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.”