Patient, Heal Thyself // Is it time to skip the scrip?

Even with more than six decades in my rear-view mirror, I hear pretty well. (Okay, some of my wife’s chore requests may not always come through, but let’s not go there).

That said, like an estimated 30 million Americans, I probably have (“suffer” is the au courant word of choice, though it insults the word’s meaning) some degree of hearing loss. For most people, it’s a natural part of aging.

And so, it was good news for ears (and brains, since hearing loss is associated with cognitive decline and depression) that came down the pike last week, when the Food and Drug Administration, in line with President Biden’s executive order of last year, decided to allow hearing aids to be sold to adults without a prescription, over the counter and online. The new rule could be implemented as soon as October.

The high costs of hearing exams and of hearing aids, which can cost thousands of dollars, are not covered by basic Medicare or many insurance plans. That has discouraged millions of the hearing-impaired from getting tested and buying aids.

We hear (if faintly) that some audiologists are complaining about what is about to become the new normal, but, hey, that’s the way the audiometer crumbles.

Being able to obtain hearing aids, like eyeglasses, without a doctor’s permission makes sense. After all, we have, and cherish, autonomy in many more consequential matters of health and life.

And it raises an interesting question: Why should any—or, at least, so many—medicines require a doctor’s prescription, or “scrip,” in the first place?

Yes, there are drugs, like opioids and narcotics, about which a reasonable argument can be made that their more ready availability would be inherently harmful, both to those using them and to society as a whole.

The same argument, though, can be made about alcoholic beverages. Not to mention another unhealthy and addictive chemical routinely overdosed on by many of us (present writer no exception), namely, the disaccharide called sucrose (which you may know as sugar). Not only is no prescription needed for it, and not only is it widely abused, it is actively promoted by a broad assortment of companies and merchants without government interference.

What’s more, many over-the-counter drugs, like acetaminophen (brand name Tylenol) and magnesium sulfate (Epsom salts), carry the potential of fatal overdoses. No scrip needed for those potential poisons either.

And, outside the realm of drugs, we can readily buy all sorts of potentially dangerous things. No professionals’ prescriptions are required for purchasing knives, guns or caustic chemicals.

No responsible person would ever opt to buy and use an antibiotic or antifungal medication, or anticoagulant or beta blocker, or even a sedative, without first discussing with a medical professional whether the drug was indicated and safe for the patient to take. (And, as far as irresponsible people are concerned, they have no lack of other easy and legal ways of harming themselves.)

But, once a citizen, having done due research and consultation, deems a drug appropriate, why should he not have the option of simply… buying it? Like he can a beer or donut? And, while the economics here are complicated, deregulating many prescription drugs would likely result in lower prices for them.

As it happens, more than 700 drugs that required a doctor’s prescription 20 years ago no longer do, according to the Consumer Healthcare Products Association. There are likely hundreds more that are entirely safe for consumers to use on their own but are still unobtainable without a visit to a doctor and a prescription.

Shouldn’t people be trusted to, after consultation with a medical professional (and, if indicated, a halachic authority), make their own decisions about what to put in or on their bodies?

Yes, lines need to be drawn. As noted above, there are some drugs whose regulation by government arguably makes sense. But it doesn’t take an absolutist libertarian mindset to acknowledge that allowing adults to purchase medicines that they have, after due research and consultation, deemed useful isn’t a crazy idea.

In fact, it may well be one whose time has come.

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