All Medicine Should Be Over-the-Counter
Jacob M. Appel is a bioethicist and fiction writer. He holds a B.A. and an M.A. from Brown University, an M.A. and an M.Phil. from Columbia University, an M.D. from Columbia University's College of Physicians and Surgeons, an M.F.A. in creative writing from New York University, and a J.D. from Harvard Law School. He has most recently taught at Brown University in Providence, Rhode Island, and at the Gotham Writers Workshop in New York City. He publishes in the field of bioethics and contributes to such publications as the Journal of Clinical Ethics, the Journal of Law, Medicine & Ethics, and the Bulletin of the History of Medicine. His essays have appeared in The New York Times, The New York Daily News, The Chicago Tribune, and other publications.
Appel has also published short fiction in more than one hundred literary journals. His short story, Shell Game With Organs, won the Boston Review Short Fiction Contest in 1998. His story about two census takers, "Counting," was shortlisted for the O. Henry Award in 2001. Other stories received "special mention" for the Pushcart Prize in 2006 and 2007.
He is admitted to the practice of law in New York State and Rhode Island, and is a licensed New York City sightseeing guide.
Appel contributed a Dangerous Idea to Big Think's "Month of Thinking Dangerously," advocating that we add trace amounts of lithium to our drinking water to help reduce the suicide rate.
Appel is a Big Think Delphi Fellow.
Question: Why should all medicine be available over the counter?
Jacob Appel: Well it’s interesting you ask that because historically in the United States, all medicine was available over the counter without a prescription. It’s interesting to note one of the first “medications” that you needed a prescription for in the United States was beer. Because beer was prescribed at Prohibition and doctors would prescribe beer for various ailments, for small pox, for rabies, for measles. I should add, not effectively. This is not a good remedy. And from that, from the interest in protecting the rights of doctors, over time, the prescription right of doctors, which is really what it’s about.
The theory is we should protect from themselves. People don’t know the consequences of the medication. The reality is, in the world of the internet, in the world of the educated consumer, most people go to the doctor and say, “This is what I want medically, and there are enough doctors out there that honor this request anyway. That the harm of not letting some people buy medication over the counter and forcing them to have a doctor’s appointment with the added cost will keep certain people from getting the medical care they need. Which in my opinion is far greater a risk than the small number of people who might not be educated enough or informed themselves enough to use medicine in a dangerous way. I think it’s important to keep in mind there are many people out there, and I see them every day who really do need medication. Medical medication, psychiatric medication, who know they need it, who don’t get it because they haven’t been able to get to a doctor, or can’t afford a doctor, or have time to see a doctor to get the prescription.
Forcing people to make a doctor’s appointment in order to get medicine keeps some people from getting the care they need.
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