The moral imperative
Council makes right decision on the ethics of mass fluoridation
Calgary Herald February 8, 2011 10:00 PM
Calgary city council deserves praise for voting overwhelmingly Tuesday to remove fluoride from Calgary's drinking water. The 10-3 vote, with Mayor Naheed Nenshi absent for meetings in Toronto, is a courageous step on a contentious issue.
Despite pressure from the scientific establishment to keep fluoridation, council made the right decision.
Imposing mass fluoridation on an entire population is ethically questionable.
With the many widespread topical applications of fluoride that are available today, we have argued that fluoridation is a vestige from another era and that fluoride should be removed from Calgary's water -- as it has in other cities and in nations that include Germany, Sweden, the Netherlands, Czechoslovakia and Finland.
In 2004, British forensic ecologist Douglas W. Cross and Robert J. Carton, a risk assessment manager for the U.S. Environmental Protection Agency, forcefully argued that fluoridation is a violation of medical ethics and human rights.
Because it administers fluoride to large populations "without informed consent or supervision by a qualified medical practitioner, fluoridation fails the test of reliability and specificity," they wrote. "The ethical validity of fluoridation policy does not stand up to scrutiny relative to the Nuremberg Code and other codes of medical ethics."
Calgary city council wisely decided not to refer the issue to University of Calgary medical experts who offered to educate them on the benefits of fluoridation.
Judging from the public comments by some of those experts, the U of C review likely would have been a predictable reaffirmation of the benefits of fluoridation from the scientific establishment. Calgary aldermen showed they are quite capable, thank you very much, of reviewing the literature already widely available.
Last year, for instance, the European Union's scientific panel did an exhaustive review of the evidence and concluded that there are no risks to most of the population when acceptable fluoride levels of less than 0.8 parts per million are ingested in drinking water. Calgary has 0.7 parts per million.
However, the EU science panel also concluded that "topical application is the more efficient measure."
And, in the critical risk group of children, it said that "a very narrow margin exists between achieving the maximal beneficial effects of fluoride in caries prevention and the adverse effects of dental fluorosis."
The report also said there may be risks to children up to age 12 who consume large amounts of water and use more than the recommended doses of fluoridated toothpaste.
The scientific establishment invokes the precautionary principle to justify fluoridation, saying that it benefits the poor and disadvantaged who cannot afford fluoride treatments.
Yet, if there are risks to an age-specific demographic that may ingest potentially harmful amounts of fluoride when not supervised, there must be a moral imperative to respect the autonomy of individuals to choose not to consume it.
Calgary council wisely realized that forcing everyone to swallow fluoride, rather than applying it to their teeth, is wrong.
Council deserves praise for making this decision