed to increase pleasure.

But avoid pain, first and foremost. Avoid the pain of stress and anxiety.

Besides, these drugs are prescribed. It’s not a question of a right, right?

Wrong. I see no persuasive reason for the prescription system, either. If I want a pain killer, it’s my business, no one else’s.

The arguments for the current manner of regulating drug usage is harm prevention. And, surely, people can hurt themselves with drugs. As they can with food. As they can with cars. As they can climbing rocks and mountains. As they can believing weird things about “being clear” (and I’m not referring to Peircean pragmaticism).

The reasons for treating one’s own medicinal use as a right, and the costs of said exercise of the right as one’s own responsibility, are the same here as regarding speech. These reasons include:

  1. Each person has the greatest incentive to learn from his/her mistakes, to make the best search for knowledge and advice, so it is almost natural and commonsensical to leave such decisions up to each person, not to “each other.”
  2. Other persons often face strong incentives to exploit persons under their care. By distributing responsibility to each person’s own self, rather than to some organization of others, one cuts down on temptations for corruption and abuse.
  3. When a responsibility is one’s own, the natural relations with others tend to be contractual, and contracts contain more clarity of scope and correction than other forms of interaction, which tend to be arbitrary and murky. When things go bad, it is easier to correct for mistakes and error when rights and responsibilities are assigned to each person rather than focused on professional bodies.
  4. Charitable aid and generosity are more clearly demarcated, and flourish with less chance of self-delusion, when responsibilities are individually assigned rather than collectively devolved onto other groups.

These sorts of reasons for individual freedom and personal responsibility apply to matters of belief and speech and to matters of care and feeding as well as medication. When the default position for rights and responsibilities, for adults, is to the persons themselves, feedback systems are set in place for widespread chance at learning. When these rights are taken away, or the responsibility for bearing the costs associated with exercising those rights is taken away, you end up with people becoming weaker of judgment, more foolish.

This principle of what might be called moral education was summarized in relation to money in a classic essay:

The ultimate result of shielding men from the effects of their folly,
is to fill the world with fools.

And here we come back to the sentiment I began with. It is a somewhat harsh doctrine. Voltaire is said to have declared “I may disapprove of what you say, but will defend to the death your right to say it.” I revised this for drug use, to say “I may disapprove of what you take, but will defend till your death your right to take it.” Drugs are dangerous things. You can, indeed, cause yourself much harm, even death. I can see no reason to mask the danger here. I support freedom even if some, under the tutelage of generalized personal responsibility, fail rather than grow.

This harm and the possibility of failure is why many people wish drugs regulated, prohibited (depending on the drug). But this intention of helping does not guarantee that people are actually and truly helped.

The unintended effect of the prohibition of something some people really, really want, means that they purchase those goods on the black market. And there, without standardization, dosage is hard to control. Drug overdoses, which on the free market would be the occasional result of carelessness, is, on the black market, a too-frequent and far too common result of prohibition itself.

The clarity that freedom engenders would surely help many who now abuse illegal drugs. But it is very hard to get people to rethink old prejudices against freedom in these cases. In other cases, too. So often folks let themselves assume that freedom doesn’t work “in this case,” but still expect it in so many others, like where they wish to eat, where they find employment, and much else.

The logic of liberty works across all (or: nearly all?) realms of experience. Responsibility, the flip side of freedom’s coin, promotes betterment by providing feedback and spurring learning. Few elements of life neatly wrap up into a tight system where learning is perfection. We all make mistakes. Sometimes we make fatal mistakes. But not allowing us to make some mistakes ill prepares us for all sorts of situations. And the sheer bulk of regulation in all walks of life, from education and medical care to dining and wining and even signing, weakens us, turns us, increasingly, into sheep who require shepherding, rather than more independent stock who have the wherewith to decide when to follow the flock, when to strike out on our own.

Yesterday I wrote on the new blog The Libertarian Standard about the unfortunate, half-hearted manner in which drug de-regulation will most likely occur. The lack of courage amongst the knowing population on this issue saddens me. But it’s not just courage that is lacking in the populace.

What is most lacking is the vision of social causation that sees human beings as complex and fallible, not perfectible but most adaptive if held responsible for their actions. Our diversity requires distributed responsibility, several property, and individual freedom. And we must be able to think beyond the obvious or the merely traditional. We must apply Bastiat’s lesson of looking beyond the easily seen, outwards, towards what is usually unseen. But there. And vitally important.


UPDATES: I wrote more about this on my blog, Wirkman Netizen, and on The Libertarian Standard.


Filed under: Drug Policy, Nanny State
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Henry Hazlitt"[T]he whole of economics can be reduced to a single lesson, and that lesson can be reduced to a single sentence. The art of economics consists in looking not merely at the immediate but at the longer effects of any act or policy; it consists in tracing the consequences of that policy not merely for one group but for all groups."
Henry Hazlitt, Economics in One Lesson
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