I criticize occupational licensing as an inefficient grab at economic rents, but as I’ve pointed out before, there are examples where they seem like the most effective way to reduce public risks. Even where I disagree with, or am at least skeptical of, the desirability of occupational licenses, it’s important to recognize the benefits. So sometimes it’s good to call attention to the victories of the American Medical Association; to many libertarians, the scapegoat for all of our medical cost woes.

Charlatan, a book by Pope Brock, seems like one of these victories. It follows the 1920s-30s cat-and-mouse battle between medical quack John Brinkley, and the Morris Fishbein, the editor of the Journal of the American Medical Association. Brinkley’s scam was a “cure” for -ahem- lack of vitality, and his “treatment” was to sew a goat’s testis into the scrotum of the afflicted. Obviously, many died and many were injured. Fishbein eventually got the quack dragged into court, where he was stripped of his medical license.

Should people be allowed to have invasive procedures that have no chance of having an effect? To many of the same libertarians that are highly critical of the AMA, the answer will be yes, if these procedures do no harm to anyone else (we’ll ignore the goat for now), and the individuals are of otherwise sound mind, then they should be allowed.

To most of the people who believe the net benefits of the AMA outweigh the costs, the answer will be no, people should not be allowed to pay someone to do serious physical harm to them under the guise of medicine.

In some ways, the desirability of organizations like the AMA and other medical regulations depends on how willing you are to allow individuals with extreme preferences to exercise their autonomy. Homeopathy and other New Age “treatments” are the mild areas over which this debate occurs. Cases like this goat treatment, and Body Integrity Disorder, are the more extreme examples.

In any case, in the event that you think people should be prevented from having goat testis sewn into their bodies, this was a victory for the AMA. I’m going to call the prevention of this surgery a good thing, but I’m open to persuasion.

H.T. Michael Shermer

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