I found Dr. Flanigan’s article extremely insightful about how self-medication should be society’s aim over prescription drug laws. As someone who is a minority and whose race has been historically neglected and exploited by the medical community, the points made in this article did lead me to believe Dr. Flanigan’s ultimate conclusion, which is that prescription drug laws violate patients’ rights to self-medication and that a non-prohibitive drug system should be implemented alongside prescription-grade drugs being made widely available to patients without a physician’s consent or knowledge. I did, though, have doubts about prescription-grade drugs being made available to patients without their physicians’ consent or knowledge. This is because of the high rates of substance abuse in the United States that disproportionately affects some communities more than others, such as Appalachia and low-income persons. In light of this, Dr. Flanigan adds the clause that patients who are informed and freely consent to pursue self-medication over treatment options recommended by their physician essentially waive their rights against any risk or harm done to them through their pursuit of self-medicating activities.

Nonetheless, the ethical arguments Dr. Flanigan uses to support her ultimate conclusion does cause me to wonder how other factors will affect people’s ability to self-medicate. For instance, I believe that Dr. Flanigan wrote this piece under the assumption that people who choose to self-medicate must also have the ability to consistently purchase and access self-medicating products or treatments. Of course, this is a highly idealistic perspective. Our healthcare system in the U.S. is not as effective as other nations’ healthcare systems, such as Canada or Denmark. For years, many individuals, especially if they were minorities, have expressed apprehension over going to the hospital mainly because of the exorbitant fees and insurance costs one could incur from simply being transported to a hospital in an ambulance. In response, these individuals might choose to self-medicate over a physician’s recommended treatment, but what of those who don’t have insurance or are not making a livable wage to support themselves and their families? How will they be able to self-medicate? Who is responsible for regulating the prices of self-medication products and treatments to prevent price gouging among pharmaceutical suppliers?

There is a huge upset among students about the refusal of the University to remove the names Ryland and Freeman from campus buildings. The way we see it, these names should have no place on our campus. To us, the choice seems so obvious– rename the buildings named after old and dead racist white men. To a group of old white men, the choice is not so obvious. The decision to keep a building named after slave owner Robert Ryland, was justified due to the fact that he was Richmond’s first president. It was also justified by the ~Board of Trustees~ as well as President Crutcher because they believe that “removing Ryland’s and Freeman’s names would not compel us to do the hard, necessary, and uncomfortable work of grappling with the University’s ties to slavery and segregation, but would instead lead to further cultural and institutional silence and, ultimately, forgetting” (Richmond Times Dispatch https://richmond.com/news/local/education/the-university-of-richmond-confronts-its-racist-legacy/article_2026f8f5-431f-5959-87de-cc33f91987dc.html). 

I find this justification pretty problematic. Yes, I agree that it is important to recognize the shortcomings of our University, both past and present. However, having the buildings of our campus named after these men does not seem productive to me. By keeping these names on our buildings, it seems we are uplifting a legacy of racism instead of denouncing UR’s racist legacy. It’s like the monuments on Monument Avenue. Did Robert E. Lee really have to be on a literal pedestal in the middle of the city’s most famous street in order to remember Richmond’s past, along with many other segregationist political and social leaders of the confederacy? Looking at the vandalism and deconstruction of monuments on that street today, it seems everybody collectively decided the answer to that is no. It was a huge win for activists when these monuments were finally reconsidered. 

Students, and I’m sure staff, are feeling very disconnected from the decisions of the famous ~Board of Trustees~ consisting of the other portion of rich white men of whom the rest of our buildings are named after. I know this is just how University’s operate because of course they have to consider finances, endowment, and pleasing donors. I do find it kind of sad that the money is used to justify the preservation of racist legacies, but is there anything we can do about that? Or is that just how it has to be? I’m afraid it’s the latter, but I still hope for change and will encourage my peers to keep fighting.

In doing this reading and listening to the podcast, I think one of the most interesting and important points made was the relationship between culture and the assumptions and/or beliefs we hold. Dr. Bezio describes in the podcast how the culture we belong to plays a significant role in the forming of our assumptions, and subsequent actions such as laws and policies that work to protect these assumptions. One example of this is the wearing of a hijab or other head and/or face coverings by women who are typically Islamic or another subset of a religion. As Dr. Bezio says, in the United States and many European countries, this wearing of the hijab and/or other facial coverings is uncommon because the cultures of these countries are largely rooted in and dominated by Christian beliefs; however, in many other parts of the world, these religious practices are seen as the norm, for Islam, instead of Christianity, serves as a base for the culture. Thus, culture strongly impacts the assumptions we hold and the actions we take, for in many Western countries, wearing a hijab and/or other covering is seen as outside the normal culture and odd, leading to assumptions such as that these women are being forced to wear these coverings and are being oppressed, and it is these assumptions that have led some countries to even ban the wearing of these covers, even though it is only seen as more restrictive or unnatural because of the culture.
Flanigan goes on to relate to this belief of the influence of culture on our assumptions, beliefs, and actions. In describing the doctrine of informed consent, Flanigan goes on to describe one of the justifications of the doctrine of informed consent, which is epistemic authority. Epistemic authority refers to the idea that “physicians ought to treat the whole patient, not just the condition”, and that individuals know best what their overall interests and well-being is (Flanigan 580). One example of the epistemic authority justification for DIC is Flanigan’s discussion of blood transfusions. In some religions, blood transfusion is not allowed, as it is seen as morally wrong; thus, in this situation, individuals of this religion know what is best for their interests, per their religion, and have the right to deny this medical treatment, even if it would help them, because of their beliefs. Like in the podcast, the culture of individuals helps to form their beliefs, such as this religious individual whose religion, and the culture associated with the religion, helped them to form the assumption that blood transfusions are wrong, even if they may be acceptable in other societies, and something they can deny. Our culture, oftentimes with its religious underlying, influence our making of assumptions, whether it be that hijabs are restrictive or that blood transfusion is unallowable, and causes us to take actions in accordance with these assumptions, such as ban the wearing of hijabs or refuse a blood transfusion, even if these actions appear unnatural or uncommon to others from different cultures.

Money is the ultimate equalizer. The names on Ryland Hall and Mitchell-Freeman should be changed. One would be hard pressed to come up with moral reasons to keep the names as they are now. However, moral reasons are not what are being considered. The Board of Trustees does not want to send the message that if you donate money that your name could be stripped from your contribution at a later date. Whether that view is personally motivated or not is irrelevant. It exists and is likely here to stay. The Board of Trustees is in charge of maintaining the well-being of the University, i.e. its finances. To that end they are doing a pretty good job. The “simplest” fix to the issue at hand would be for someone exceptionally rich to donate a vast sum of money on the condition that the names are changed. The hard part is finding that person. Odds are if any of the current/past donors cared enough then it would already be done. I have heard arguments that the Board of Trustees should listen to what the students want as ostensibly we are the heart of the university. That is unlikely to happen. Instead, we should aspire to do better when we are in their position. When we are on the boards of organizations and universities in the future, we should try to put aside our egos and listen to the student body and generation we are affecting. Will this happen? That is hard to say, only time will tell.

On a related note, the timing of the name changes was poor at best. It was done on a random Wednesday, the day after the email was sent out. The process of research and decision making took a decently long amount of time, so odds are people would not notice if the decision had been delayed a few more months to the end of the semester. This would have reduced negative publicity and given the University more time and options to deal with the backlash we now know with the benefit of hindsight was inevitable. I am not advocating for pushing the problem further down the road, but instead a more conscientious effort to apply whatever decisions were made. Ryland is not even done being renovated so the University certainly had time to make a decision on that building. With regards to Mitchell-Freeman, as a resident, I still catch myself calling it Freeman Hall. It is ingrained in my mind and it will take time for that to change. If the change had been made over the summer, then the next set of residents would naturally call it by its new name. That does not mean that people who currently live in the building and others around campus get a free pass in calling it Freeman, but instead those individuals who refer to it most would be more easily be able to set a positive example. Long story short, the whole process was a mess and the University has a lot to learn

I fully understand that the University of Richmond is a financial institution that is only able to survive because of the donations (both current and historical) from wealthy individuals such as Charles Ryland and Douglas Freeman. I also understand that publically attacking these individuals would lead to many conservative donors pulling their funding from the University, which could lead to its downfall because (statistically speaking) most of the donors are probably conservative.  Does that make their non-action morally right or acceptable? No, I don’t think so. But I do think that looking at it as a financial matter, rather than an emotional one, can help someone see why UR acted the way it did. Whoever decided on this course of action most likely plugged all the pros and cons and found that this weak, half-way solution produced limited long-term consequences because the people who would be most upset (students, various professors) don’t actually make that much of a financial impact on the university’s bottom line. Many of us are upset by their decision, but I don’t think that any of us are going to switch schools because of it. Donors don’t have that same obligation to keep giving UR money and their opinion literally decides the future of the university, so the administration will always side with them.

As a student, this is immensely frustrating because (as Dr. Bezio mentioned) UR pretends to only care about students and our well-being, and refuses to acknowledge that their real loyalties lie with the donors. I think that this was a terrible way for the university to handle the situation because it fails to recognize and acknowledge its own shortcomings. I believe that if they had said something along the lines of “We know this isn’t enough, but it is the most we can do at the moment and we’ll do more later,” that would have been much more acceptable to the student body. I guess that could still anger donors who would pull funding, so it’s like being stuck between a rock and a hard place. Do you think that there was a way that UR could have mad everyone happy?

I think this podcast does a great job of illustrating exactly how implicit biases and stereotypes create a butterfly effect of harmful consequences. I am saddened to learn about the problematic origins and ineffectiveness of the D.A.R.E program, as I was the valedictorian of my DARE group in the fifth grade. Additionally, I see the power and pervasiveness of implicit biases enforced by the media and stereotypes from my own experience. I grew up in a rural and very non-affluent area that was relatively diverse, and yet the same implicit and harmful image of predominately persons of color as ‘drug abusers’ comes to my mind. As discussed in the podcast and in my previous blog post, that images such as these portrayed by the media are responsible for this.

That brings into question why the media is so set on perpetuating harmful images, and I think this podcast fills that information gap. People in power, like the First Lady attempting to stop drug abuse or the racist lawyer from the 1930’s who criminalized marijuana (forgot his name), have the means and ability to get their implicitly biased message out to the world. This makes it of the utmost important for everyone, especially those in power, to expose themselves to otherness and different opinions in order to diminish implicit biases to the best of their ability.

Hidalgo’s article, “The Duty to Disobey Immigration Law,” was a very interesting read, which provided a viewpoint uncommon for American ideology. A focus of American culture is trust in the justice system and the sanity of laws, especially regarding obedience–but, the article focuses on a guiding factor even more important than the law, morality. Hidalgo argues the moral responsibility to disobey immoral immigration laws, as it is more important to follow moral values rather than an unjust law. Additionally, he focuses on the unconstitutionality of immigration laws, describing the violation of individual liberties/freedoms. In his argument concerning the unconstitutionality of these laws he ironically utilizes the justice system  to his advantage. This article highlights the problem of authority, although we are taught to follow the leader/authority figure, they are not always correct, and when they act unjustly one must disobey. The guiding factor in these situations should be ethics and, in this case, the violation of rights of immigrants. However, the argument becomes difficult with different assumptions of the law/morality.

I, personally, agree with most of Hidalgo’s view points, as the prosecution and treatment of  of undocumented immigrants is completely immoral and unconstitutional and must be rejected despite the written law. However, in Dr. Bezio’s podcast, the formation of assumptions is explained, especially about our assumptions concerning  culturally/racially different people. Donald Trump and other republicans fomented the assumption of undocumented immigrants as criminals, dangerous, and rapists, convincing their followers to believe the same, when the statistics clearly point to the contrary. These assumptions are based in morality, it is seen as immoral to allow undocumented immigrants in the country because they are “predators” so they need to protect their community. Additionally, they argue the stance of law and order to respect the laws in place because they are just. These ideas, which I strongly disagree with, are based on the same principle as Hidalgo’s argument. It is interesting to note the different, polarizing ways in which both morality and lawfulness can be implemented to argue opposite viewpoints–this is the power of our assumptions.

As I was listening to the podcast, I couldn’t help but think of my FYS from last year: Storytelling and Identity. The entire purpose of the class was to break down our assumptions around people in juvenile incarceration, so once a week we went to Bon Air Correctional Facility to talk to inmates. These visits weren’t meant to be serious or accusatory but were designed to show our similarities even across our different incomes, education levels, and life stories. Although they were incarcerated and I was not, there were many similarities between me and many of the guys that I spoke with. I had assumed that they would all be dangerous, aggressive, and vulgar when in reality, they were funny and interesting people. Because I had never interacted with someone who was in prison, I formed all of my ideas of a prisoner off of murder-mystery TV shows like Criminal Minds and Bones. Without exposure to this population, I saw them all as “abnormal” and automatically evil. In reality, most of them were detained on drug charges, larceny, or other non-violent crimes. Moreover, all of the inmates that I spoke to said that they committed their crimes out of need, not desire like the media prefers to portray.

Perhaps even more shocking was the fact out of the 20 plus inmates that I interacted with, not one of them was white or from an affluent area. The vast majority were black and the rest were Hispanic, with most of them coming from New Port News or Portsmith, which are both low-income areas of Virginia. This shows the racist nature of the justice system that Dr. Bezio discussed and how the canons that were put into place in the eighties are still very present. Most of the inmates had at least one parent that was currently incarcerated, and many had been put in foster care or abandoned either because both parents were in jail or the single parent could not afford to keep their child. In over-policing and over-charging POC and low-income people, it creates an inescapable cycle of poverty that compounds through generations and until this problem is addressed it will not go away.

I will preface my blog post by stating I am against all prescription drugs being unrestricted. In the first section, when Dr. Flanigan writes the “risky access” part, why does Danny not just get a second opinion? For something as nuanced as diabetes treatments, doctors usually have different views on how to best proceed. Further, Danny is not a doctor. How would he know what type of insulin to purchase? The amount? Usage? Some of you might say that he could use the internet, but I counter that the internet can be very misleading. He would most likely come upon the wrong answer, possibly causing terrible harm to himself. While I guess it is his choice to do terrible harm to himself, it does not seem like such a good idea. Another point of contention I have is when Dr. Flanigan states, “Even if an institutionalized right of self-medication did cause more anxiety for all patients, widespread low-level unease wouldn’t necessarily outweigh the anxiety and fruition that is borne by patients who would take advantage of medical option that they presently lack under prohibitive regimes” (582). The easy counter to the statement is that the widespread low-level unease for all patients might actually outweigh any benefits that other patients would garner. We can not know the answer because, as the Effective Altruism reading pointed out, QALY’s and WALY’s are an inexact science at best. Dr. Flanigan’s statement also provides a significant reason why all prescription drugs will never be unrestricted entirely; Too many people would be negatively affected by it, so they will not vote for it. I personally would not trade having more anxiety for others to have the ability to take advantage of previously unattainable medical options. Granted, I have always had great relationships with my physicians and have been recommended to some of the world’s best in their respective fields. That likely skews my views in favor of physical control and many members of my family being doctors.
A particular part of Dr. Flanigan’s work seems especially relevant during these COVID times. If antibiotics become unregulated, then ‘superbugs’ would likely become more apparent. Considering the past year, I would not be surprised if said actions resulted in a pandemic. Why would we risk that? Sure, the paper touches on public health risks usurping certain rights, but that is after the fact. Why be reactive when we could be proactive in preventing another pandemic?
I do not know enough about the inner-workings of drug prices and insurance coverage to have a fully informed opinion on what would happen to those markets if prescription drugs were unrestricted. However, I hypothesize that drug companies and insurance companies would lose money, which makes all of this unlikely because whether we like it or not, money talks.

I have never given much thought to prescription drug laws, in my mind I just thought if I get sick or have a medical emergency a doctor or nurse practitioner will tell me what I need to get better and point me in the direction of any prescription drugs I may need. I have also never put time into thinking about the government’s paternalistic role in prescription drugs. This prompted me to ask myself, which is more moral, giving someone an untested drug they need knowing it could have negative side effects, or not giving someone an untested drug they need knowing they will suffer without it? Do I just think it makes sense to not give someone a drug we don’t know is safe because that is what dominant culture has told me? Did other countries adopt similar pharmaceutical regulations because they are a good idea or because they felt it was necessary? After listening to the podcast I have an increased idea in my mind that other countries have their reasons for the things they do, while we might think it is “normal” to regulate drugs I feel as though other countries would have had to decide on their own that it was a good idea to have prescription drug regulations because our normal is not automatically other counties normal.

I wrote a paper critiquing the rhetoric of Nancy Ragan’s “Just Say No” campaign in my FYS first-semester last year. I am really glad Dr. Bezio talked about the racial dynamic in the advisements in her podcast because it is a side of the campaign I did not come across in my research about the language of the campaign. On a side note, I have a feeling if I had my professor would not have enjoyed reading/wanted to read my paper on the subject, but I would have loved to explore it.