While SRY being silenced will lead to a female phenotype, it isn't the only cause. Another common cause is a mutation in the male androgen receptor. You can pump out testosterone and DHT all day long but if none of your cells can recognize it, you'll have the same net effect. My main point is that if you are going beyond karyotyping to determine gender you are going to have to inspect more than just the single SRY gene.

On a practical side you would never get this past any ethics committee. They would laugh you out of the room for proposing to create a new human life to determine gender.

Billing is the easy part. Getting them to pay is the hard part which is why if we're going to have people "pay" for their own mistakes we need to sort that out up front so that payment can be assured rather than chased after.

You've lost me with your reference to "a medication whose properties are actually fairly well characterized." Are you trying to morph this into some argument about illegal drugs because that's a whole different argument.

But yes, you can refuse treatment and you can accept treatment.

Again I'm not really sure what you're proposing here. The medical community should care about the population at large with respect to such issues as drinking water? They do and they even have their own specialty (Community Medicine).

As far as I know lisinopril does not affect the liver. But it can seriously impair your renal function and mess with your electrolytes (specifically potassium).

If there's a drug that works for you, discuss it with your doctor. Most of the time they are very receptive. If they are not or cannot provide you reasons why they disagree with using that medication then you might need to find another doctor who actually listens to their patients.

This is a specious argument. Unless you plan to sit at home and die quietly how exactly is the ER physician supposed to determine if you did this to yourself or not? The concept works okay in theory but fails to be even slightly practical or implementable. Unless the idea is to just let the ER physician decide on their own accord who they should or should not treat.

As a society we don't tell you how to care for yourself. As long as you are 18 and of sound mind you cannot be treated against your will. Nobody can force you to see a doctor, take any medication, or anything else. If they do treat you against your will in most places that's at least assault.

You can see an MD, DO, PA, DDS, NP, acupuncturist, aromatherapist, shaman, voodoo doctor, crystal healer, televangelist or anything else that floats your boat.

What we do say is that the average person does not understand pathology, physiology, pharmacology, and pathophysiology to make complex judgments about the medication they should be taking. (You do get to make simple decisions assuming there are reasonably safe drugs to treat the problem like NSAIDs.)

In Texas the doctor must give you a copy of your medical records upon request. If they don't comply in a timely fashion then you can file a complaint (and many do) with the Texas State Medical Board. They also can't withhold your records because you owe them money. They can charge you a nominal copying cost, though. I wouldn't be for always providing medical record copies that, for the most part, are going straight into the garbage bin. We no longer force receipts on people who pay at the pump, this shouldn't be any different. Also making most drugs over the counter is a seriously bad idea. Yes, there are some that could be OTC and the impact would be minimal. But if you have hypertension do you know if you should be on an ACE inhibitor, beta blocker, Calcium channel blocker, ARB, or something else. Careful 'cause if you "guess" wrong you could cause renal failure or even kill yourself.