Who would make health decisions about children in a libertarian society: parents or medical professionals?
(From the Ask Dr. Ruwart section in Volume 19, No. 9 of the Liberator Online. Subscribe here!)
QUESTION: I just read about Boston Children’s Hospital taking children away from their parents if 
they don’t agree to treat their children the way the doctors recommend. Would this happen in a libertarian society?
MY SHORT ANSWER: In a libertarian society, a child’s guardians, normally the parents, would decide whether the treatment was worth the risk. No treatment works for everyone and every treatment has side effects in some people. Parents might not always make the optimal decision for their child, but doctors won’t always either. If the doctor feels strongly about a certain treatment, he or she should take the time to convince the parents of its worth, rather than use aggression to enforce their recommendation.
The article you cited indicated that children are taken from their parents most frequently “when doctors diagnose the child with a psychiatric disease, but the parents think the condition is a physical one.” Mental problems can be caused by physical factors, such as diet, genetic abnormalities, and certain vitamin deficiencies, which blur the distinction between psychiatric and physical. These factors are often downplayed or totally ignored in physician training. Licensing boards determine the medical school curriculum and reinforce the status quo, rather than cutting-edge or “politically incorrect” knowledge. Emphasis is placed on drug treatment instead of prevention or nutritional therapy, primarily due to FDA regulations. Since children often respond more negatively to psychiatric drugs than adults, forcing children to take them can actually be detrimental.
In a libertarian society, medical practice would be more diverse, since doctors would be certified instead of licensed and prevention wouldn’t be hampered by FDA regulations. Consequently, our medical science would be more advanced. In a society accustomed to using persuasion, rather than coercion, parents are likely to become better informed by doctors and make the best decision for their children.
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Got questions? Dr. Ruwart has answers! If you’d like answers to YOUR tough questions on libertarian issues, email Dr. Ruwart
Due to volume, Dr. Ruwart can’t personally acknowledge all emails. But we’ll run the best questions and answers in upcoming issues.
Dr. Ruwart’s previous Liberator Online answers are archived in searchable form.
Dr. Ruwart’s latest book Short Answers to the Tough Questions, Expanded Edition is available from the Advocates, as is her acclaimed classic Healing Our World.
they don’t agree to treat their children the way the doctors recommend. Would this happen in a libertarian society?
MY SHORT ANSWER: In a libertarian society, a child’s guardians, normally the parents, would decide whether the treatment was worth the risk. No treatment works for everyone and every treatment has side effects in some people. Parents might not always make the optimal decision for their child, but doctors won’t always either. If the doctor feels strongly about a certain treatment, he or she should take the time to convince the parents of its worth, rather than use aggression to enforce their recommendation.
The article you cited indicated that children are taken from their parents most frequently “when doctors diagnose the child with a psychiatric disease, but the parents think the condition is a physical one.” Mental problems can be caused by physical factors, such as diet, genetic abnormalities, and certain vitamin deficiencies, which blur the distinction between psychiatric and physical. These factors are often downplayed or totally ignored in physician training. Licensing boards determine the medical school curriculum and reinforce the status quo, rather than cutting-edge or “politically incorrect” knowledge. Emphasis is placed on drug treatment instead of prevention or nutritional therapy, primarily due to FDA regulations. Since children often respond more negatively to psychiatric drugs than adults, forcing children to take them can actually be detrimental.
In a libertarian society, medical practice would be more diverse, since doctors would be certified instead of licensed and prevention wouldn’t be hampered by FDA regulations. Consequently, our medical science would be more advanced. In a society accustomed to using persuasion, rather than coercion, parents are likely to become better informed by doctors and make the best decision for their children.
* * *
Got questions? Dr. Ruwart has answers! If you’d like answers to YOUR tough questions on libertarian issues, email Dr. Ruwart
Due to volume, Dr. Ruwart can’t personally acknowledge all emails. But we’ll run the best questions and answers in upcoming issues.
Dr. Ruwart’s previous Liberator Online answers are archived in searchable form.
Dr. Ruwart’s latest book Short Answers to the Tough Questions, Expanded Edition is available from the Advocates, as is her acclaimed classic Healing Our World.
QUESTION: I now identify more with anarcho-capitalism and I want to disengage from political action. I further hope that politics will become increasingly irrelevant to people as liberty ideas spread. What do you think of this approach?
MY SHORT ANSWER: Everyone must follow their hearts. If you are called to something other than political action, that’s where you should put your energy. That is where you will be most passionate and successful and where you will find your next step, whatever that may be.
We need people in the liberty movement in politics, but we also need those who actualize the stateless society, as you’d like to do. In my opinion, running as a candidate provides a wonderful platform for teaching others about libertarianism. Taking political action at some point is probably necessary to change the system. However, when society is ready for liberty, it will look beyond politics to see what works. Each of these three activities takes people with different talents and attitudes; we need them all.
Enjoy your journey; feel free to share what you find!
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LEARN MORE: Suggested additional reading on this topic from Liberator Online editor James W. Harris:
Some libertarians have long pondered the question of the need, desirability and nature of political activity. Following are two articles from prominent anarcho-capitalists, one pro-political activism, one against. Both make great reading, regardless of one’s views on the subject.
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with a consumption tax (national sales tax). This seems like a very good idea. First, it would mean foreign manufacturers would pay almost the same tax as domestic ones. Second. it would remove the need for large accounting and legal departments in corporations, and would certainly simplify the paperwork of small businesses. Third, it would eliminate the ability of the wealthy to utilize loopholes in the present tax system. There are many more benefits I can see, and I can’t see a downside. Am I missing something? Do libertarians support this idea?
My Short Answer: Libertarians recognize that taxation of any kind is theft and therefore do not support taxation. However, some dedicated libertarians have been working to replace the income tax with a consumption tax, like the one you’ve outlined.
Among other things, they believe that people would feel the bite much more if everything they bought came with a double-digit sales tax. Tax increases would be more visible — and more unpopular for politicians to propose. The abuses perpetrated by the IRS would also end. Public support for abolishing taxes altogether would increase.
However, one danger many libertarians see in proposing this switch is the possibility that we would end up with a national sales tax AND an income tax.
Why not simply get rid of the income tax and replace it with nothing, as libertarian presidential candidates like Ron Paul and Harry Browne have proposed?
As 
QUESTION: I want to see the removal of all references to a god from money, courts, and schools, as I believe these are a violation of the separation of church and state. What is the libertarian stance on this?
MY SHORT ANSWER: In a libertarian society, all schools would be private. You could send your children to a school that catered to your tastes (i.e., no references to a deity or religion) and religious people could send their children to a school devoted to Him (or Her as the case might be).
Competition in currency, which would be most likely in a libertarian society, would probably result in some private currencies without a religious reference and others with one.
Some libertarians believe that courts should compete as well; others want a monopolistic system like we have today. Since a libertarian society’s code would be ‘honoring our neighbor’s choice,’ it’s likely that courts would offer both Bible-based oaths and secular ones.
It’s a matter of choice. You choose what you want; others choose what they want. The market gives multiple choice; the government usually gives a one-size-fits-all monopoly.
If someone wants to use government to outlaw religious references, he can only do so by giving the government power to impose religious references. Rather than advocating such a win-lose situation, libertarians promote the win-win options that occur when we honor our neighbor’s choice, rather than imposing our own.
(For a more detailed explanation of what the phrase “honoring our neighbor’s choice” entails, 
QUESTION: I’m not sure libertarianism can work unless people are rational and reasonable. And I’ve encountered at least as many irrational, unreasonable folks in my life as I have rational and reasonable ones. I’d like to know: how does libertarian philosophy address that issue?
MY SHORT ANSWER: The ideal political system is one which teaches people to be rational and reasonable. Only libertarianism does this by rewarding responsibility and penalizing irresponsibility.
Conversely, our current system usually does just the opposite.
You’d probably have run into fewer irrational, unreasonable folks if the 20th century had been more libertarian!
LEARN MORE: Suggested additional reading on this topic from Liberator Online editor James W. Harris:
Nobel Memorial Prize in Economic Sciences-winning libertarian economist Gary Becker addresses this question briefly in his essay “
the FDA’s delaying the approval of life-saving ones?
MY SHORT ANSWER: In 1992, Congress passed the Prescription Drug User Fee Act (PDUFA), allowing drug companies to voluntarily pay about $100,000 to get a speedier review. The money went to hire new reviewers.
The fee has grown steadily; it’s now over one million dollars per drug. The part of the FDA that reviews drug applications now receives about 50% of its funding from drug companies. FDA employees (e.g., Dr. David Graham, the whistleblower on Vioxx) have reported being told by supervisors that the drug companies — not the American public — are the FDA’s clients. This should be expected, as he who pays the bills makes the rules.
Does this mean that the FDA now approves unsafe drugs? It depends on how you look at it. Withdrawal rates (the percent of approved drugs removed from the market) from 1962-1992 and 1993-2013 are virtually identical at about 3%. As time goes on, however, more drugs approved during 1993-2013 are likely to be withdrawn. The differences may be small, though, as most withdrawals occur quickly. On the other hand, Vioxx, approved post-PDUFA, was by far the biggest drug disaster in history.
Does the FDA still delay approval of life-saving drugs? Yes! It does so by demanding that companies perform studies taking an average of 13-plus years. Prior to 1962, the average time was about 4 years. I suspect that these delays are still more costly, in terms of lives lost, than approvals of unsafe drugs.
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QUESTION: In a libertarian society, when marriage becomes a private institution, what will happen to the right of a person not to be forced to testify against their spouse in a court of law?
MY SHORT ANSWER: In a libertarian society, no peaceful person could be forced to do anything, including testify against another. Today’s government simply threatens people with prison and fines unless they give information, often at great cost to themselves (e.g., missing work).
Does this mean if you were charged with murder that the witness who could save you wouldn’t testify? Probably not. Witnesses could be reimbursed for lost work and other expenses for testifying, so their cost would be minimal. Withholding crucial information would likely be considered socially unacceptable. Few people would want to be embarrassed by a public announcement that they had done so — and caused an innocent person to suffer.
Even today, it’s almost impossible to force someone to testify truthfully. Witnesses lie to protect themselves and others, even under oath. That’s probably the real reason that spouses can’t be forced to testify today: they are the ones most likely to twist the truth for the benefit of their loved ones.
LEARN MORE: Suggestions for further reading on this topic from 
MY SHORT ANSWER: Some individuals feel called to do that, but it’s tough. After Congressman Ron Paul qualified to be nominated for president in 2012, the GOP 
QUESTION: Recently in the Liberator Online you answered a question with the following supporting argument:
“For example, about 75% of the tax dollars that are targeted to welfare programs actually go to the middle-class administrators rather than the needy. In contrast, private programs give about 75% of donated dollars to the poor. Thus, the poor get more when charitable giving is private.”
I am interested in where you got your statistics. I want to share this argument with friends, but I like to provide references. Could you do so?
MY SHORT ANSWER: Gladly! These are the references that I’m currently citing in the latest version of my book 
QUESTION: If the private sector can provide education better and cheaper than the government, why aren’t they doing it? Nothing is stopping private industry from providing better service than government schools to poor children. They can do this right now and it is 100% legal. So why don’t they?
MY SHORT ANSWER: Actually, providing education to poor or even middle-class children is NOT 100% legal. Parents who send their children to school are required by law to utilize schools that meet specific requirements, such as certified teachers, accreditation, and specific types of curricula.
Even home-schoolers must abide by regulations, which differ from state to state. If parents don’t follow these regulations, their children can be taken from them by Social Services, even if the children can ace every standardized test.
In spite of these hurdles, the private sector already does provides better education for many poor and disadvantaged. The typical Catholic inner-city school takes 88% of all applicants, many of whom are not even Catholic. About 20% of Catholic schools accept students expelled from public schools. Even after adjusting for race, family background, and social class, the average Catholic high school student gained three years of learning above that of the average public school student. The educational gap between minorities and whites narrows for minorities in Catholic schools.