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07/09/2013

"As a Patient: I Am My Own Doctor. Trust Me"

Could there be the possibility that medicine and the medical system including the schools that teach medicine and the organizations and governmental agencies which set standards all have become paternalistic toward the patient as a person and toward the patient’s diagnostic workup and treatments?  Could it also be that the patient is currently struggling to become more autonomous in terms of their individual  various self interests but also self-diagnosis and self-therapy but is being hindered by regulations and laws or established standards limiting these opportunities? Shouldn’t the patient have more clout in setting standards which are more in the patient’s own best interest, but from their own point of view and not that of some politician or regulator?  These are questions that could be considered in view of the current public discussion and debate about the role of governments in medical care and payment for medical services.  Further. current discussions, for example, deal with the restrictions to ready availability to those in need of anti-cancer drugs , restrictions  of drug availability by denying “over the counter”purchase without a physician’s prescription or how life-saving organ transplants are allocated. In addition, there are a number of states in the United States which set regulations  potentially limiting the activities of practitioners of alternative medical treatments and thus limiting access by the patient.
One could argue that in these days of accessibility of medical information on the internet and other forums, both in terms of symptoms, diagnosis and approaches to therapy, that individual patients, for a host of medical conditions, reasonably could and should, saving time and money, be able to diagnose themselves (having diagnostic testing available on their request) and be able to treat themselves and not depend on obtaining a physician’s office visit, wait and then ask the doctor for a prescription.  That means that all medication could be obtained from  a pharmacy without a physician’s prescription.  That argument could also include that the patient should have the freedom to  access any and all alternative  medicine practitioners with the use of their full armamentarium of  offered therapeutic tools, unhindered by bureaucratic laws or regulations.   One could argue: let the patient be fully responsible for themselves as they should be and be fully able to use the services of a licensed physician or surgeon as part of the patient’s  own selection from a host of other opportunities for diagnosis and treatment. One could argue that there are limits to the excuse of protecting the patient from themselves or from those who they consult.  And in the final analysis, it should be the patient who sets the course for their own diagnosis and treatment and for that course all patients should have freedom to obtain and use whatever tools are available.

Would you make the, perhaps Libertarian argument I presented above or do you think that the status with regard to a patient’s medical care is just fine now with adequate autonomy presented to the patient?   Let me read your opinion.  ..Maurice.

Graphic:  From  The U.K. Guardian via Google Images

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