Ethics of Artificial Water Fluoridation in Australia

Ethics of Artificial Water Fluoridation in Australia
Niyi Awofeso*
+ Author Affiliations
School of Population Health, University of Western Australia, and School of Public Health, University of New South Wales, Australia
Corresponding author: Niyi Awofeso, Email: niyi.awofeso@uwa.edu.au
Abstract

A recent decision by several Australian federal politicians to support a parliamentary review of artificial water fluoridation has an intensified debate on the public health intervention. While there is a majority agreement among Australian dentists and other health professionals that adequate enamel fluoride is essential for dental health, the ethics of artificial fluoridation of public water supplies as a contemporary vehicle for facilitating adequate supply of fluoride to teeth is highly contested. Opponents of artificial water fluoridation insist that there are many alternative sources of fluoride, that mandatory water fluoridation violates the ethical principle of autonomy and that water fluoridation is not only expensive and unnecessary but also may endanger health by causing fluorosis and, potentially, hypothyroidism and pathological bone fractures. In contrast, proponents of water fluoridation posit that mandatory water fluoridation facilitates health equity and that the benefits accruing to society from prevention of dental caries (beneficence principle) outweighs impairment of individual autonomy. This article utilizes Childress’ ‘justificatory conditions’ to evaluate the ethical appropriateness of artificial water fluoridation in Australia. The author concludes that there is insufficient ethical justification for artificial water fluoridation in Australia.
© The Author 2012. Published by Oxford University Press. Available online at www.phe.oxfordjournals.org