The fluoridation farce

Part 3: Water fluoridation is not ethical

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The arrogance surrounding the ethical considerations of mandatory water fluoridation in Australia is staggering. The tactics used to defend and promote the process of adding toxic fluoridation chemicals to our drinking water are also far from ethical.
“No physician in his right senses would prescribe for someone he has never met, whose medical history he does not know, a substance which is intended to create bodily change, with the advice: ‘Take as much as you like, but you will take it for the rest of your life because some people say that it can reduce tooth decay in children”
Dr Peter Mansfield
MA, MB, BChir FRSA, GP, independent scientist, member of the Advisory Board for the Systematic Review of Public Water Fluoridation conducted by the NHS Centre for Reviews and Dissemination, University of York (known as “The York Review”, McDonagh et al., 2000).
  • A subtle reminder: ethics involves truth and honesty, not regularly hiding the facts and misleading people;
  • Informed consent is essential;
  • An uncontrolled dose of fluoridation chemicals;
  • No personal prescription or regard for an individual’s circumstances means some disadvantaged groups are vulnerable;
  • No ongoing monitoring;
  • Fluoridation robs you of your choice;
  • Fluoridation has never been proven safe;
  • Fluoridation is arrogant and disrespectful;
  • General ethics are often neglected;
  • The NHMRC’s methodology regarding fluoridation is far from ethical.
Overview of ethics

The term ‘ethics’ is derived from the Greek word Ethos and is used to describe the guiding beliefs and ideals that characterise a community, nation, or ideology. At its simplest, ethics is a system of moral principles that affect how we live and make decisions. The field includes both general and applied ethics.

Within general ethics there are several foundational premises. Firstly, an unwavering respect and commitment to truth and honesty provides an essential foundation.  Without such a commitment anything built on this framework will ultimately collapse. General ethics involves being independent and impartial, without any self-interested agenda, or personal need to defend long-held views. Under general ethics we should also act professionally, be socially responsible and act in the public interest, be open, transparent and fully accountable to our peers.

Water fluoridation is a specific health or medical intervention and therefore also involves the field of applied ethics; the analysis of a specific, controversial moral issue. In this case, applied ethics is specifically the field of medical ethics.

The major elements of ethics:
  • An unwavering commitment to truth and honesty;
  • Independence and impartiality;
  • An absence of self-interested or personal agenda;
  • Not defending long-held beliefs just because they are established;
  • Acting professionally in all ways;
  • Being socially responsible and acting in the public interest;
  • Being open and transparent;
  • Being fully accountable to our peers.
Fluoridation and medical ethics

While chlorine and other chemicals are added to reticulated drinking water in many countries, they treat the water to render it safe for consumption. Fluoride does not treat the water—it is a treatment of people, supposedly to combat or prevent tooth decay.

In the United States, the Food and Drug Administration (FDA) accepts that fluoride used for tooth decay is a drug, not a nutrient.

The US FDA acknowledges that fluoridation chemicals are a drug not a nutrient

In Australia, the Therapeutic Goods Administration (TGA) defines “therapeutic goods” as goods that are likely to be taken for “therapeutic use”, defined as “preventing, diagnosing, curing or alleviating a disease, ailment, defect or injury in persons”. It is therefore irrational and unethical to exclude water fluoridation from TGA regulation on the grounds that it is not a therapeutic good.

By its very nature fluoride is a therapy or medication, making the fluoridation of public drinking water supplies a form of mass medication. This is a major reason that most European nations and numerous other countries have rejected the practice of fluoridation—because the public water supply is not an appropriate means of administering medication.

In June 2018, The New Zealand Supreme Court confirmed this stance, ruling that water fluoridation is “compulsory mass medication, in breach of human rights.”  The panel of judges also stated: “The impracticality of avoiding fluoridated water makes it compulsory in practice.”  Chief Justice Sian Elias then held that fluoridation was not prescribed by law, applying section 6 of the Bill of Rights Act, and was therefore unlawful as it breached section 11.

Using the public water supply as a vehicle to deliver medication violates medical ethics in several obvious ways:

1. Fluoridation deprives the individual of their basic right to informed consent to medication.  Everyone has a basic right to give or withhold their consent to a medical treatment or therapeutic intervention. No one is legally allowed to put a medication into someone else’s drinking water, regardless of whether they believe it is in the best interest of that person or not. Even a doctor cannot force a patient to take a particular medicine.  As the Australian Medical Council’s “Code of Conduct for Doctors in Australia” states:

3.5 Informed consent
Informed consent is a person’s voluntary decision about medical care that is made with knowledge and understanding of the benefits and risks involved.

A doctor must therefore inform the patient of the medicine’s benefits, side effects, alternatives, and then allow the patient to decide whether to take the medicine or not.  In the case of water fluoridation our health authorities simply tell the individual that fluoridated water is beneficial and then proceed to add it to their drinking water, irrespective of their consent. Fluoridation allows government bodies to impose on the public what an individual doctor is prohibited from doing to any individual.

2. Fluoridation provides an uncontrolled dose. Although Australian water suppliers can generally control the concentration of fluoride added to water within a narrow range, they cannot control the dose that an individual receives. The dose depends entirely on two factors beyond the water supplier’s control: (i) the amount of water consumed by the individual, and (ii) the individual’s body weight. The more an individual drinks the more fluoride they will ingest.  Labourers, tradesmen, athletes, or anyone working outside, especially in Australia’s hot climate, will tend to consume well beyond the average daily amount of water.  Also, the less an individual weighs, the greater the dose (by body weight) they will receive for each glass of water consumed.

3. Fluoridation does not involve a personal prescription, tailored for the individual’s circumstances. Medical science understands well that individuals respond very differently to the same dose of a given medication. In fact the dose of a medication that is safe for one individual may be toxic for another and this applies very much to fluoride.

In particular, those most susceptible are:

  • Individuals with poor kidney function are not able to process and excrete as much fluoride as a healthy person, so more fluoride will accumulate in their bones causing fluoride-induced bone damage. Fluoride is also nephrotoxic so it will continue to reduce the kidney’s functioning;
  • Diabetes and pre-diabetes patients;
  • Individuals with hypersensitivity to fluoride’s toxic effects (sometimes misnamed as ‘fluoride allergy’)—fatigue, headaches, depression, skin rashes, respiratory distress and more;
  • Infants and bottle-fed babies. They are at the most sensitive stage of their life; hence recommendations by many dental researchers that young infants should not consume fluoridated water;
  • Individuals with iodine deficiency. There is compelling research showing that they are more susceptible to neurological damage or under active thyroid from low levels of fluoride exposure;
  • Individuals who are deficient in calcium, vitamin C, and/or vitamin D as fluoride’s toxic effects on bone tissue are amplified in these individuals. The elderly and very-low income groups are particularly prone to these conditions;
  • Individuals who drink large quantities of water, including athletes, manual labourers, tradesmen and those with polydipsia (excessive thirst or excess drinking).

It is a basic principal of modern pharmacology that each individual must be assessed and a medication only then prescribed according to the individual’s personal circumstances. Using public drinking water to administer fluoride in this manner is reckless.

4. Fluoridation does not involve a medical expert’s ongoing monitoring. A doctor will never prescribe a medication and say “just keep taking these for the rest of your life and you work out the dose.”  Of course a doctor should oversee and monitor the patient for unexpected side effects or sensitivities that arise. With fluoridation there is no ongoing monitoring. There is also no program or system in Australia or other fluoridating countries to track the level of fluoride building up in people’s tissues or bones, or to monitor for side effects.

5. Fluoridation effectively robs people of their choice. It is unacceptable that many individuals who, having informed authorities they do not consent, are still subjected to the medical treatment of fluoridation regardless.  Adding fluoridation chemicals to a public water supply is obviously a huge imposition on people who don’t want this (or can’t tolerate it) in their drinking water.  Given the scientific understanding that fluoride is only effective when applied topically, people who want fluoride can simply apply it to their teeth with toothpaste or other means.

Many Australians are not even aware that standard gravity water filters are not able to remove fluoride from drinking water. Even if an individual installs an expensive reverse-osmosis filter or can afford to buy bottled water, fluoride is still present in the water used for bathing and showering. And even for those people who can afford a full house filter (normally costing between $2,000 and $5,000), they still cannot avoid fluoride water because mains fluoridated water is used to make a wide range of processed foods including beverages, bread, tinned food and other processed foods. Normal living also includes eating in cafes or restaurants, where tap water is used. It is also relevant that reverse-osmosis filters used to remove fluoride also remove valuable minerals from the water.

6. Fluoridation has never been proven safe.
See our article: Fluoride causes harm

7. Fluoridation is arrogant and disrespectful. Fluoridation promoters argue that “fluoridation ensures that fluoride gets to those that need it most”. This is wrong on two counts: firstly no one “needs” to ingest fluoride, and secondly, the people they claim “need it most” are actually the people who are most likely to suffer from its toxic effects.

First of all, it is an obvious and flagrant violation of medical ethics because it constitutes medication without consent. Second, I am a professional research scientist, have spent quite some time going through the literature on the subject, and am absolutely shocked by the dishonesty of the people promoting the practice.”

Dominic Berry, Ph.D.
Fluoridation and general ethics

Unfortunately, the history of fluoridation is littered with tactics used to defend and promote it that are misleading, deceptive and even fraudulent. These tactics are the antithesis of ethical behaviour and conduct. In fact, the only way that Australian and other fluoridating governments seem able to defend fluoridation and keep the absurd process continuing is to consistently dismiss important scientific material, conduct biased reviews, mislead the public by not disclosing appropriate information, act dishonestly by misrepresenting the facts, and involve promoters who often engage in intimidation while referring to organisational endorsements rather than addressing the science.

Misleading statements used by fluoridation promoters, such as state health departments and dental associations, are all too common and include:

“Fluoride is a nutrient” or “essential nutrient”. This is a ridiculous and misleading statement. There is no biological process that requires fluoride. In fact there is a substantial body of scientific evidence to show that fluoride interferes with a number of crucial biological processes in the human body.

“Fluoridation is just topping up levels of natural fluoride” or “fluoride is found widely in the earth’s crust and occurs naturally in water and many foods”. Using Calcium fluoride, which is found naturally occurring in plants, rocks and seawater, as a marketing strategy to explain away a highly-toxic, industrial waste chemical extracted in the processing of superphosphate fertiliser, is also very misleading. Hexafluorosilicic acid and the derivatives used for water fluoridation are Schedule 7 & 6 poisons. 

See our article The source of fluoride

“The dilution of fluoridation chemicals to a ratio of 1 part per million renders them safe”. Hundreds, if not thousands of research studies conducted over the last 70 years suggest otherwise.

Also see our article Fluoride causes harm

“There is no debate” and “the science on fluoridation was settled 60 years ago”.  This is a biased and misleading strategy by fluoride promoters to distract attention away from debating the solid body of science that refutes their official narrative. There are now 53 studies alone that show that fluoride reduces IQ in children and hundreds of significant other harms-related studies. 

Also see our article Fluoride causes harm

“There is overwhelming scientific evidence showing that fluoride is safe and effective”. Actually there is no valid science showing that fluoridation is effective and there are hundreds of substantial studies showing the dangers of fluoride. There has never been a Randomised Controlled Trial (RCT) to prove the safety of fluoride. In Australia, New Zealand and even America there is no health authority monitoring fluoride levels in individuals.

Apart from misleading statements, there are also a number of unethical tactics used to promote and defend fluoridation, as follows:

  • Create a structure within our health system that does not provide an objective, unbiased and independent assessment and review of fluoridation;
  • Rely heavily on endorsements, rather than on the science regarding fluoride’s effectiveness and safety, and lack thereof;
  • Engage as spokespeople doctors and dentists who have never investigated the science of fluoride objectively and thoroughly, who continue to repeat official slogans and misinformation;
  • Convince the media and the general public that fluoride is safe and effective, repeatedly using misleading or incorrect information;
  • Refuse to conduct appropriate health monitoring and harms-related research studies;
  • Discourage science and health professionals from investigating this matter themselves;
  • Maintain an arrogant authority within our medical and dental associations, intimidate and threaten any member who speaks out against fluoride and refuse to publish any scientific material on the potential harms of fluoride that should be published in the interests of objective scientific research;
  • Conduct biased push-poll surveys containing leading questions about fluoridation;
  • Commence fluoridation in areas without adequately informing or involving the public. Fluoridation ‘by stealth’ is a common strategy in Australia;
  • Oppose local referenda on fluoride and push for mandatory fluoridation on a state-wide basis;
  • Avoid public debates wherever possible;
  • Engage in intimidation and bullying tactics against any members of the public, especially those with relevant scientific or medical qualifications who highlight the risks of fluoride, the poor quality of studies used to support fluoridation or the biased manner in which fluoridation reviews occur.

Medical ethics, morality, economics, legal and political issues have not deterred fluoride promoters in their efforts. Indeed, the problem has been declared a legislative matter, rather than under the jurisdiction of courts of law which might introduce such notions as ethics and reasonableness. The main beneficiaries from fluoride use are the big industries that find a profitable outlet for their otherwise embarrassing toxic byproducts. It is time for change."

David R. Hill, PEng, Professor Emeritus, University of Calgary, Research consultant & Scientific Auditor for Canadian government programs (SR&ED & NSERC) providing financial support to industry and universities, Calgary, Alberta, Canada

The host of unethical tactics and strategies used to defend and promote fluoridation in Australia is quite remarkable. Any person, especially any health professional, endorsing fluoridation simply because they believe it to be beneficial and because they are following established protocol, should investigate this matter objectively and thoroughly rather than following their peers.

Australia’s government officials have relied on their national health advisory board (NHMRC) being ethical. Unfortunately, this has not been the case. This advisory board has ignored or arrogantly dismissed the seven points listed above and as a result, well-intended medical and dental health professionals have consistently been misled.

It would appear that the effectiveness of artificial water fluoridation in the 21st century is at best questionable, given its fixed-dose medication approach, quality of fluoride used and its adverse impact on calcium metabolism and largely insignificant differences in dental caries experience between areas with artificial water fluoridation and those without."

Professor Niyi Awofeso, University of Western Australia, Public Health Ethics, August 2012.