Doctors are expected to mitigate risks, too. Valproate-induced spina bifida is a real problem, and doctors share a responsibility to prevent it when it won’t harm their patients. They share this responsibility because they previously tried making patients entirely responsible for mitigating their risk, and that approach has failed.

Nobody said the woman in the article “has to suffer”. They didn’t refuse to give her any medicine, they refused to give her a particular medicine. There are plenty of alternatives, and in fact the doctor in this article wrote the woman a prescription for a different medicine. But of course, some people only want what they can’t have.

Despite what patients often think, doctors are not drug dispensaries. It’s not their job - and never has been - to give patients the latest drug they read about online, or the drug that worked for their friend, or the drug that someone said “ask your doctor” about. If there is a less risky drug that can treat the patient, they will prescribe that instead of what the patient wants.

To take another example, vancomycin is an antibiotic of last resort. Bacteria have not yet developed widespread resistance to it, so it is reserved for patients who have antibiotic-resistant infections, like MRSA. If it is used too much, theoretically bacteria can finally develop resistance to it. And theoretically, people in the future with MRSA may suffer.

Next time you get antibiotics, try telling your doctor “No, I want a vancomycin prescription”. You will be disappointed. They are going to give you what they think will get the job done without incurring unnecessary risks, for you or other people.