Tag Archives: medicine

Flogging a dead horse – anti-fluoridationists lose in court again

flooging-horse-certificate

This certificate should be awarded to New Health NZ, the NZ Health Trust and the anti-fluoridation movement for not knowing when to give up on the “fluoridation is medicine” myth.

The NZ Court of Appeal has rejected the latest legal attempt by New Zealand anti-fluoridation campaigners to hinder community water fluoridation. You can read a summary of the ruling in the Court’s press release – New Health v South Taranaki District Council. The full Court of Appeal ruling can also be downloaded.

Of course, you might find it boring – it is full of legalese. The appeals (there were three and all were rejected) themselves were  about details – the definition of a medicine and the right of governments to make regulations. But readers might want to reflect on who took the legal action and who paid for it.

follow-the-money

New Health NZ took the High Court actions and appeals. It is an incorporated society set up in 2005 by the The New Zealand Health Trust. This Trust is the lobby group for the “natural”/alternative health industry in New Zealand and is financed by that industry. So, in effect, this legal action was taken by the alternative health industry – and paid for by this industry – which is big business.

We can get some idea of the costs involved from the financial statements of the NZ Health Trust (strangely registered as a charity) and New Health NZ (statements available on the society’s register). Unfortunately, the latest statements only provide information for the 2014 and 2015 financial years – but the legal action is several years old so you can get an idea of the money flows involved.

The NZ health Trust appears to receive grants in the hundreds of thousands per year from the alternative health industry($250,000 in 2014 and $190,000 in 2015). In its turn, it distributed “grants & donations” in the hundreds of thousands (125,000 in 2014 and $130,000 in 2015).

nz-health-trust

New Health NZ received grants of around $100,000 per year ($100,00 in 2014 and $95,000 in 2015). It paid out similar amounts in “Professional and Consultancy Fees” ($95,156 in 2014 and $95,124 in 2015).

new-health-nz

These amounts are of the order required for the legal actions taken by this group.

So here we see a money flow from the “natural”/alternative health industry, through the New Zealand Health Trust to New Health NZ to pay for legal attempts to halt community water fluoridation.

At least, this time, New Health NZ was ordered to pay costs – a sure sign that the court believes their legal actions no longer have any community value.

A sign that they should stop promoting their myth that community water fluoridation is a medicine – they should stop flogging that dead horse.

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Attempting a tyranny of the minority on fluoridation

quote-whereas-back-then-i-wrote-about-the-tyranny-of-the-majority-today-i-d-combine-that-with-the-ray-bradbury-212862

Tom O’Conner, president of Grey Power, describes community water fluoridation (CWF) as the “Tyranny of the Majority” (see “Fluoridation of water a trampling of our right,” Timaru Courier, May 26th).

Well, it is nice to see an anti-fluoridation piece which does not resort to scientific misrepresentations and distortions.* These fallacious “scientific” arguments a really just a proxy for the underlying political or values beliefs of the person advancing them. It would be more honest if we discussed these instead of wasting time on the scientific arguments. So, thank you,Tom.

But what about this “tyranny of the majority” argument? Most anti-fluoride campaigners will probably support it.  While we might have  an idea of what it means here is a more specific definition offered by Wikipedia:

“The phrase “tyranny of the majority” (or “tyranny of the masses“) is used in discussing systems of democracy and majority rule. It involves a scenario in which decisions made by a majority place its interests above those of an individual or minority group, constituting active oppression comparable to that of a tyrant or despot. In many cases a disliked ethnic, religious, political, or racial group is deliberately penalized by the majority element acting through the democratic process.”

Freedom of choice

So I think O’Conner has let his emotions get out of hand here. Sure, CWF usually results from a majority decision, but there is no deliberate penalising of any minority group. In fact, “fluoride-free” community taps are often provided by councils to make sure the minority freedom of choice is maintained. Where is the tyranny in that?

There may be a number of reasons for people to object to the quality of the provided tap water – the taste, presence of chlorine, colour, etc. Tap filters are common – and specific filters are available for removing fluoride, chlorine. colour, tastes, etc. Bottled water or water from different “natural” sources are also used by people who object to tap water for one reason or another. In some countries people (and especially tourists) never drink tap water – they use bottled water.

Whenever I check with anti-fluoride campaigners I find they already exert their freedom of choice by obtaining their drinking water from a separate source or using a fluoride removal system like an appropriate tap filter, distillation or reverse osmosis. You have to ask – if they have already exerted their freedom of choice, what the hell are they talking about with this argument? Perhaps the freedom to prevent the choice of those who voted for a safe and effective social health measure – CWF?

Fluoridation is medicine myth

O’Connor evokes the New Zealand Bill of Rights Act 1990 – in particular the clause which says:

“Everyone has the right to refuse to undergo any medical treatment.”

This clause in Part 2 of the Act – Civil and political Rights – includes rights such as not being deprived of life,  subjected to torture or cruel treatment and not being subjected to medical or scientific experimentation. This suggests he is again being rather extreme to see CWF as a form of forced medical treatment. Hell, it isn’t even a form of forced drinking of tap water given that no-one is denied alternatives.

In fact, New Zealand legislation  is clear that fluoride is not a medicine when used at the low concentration present in fluoridated water. Anti-fluoride campaigners have attempted to challenge that in court but every attempt has been rejected. See, for example, NEW HEALTH NEW ZEALAND INC v ATTORNEY-GENERAL [9 October 2014] and NEW HEALTH NEW ZEALAND INC v ATTORNEY-GENERAL [4 September 2015]

Tom O’Connor plays down these decisions – always hopeful that the next appeal by New Health NZ will succeed. But in doing so he is attempting to push  the proverbial uphill.

[By the way, New Health NZ is an astroturf organisation set up and financed by the NZ Health Trust – the lobby group of the NZ “natural”/alternative health industry. It has deep pockets – see Big business funding of anti-science propaganda on health]

But, to hell with the legislation. O’Connor argues:

“it is illogical to argue that fluoride is not  a medical treatment but then introduce it to drinking water to combat tooth decay.”

Then what does he, and his anti-fluoride mates, think of chlorination of  our drinking water supplies. This disinfection process is not a medical treatment but is clearly meant to prevent disease. According to O’Connor’s logic, it should be seen as a medical treatment and thus subject to the Bill of Rights!Incidentally, many opponents of CWF are also opposed to chlorination. But tend to be less public about this preferring to see CWF as the “low hanging fruit” and mobilisation against chlorination a future project once CWF has been defeated.

Incidentally, many opponents of CWF are also opposed to chlorination. But they tend to be less public about this preferring to see CWF as the “low hanging fruit” and mobilisation against chlorination a future project once CWF has been defeated.

O’Connor extends his logic:

“If it [CWF] is a medical treatment the Bill of Rights clearly prohibits its introduction to communal drinking water. If it is not a medical treatment to combat tooth decay, there is no logical reason to introduce it to communal drinking water. There is no middle ground.”

The fact that exactly the same logic can be applied to iodised salt or the disinfection of communal drinking water by chlorination surely shows the danger of bush lawyers taking it into their own hands to define and interpret the law.

Just imagine if a minority managed to prevent communal water disinfection by using the Bill of Rights, the right to refuse to undergo medical treatment, their perverted concept of “freedom of choice” and arbitrary definition of chlorination as a “medicine.” Doing this, and at the same time denigrating democratic decisions as the “tyranny of the majority” they would, in fact, be imposing their own tyranny of a minority. One that denied a safe and effective water treatment process prevent sickness and spread of diseases.

*Note: Mind you, O’Connor still manages to misrepresent the scientific aspects by saying:

“The key issue here, however, is not the effectiveness or otherwise of fluoride as a treatment for oral health. That is an unresolvable argument between competing proponents and opponents which lay people are  not equipped or even obliged to decide.”

Sure – the debate may not be resolvable, given that is driven by ideological factors. But the science is resolvable. The effectiveness or otherwise of CWF is an objective fact which can be determined by proper investigation of reality. Yes, that requires scientific and health experts and not lay people.

The wise lay person recognises her limitations in areas outside her expertise and takes the advice of the expert. We listen to the advice of mechanics about our cars, builders about house construction, engineers about road construction, oncologists about cancer treatment, etc. We should do the same with the science related to CWF.

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Are submissions on fluoridation worth it?

Like most people I struggle to find the energy when representative and government bodies call for submissions. But I did make the effort recently when Medsafe called for submissions on their proposed clarification of how fluoridating agents are defined in the medicine regulations. I am pleased to see the simple suggestion I made was accepted. But my purpose here is to illustrate how this consultation proceeded and how opponents of community water fluoridation (CWF) tried to swamp it with their submissions.

The background

Last November the Ministry of Health (MoH), through Medsafe, called for submission on a change to the Medicine Regulations 1984. This change had been recommended by the High Court and the Crown Law Office who specifically suggested that fluoride compounds used for CWF be exempt from definition as a “medicine.” This arose from the defeat of attempts by an anti-fluoride group, New Health NZ, to use the argument that fluoridation was medication in the High Court actions against CWF. Despite these defeats the High Court and Crown Law Office considered the regulations should be clarified to remove the argument from repeated litigation.

Simply, the proposal was to add a new regulation:

“Fluoride-containing substances, including the substances hydrofluorosilicic acid (HFA) and sodium silico fluoride (SSF) are not medicines for the purposes of the Act when they are manufactured and supplied or distributed for the purpose of fluoridating community water supplies.”

Medsafe asked for responses to the following questions:

  • Question 1: Do you support the proposed amendment? If not why not?
  • Question 2: Are there other fluoride-containing compounds used to treat community water supplies that should be specifically named in the regulation? If so, what are they?

Submissions – quantity or quality

The report from MoH on the process and their recommendations to cabinet give an idea of the submissions made and the final decision.

As we might expect from past experience the submissions were dominated, in numbers if not quality and relevance, by those from the anti-fluoride groups. They had organised a national and international campaign to swamp Medsafe. Paul Connett’s Fluoride Action Network, Fluoride Free NZ and New Health NZ even provided texts and templates to copy and paste into submissions.

Here is the description of the consultation outcome in the MoH report:

MOH-report-extract

So, the activist organisations can certainly mobilise their forces for submissions. But concentration on numbers and not content – and cynical provision of content to followers anyway – didn’t win them any credence. Did they really think blatant duplication of submissions would not stick out like a sore thumb?

It is also heartening to see that the MoH was not swayed by blanket repetition of arguments which do not have credible scientific support. (I guess we can also see why the anti-fluoride activists groups are putting so much effort into their campaign to attack and discredit the NZ Fluoridation Review which summarises the scientific evidence.)

Sometimes suggestions are accepted

I had made the simple suggestion tha sodium fluoride be added to the short list of examples of fluoride chemicals used for CWF. So this recommendation to cabinet pleased me

recommend-to-cabinet

Nice to know that the consultation was not a sham and that reasonable and credible suggestions were listened to and even accepted. It is worth making submissions even when one is aware they me in a minority. If something is worth saying it should be said despite attempts by others to confuse issues.

Also nice to know that some consultations are not simply swayed by quantity and not quality – as was the case for the Hamilton City Council fluoride consultation in 2013 (see When politicians and bureaucrats decide the science).

The Hamilton City Council consultation also showed an extreme naivety in the Council’s willingness to ignore the established science. I wonder what approach they would have taken if the NZ Fluoridation Review had been available at the time?

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Is fluoridated water a medicine?

One of the predictable claims made by anti-fluoridationists is that fluoridated water is a medicine and therefore should not be imposed on the public.

It’s all semantics, of course, but some anti-fluoridationist get pretty dogmatic about it. So the people who run the Fluoride in Water* Facebook page decided to check it out with Medsafe – the New Zealand Medicines and Medical Devices Safety Authority.

Medsafe-Logo

Here’s the guts of the reply they got from the Medsafe Pharmacovigilance Team:


“A medicine is defined in S3 of the Medicines Act as:

a substance or article, other than a medical device, that is manufactured, imported, sold, or supplied wholly or principally for

a) administering to one or more human beings for a therapeutic purpose

b) use as an ingredient in the preparation of any substance or article that is to be administered to one or more human beings for a therapeutic purpose,

  • where it is so used- in a pharmacy or a hospital; or
  • by a practitioner, or registered midwife or designated prescriber, or in accordance with a standing order; or
  • in the course of any business that consists of or includes the retail sale, or supply in circumstances corresponding to retail sale, of herbal remedies;

c) use as a pregnancy test.

S4 defines the term therapeutic purpose as:

  • treating or preventing disease
  • diagnosing disease or ascertaining the existence, degree, or extent of a physiological condition
  • and several other non-pertinent activities.

“However, Medsafe has never considered the fluoridation of water to lead to the creation of a medicine. Fluoride is found naturally in water at varying concentrations and water is not supplied for a therapeutic purpose. We consider that the principal use of water and foodstuffs (which contain minerals or fluoride) is dietary and not therapeutic. We therefore do not consider the addition of substances such as chlorine or fluoride, or alum to water to be under the remit of the Medicines Act but rather under the control of other public health and water quality legislation. A similar argument can be used in relation to quinine. While quinine is a medicinal substance, the quinine contained in a gin and tonic, no matter how therapeutic we might think consuming one may be, does not make tonic water (or gin) a medicine. This pragmatic approach to the legislation is clearly what was intended by parliament. Too rigid an interpretation quickly makes everything a potential medicine. After all we drink water to prevent dehydration which is a symptom of a disease state. This kind of over-interpretation of the wording of the legislation is not, and has never been the intention of parliament.

“Finally while we must accept that fluoride in certain concentrations and formulations is scheduled as a medicine in several schedules within the Medicines Act, the concentrations of fluoride in drinking water are well below the threshold for consideration as a medicine and so would be considered to fall within the controls of other legislation, such as water quality control etc. Fluoride is also an element and it is naturally found in a great many places, the presence of fluoride, or any other element or mineral in an item does not make the item a medicine. After all, lithium can be used as a medicine, but its presence in a lithium battery, or a paint, does not make that product a medicine.”

via Why fluoride water is not classed as a medicine under the Medicines Act – Medsafe.


* Follow that Facebook page if fluoridation interests you – it’s one of the few trying to give good scientific information and counter the misinformation that seems to be common on social communication sites like Facebook and Twitter.

For further articles on fluoridation look at the links on the Fluoridation page.
See also: Fluoridation

Evidence should trump “legal muscle”

Ian at Evidence Based Thought reports on a conflict that has arisen over the use of titles by some alternative medicine practitioners – in this case chiropractors.

While this is a case of a group attempting to claim scientific credibility inappropriately there is a bigger issue here. The New Zealand Chiropractic Association has responded to a critical article in the New Zealand Medical Journal with a threat of legal action if the article is not withdrawn.

The Editor of the Journal has rejected these demands and has called on chiropractors to debate the evidence presented in the original article. He said “lets hear your evidence, not your legal muscle.”

We should all applaud the editor’s stand.

The person in the street might be surprised by the frequency with which legal pressure is used to suppress information they should rightly have access to. Often the facts never come to light – legal threats being sufficient to maintain silence. I have personally twice experienced the institutional restriction on publication of research findings – purely because of legal threats from a commercial company.

Citizens should not have scientific information censored when it concerns products they are considering purchasing. Their access to information about environmental issues should also never be censored.

But, more important still, our access to information on health and medicine should not be subject to censoring by legal threats like this.

See also:
Chiropractors resort to legal intimidation?
Silence Dissent!