Tuesday, January 24, 2017

Risk and Freedom

I just heard my governor is thinking of passing a law limiting prescriptions of opiate drugs to only one week of medicine. Since I suffer from chronic nerve damage and depend on opiates to be able to work and raise my son, this harms me directly. Even now I need to go to my doctor every two months, since the feds are not fond of longer prescriptions, but if this law passes, I will likely be unable to work, since my job is not letting me take off part of a day every week to see my doctor. In short, a nominally Republican governor, in the name of "stopping drugs"1 is forcing me to become "disabled" when I could lead a normal life if only I had normal access to medication. Nor is it even achieving what it sets out to do, as I could take $10 or $20 and find opiates in Baltimore, or even Annapolis, within an hour or less. So all it does is inconvenience the ill, while doing nothing to stop drug use2.

I have often discussed the drug laws under which doctors operate with friends, and find it a terrible policy. Until I found my current doctor, I often found myself in pain because stopping my pain would take "too much medicine", or forced to go through withdrawal when a doctor decided he had prescribed too much and cut off my medication. (In two years I underwent withdrawal three times.) All this because the federal government does not trust doctors' judgment and worries some people may either get "too many" drugs or get drugs they "do not need". Well, let us think about this. We have two choices. We can allow people in pain to get medication that alleviates that suffering, or maybe even allow people to function who are currently called disabled, but would have to accept that maybe some people would get drugs that are not strictly necessary, and maybe even a few people who have no pain might get pain killers. The alternative is to try to stop people from getting drugs they don't "need" (by whatever definition3), but as a consequence, people in pain will be inconvenienced by frequent doctor visits, and many will either get too little pain relief or maybe get none4.

This argument points out one troublesome aspect of true liberty, akin to the one I discussed in "The Right to Be Wrong -- An Uncomfortable Argument". Freedom often mean accepting things that you may not like. And just as freedom means accepting people may say things you don't like, run businesses in discriminatory ways, and so on, freedom also means accepting risk. And that goes contrary to our modern philosophy. Just look at the argument about drugs. We would rather make sick people suffer with too little relief than run the risk that people may get drugs we find unacceptable. We cannot live with the risk people may behave in unacceptable ways.

But it is not just behavior. Risk is very real as well. Our current government is, at its heart, risk averse. We pass law after law based upon the worry that some problem may occur. All our laws are intended to change the world to make life "safe", to make it "fair" to ensure none suffer any hardships. Why do so many call it a "nanny state"? Simple, because it seems more and more our state is willing to curtail our freedoms out of fear that we might suffer some hardship, physical, financial or emotional. And not just content to protect us, the law goes even farther, trying to channel our behavior into "proper" behavior out of fear that we might make a "wrong" choice, or be led into "improper" behavior.

We need to eliminate this belief. Government cannot prevent all hardship, nor can it make life free of risk. All it can do is eliminate opportunities and reduce overall happiness. Freedom, true freedom, means accepting that life may bring hardships, and others may suffer as well. If you worry about risk, in a truly free state, you will prepare for it yourself, you will not force others to live by your level of risk aversion, and cut off their choices to match the fear you feel. Freedom means allowing others to run risks, and preparing personally for the threats you might face. Freedom means risk, and others acting in ways we may not like, but it also means opportunities, and the ability to behave as we wish, whether others like it or not.

And that is what we need to understand. When we strive for elimination of risk, "fairness" and "right" behavior, it means we lose our liberty, we eliminate our ability to choose and little by little allow ourselves to be enslaved, and we still do not gain the supposed benefits. It is a process of selling off our freedom to gain nothing but illusory benefits.

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1. He also has an emotional appeal, as he lost a family member to drug overdose. However, that is a poor guide for policy. I thought conservatives were led by reason, not emotion. Yes, it is sad that people suffer tragedies, but that does not mean government is the tool to prevent those incidents. Trying to make life perfect via government is a prescription for misery and totalitarianism. ("Life Is Not Fair - And Trying To Make It So Makes Things Worse", "For Your Own Good -- The Problem with Subjective Rights", "The Road to Violence", "The War of All Against All", "In Loco Parentis", Hard Cases Make Bad Law", "The Sexual Revolution and Prostitution", "Selfishness as Reason - 'Wants', 'Needs', 'Fairness' and Other Guises for Arbitrary Decisions" and "Arbitrary Choices")

2. I admit up from, I believe in decriminalizing drugs. For that matter I believe in eliminating the prescription drug system, and allowing free purchase of medicine. (See "Drug Legalization", "The Danger Inherent in Banning "Bad Ideas"", "Guns and Drugs", "Missionary Zeal and Human Discord", "Smoking Versus Sex -- Want and Need Take Two", "Common Sense,Philosopher Kings, Arbitrary Law and Dictatorship", "Guns and Drugs", "The Problem of Established Perspectives", "De Gustibus Non Disputandum Est", "Guns and Drugs", "Nonsensical Regulation", "The Free Market Solution", Medical Regulations" and "Medical Regulation II")

3. I am not sure exactly what "need" means, as it is a meaningless word. If a stressed person gets valium from a psychiatrist it is valid and "needed", if he does it himself, or uses an illegal depressant,  he does not "need" it. And exactly how much pain relief is "needed"? Can the government tell how much pain I have or how well a drug suppresses it? Even doctors admit they cannot, but a bureaucrat making a singular rule for all can? For that matter, if an individual gets benefit from recreational drugs, who is to say he does not "need" them? By that definition, your books, your television, your church and anything beyond bread and water could be made illegal, as you don't "need" it. People decide what is or is not beneficial for them, "value" is subjective, just because one says drugs have no benefit does not mean some do not find benefit in them. ("Rationality, Drug Use and Laws", "Luxury and Necessity", "Putting My Cards on the Table", "Arbitrary Choices", "Addicts?", "Standing By My Principles", "Who Does it Harm?", "It Doesn't Matter to ME...")

4. Once, when forced to go through withdrawal while suffering horrific pain, I tried to change doctors. The doctor I saw, being a pillar of compassion told me I was a "drug seeker", and scolded me for "going through withdrawal" (which I told him was the case). The fact that I had discolored hands and feet, medical history of nerve damage and other documentation (though at the time no diagnosis, as it took doctors six years to figure it out -- cf "Morbus non Gratus"). That is the sort of behavior the current system favors, judgmental doctors denying treatment (and often insulting -- it happened more than once) to those in pain for fear of being prosecuted.

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UPDATE (Later the Same Day): I am not sure if the initial description I heard of the law is entirely accurate or not. I am getting multiple, conflicting descriptions. On the other hand, since people who require pain killers are routinely treated as potential criminals and "guilty until proven innocent" of moral turpitude, I am inclined to always expect the worst when it comes to drug laws. You would not think to call a diabetic who came in to ask for insulin a "drug seeker", but those of us who need pain killers cannot actually ask for them or risk being called the same. We have to routinely pretend we do not want drugs we need, try over and over to substitute other drugs that often fail to work (I have had to try over a dozen drugs that had horrible side effects, did not relieve my pain, and sometimes had to do it more than once for the same drug), and accept doses far below what we need, waiting two or three visits before hinting obliquely that our continued excruciating pain might demand a tiny increase. If we treated, say, heart medications the way we treat painkillers, we would have people dying left and right of coronaries as they waited to suggest to the doctor that maybe that erratic heartbeat might suggest they need a little more medicine. But since pain does not kill, only disables, and our prohibitionism history and war on drugs demand over the top hostility to any opiate, those suffering from pain must continue to suffer lest someone,somewhere may receive some illicit pleasure from opiates.





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