Individual consent – what does it mean and how is it obtained?
This article below is a guest contribution from Tom O’Connor responding to my article Attempting a tyranny of the minority on fluoridation. I invited Tom to discuss the issue here, and offered him a right of reply because I think there is value in discussing the points he raised in his Timaru Courier opinion piece and that I critiqued in my article.
Unfortunately, in this issue, the scientific arguments are very often a proxy for underlying values issues, at least on the part of opponents of fluoridation. It is in the nature of values issues that there is no “correct” answer (in contrast to arguments about facts). Nevertheless, the values issues are important so I hope they can be developed in discussion here around Tom’s original opinion piece and his response here. In the end, such issues are decided by democratic and political means so open discussion of the issues is important.
Firstly I am not opposed to the use of fluoride to combat tooth decay per se. Nor do I have any “anti-fluoride mates” as you put it. If the government wants to make fluoride freely available there are many ways of doing that without imposing it on everyone.
There are three main elements to the fluoride debate. The first is the efficacy or otherwise of fluoride as a preventative for tooth decay.
The second is the use of reticulated potable water as a means of delivering anything other than clean water to the community.
The third is the issue of mass medication, or mass treatment or mass therapy of people without individual consent and practical convenient and affordable alternatives. Legislating to declare a medical treatment is not a medical treatment simply on the ground that the dose rate is measured in parts per million is one of the most stupid and dishonest things I have ever seen any government do. Many medications are measured in such minute quantities.
The Grey Power Federation objection to the proposed addition of fluoride to potable reticulated water is based on the third element only. We do not have a policy in the first element simply because we do not have the expertise or scientific qualifications to develop such a policy. We have not considered the second element.
That policy has been, in my view, adequately explained in the Timaru Courier opinion piece you refer to. The following comments are therefore mine alone and do not necessarily reflect the opinion of Grey Power members or anyone else.
As you rightly point out there is probably nothing to be gained in participating in the endless argument between proponents and opponents of fluoride as an oral health treatment. Both sides have accused the other of engaging in pseudo-science and scare mongering. Both are, to some extent, probably accurate and in agreement on that point alone. However, where doubts exist, it is probably better to err on the side of caution.
Territorial local authorities have the responsibility to provide potable water to their communities where no other sources are available or suitable. The principle responsibility of local authorities, as outlined in the Drinking Water Standards for New Zealand, administered by the Ministry of Health, is to ensure drinking water is as free from all other substances and organisms as possible. Using reticulated potable water to convey anything else, be it medical or not, is contrary to that principle.
The use of chlorine to remove micro-organisms and other pathogens is designed to remove unwanted and potentially unsafe matter from drinking. At the end of that process there is not supposed to be any detectable chlorine. That there often is demonstrates the difficulty of getting the addition of trace elements correct. That is a very different matter to the deliberate introduction of an additional substance which many people don’t want.
Mass treatment and individual consent
This is not the first time mass medication or treatment has been introduced in New Zealand. Iodine deficiency, as a cause for goitre, was discovered in the early 1900s and to address the problem table salt was iodised at up to 80mg of iodine per kilogram of salt in 1938. This was accompanied by an extensive public education programme and there was always un-iodised salt as a practical, convenient and affordable option on grocer shop shelves for those who did not want it.
Suggesting that those who object to fluoride in the water they pay their local authority to deliver can obtain alternative supplies from a community tap or buy it from the supermarket is unacceptable. These options are not possible, practical, convenient or affordable for many people.You may also recall a recent proposal to add folic acid to all bread products as a means of addressing a reproductive issue for women. The public outcry which saw that proposal dropped was not solely based on doubts about the efficacy of folic acid but the fact they many people simply did not want their bread medicated with anything for any reason.
You may also recall a recent proposal to add folic acid to all bread products as a means of addressing a reproductive issue for women. The public outcry which saw that proposal dropped was not solely based on doubts about the efficacy of folic acid but the fact they many people simply did not want their bread medicated with anything for any reason.
There are practical and cost effective methods of providing fluoride for those who want it. Forcing it on those who don’t want it is simply unacceptable in a free society.
I will post a response to Tom’s arguments in a few days. Meanwhile, readers are welcome to make their own arguments in the comments section.