How to Regulate the Right to Self-Medicate

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Abstract

In Pharmaceutical Freedom Professor Flanigan argues we ought to grant people self-medication rights for the same reasons we respect people’s right to give (or refuse to give) informed consent to treatment. Despite being the most comprehensive argument in favour of self-medication written to date, Flanigan’s Pharmaceutical Freedom leaves a number of questions unanswered, making it unclear how the safe-guards Flanigan incorporates to protect people from harming themselves would work in practice. In this paper, I extend Professor Flanigan’s account by discussing a hypothetical case to illustrate how these safe-guards could work together to protect people from harms caused by their own ignorance or incompetence.

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Most cited references 42

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Clinical practice. Assessment of patients' competence to consent to treatment.

Paul Appelbaum (2007)

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Wändi Bruine de Bruin, Andrew Parker, Baruch Fischhoff (2007)

The authors evaluated the reliability and validity of a set of 7 behavioral decision-making tasks, measuring different aspects of the decision-making process. The tasks were administered to individuals from diverse populations. Participants showed relatively consistent performance within and across the 7 tasks, which were then aggregated into an Adult Decision-Making Competence (A-DMC) index that showed good reliability. The validity of the 7 tasks and of overall A-DMC emerges in significant relationships with measures of socioeconomic status, cognitive ability, and decision-making styles. Participants who performed better on the A-DMC were less likely to report negative life events indicative of poor decision making, as measured by the Decision Outcomes Inventory. Significant predictive validity remains when controlling for demographic measures, measures of cognitive ability, and constructive decision-making styles. Thus, A-DMC appears to be a distinct construct relevant to adults' real-world decisions. ((c) 2007 APA, all rights reserved).

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Improving health outcomes with better patient understanding and education

Robert John Adams (2010)

A central plank of health care reform is an expanded role for educated consumers interacting with responsive health care teams. However, for individuals to realize the benefits of health education also requires a high level of engagement. Population studies have documented a gap between expectations and the actual performance of behaviours related to participation in health care and prevention. Interventions to improve self-care have shown improvements in self-efficacy, patient satisfaction, coping skills, and perceptions of social support. Significant clinical benefits have been seen from trials of self-management or lifestyle interventions across conditions such as diabetes, coronary heart disease, heart failure and rheumatoid arthritis. However, the focus of many studies has been on short-term outcomes rather that long term effects. There is also some evidence that participation in patient education programs is not spread evenly across socio economic groups. This review considers three other issues that may be important in increasing the public health impact of patient education. The first is health literacy, which is the capacity to seek, understand and act on health information. Although health literacy involves an individual’s competencies, the health system has a primary responsibility in setting the parameters of the health interaction and the style, content and mode of information. Secondly, much patient education work has focused on factors such as attitudes and beliefs. That small changes in physical environments can have large effects on behavior and can be utilized in self-management and chronic disease research. Choice architecture involves reconfiguring the context or physical environment in a way that makes it more likely that people will choose certain behaviours. Thirdly, better means of evaluating the impact of programs on public health is needed. The Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework has been promoted as one such potential approach.

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Author and article information

Contributors

Joseph T. F. Roberts:

ORCID: http://orcid.org/0000-0002-9261-7694

J.T.F.Roberts@bham.ac.uk

Journal

Journal ID (nlm-ta): HEC Forum

Journal ID (iso-abbrev): HEC Forum

Title: Hec Forum

Publisher: Springer Netherlands (Dordrecht )

ISSN (Print): 0956-2737

ISSN (Electronic): 1572-8498

Publication date (Electronic): 3 June 2020

Publication date PMC-release: 3 June 2020

Publication date (Print): 2022

Volume: 34

Issue: 3

Pages: 233-255

Affiliations

GRID grid.6572.6, ISNI 0000 0004 1936 7486, University of Birmingham, ; Birmingham, UK

Author information

Joseph T. F. Roberts http://orcid.org/0000-0002-9261-7694

Article

Publisher ID: 9415

DOI: 10.1007/s10730-020-09415-7

PMC ID: 9338001

PubMed ID: 32494992

SO-VID: 5b0a56f5-7a3d-43ed-a07f-39d8786ca93c

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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ScienceOpen disciplines: Ethics

Keywords: competence,harm reduction,pharmaceutical,regulation,self-medication

Data availability:

ScienceOpen disciplines: Ethics

Keywords: competence, harm reduction, pharmaceutical, regulation, self-medication

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