Intended for healthcare professionals

Rapid response to:

Analysis Controversy

Adding fluoride to water supplies

BMJ 2007; 335 doi: https://doi.org/10.1136/bmj.39318.562951.BE (Published 04 October 2007) Cite this as: BMJ 2007;335:699

Rapid Response:

Ethics of water fluoridation

The ethics of water fluoridation have been widely debated by experts in ethics(1 2 3), by the Courts (4 5 6), by citizens’ panels (7), and in the media. Varying, and sometimes conflicting, views have been expressed. Different people will undoubtedly take different views on ethical issues. The fact remains that fluoride confers substantial benefit to communities that receive it.

Whether water fluoridation is medication is irrelevant as the Medicines Act clearly does not apply to fluoridation which is covered in separate legislation, namely the Water Act 2003. The issue was debated in Parliament, in both Houses, and subject to a free vote. Parliament determined that decisions about the implementation of fluoridation should be made by Strategic Health Authorities after careful and widespread public consultation which could, of course, include further debate about the ethics of fluoridation.

1. Fottrell F (Chairman). Forum on Fluoridation Ireland. Dublin: Stationery Office, 2002 http://www.dohc.ie/publications/fluoridation_forum.html. 2. Harris J. The ethics of fluoridation. Liverpool: British Fluoridation Society, 1989 http://www.bfsweb.org/facts/ethics/ethicsharris.htm. 3 Holt R, Beal J and Breach J Ethical considerations in water fluoridation in Bradley P and Burls A Ethics in public and community health, Routledge, London, 2000 4. Kenny MJ. FLUORIDATION. Judgement delivered by Mr Justice Kenny in the High Court, Dublin, 1963. Dublin: Department of Health, 1963. 5. Chief Justice O'Dalaigh. FLUORIDATION. Judgement of the Supreme Court of Ireland delivered by Chief Justice O'Dalaigh 3rd July, 1964. Dublin: Department of Health, 1964. 6. Jauncey L. Opinion of Lord Jauncey {Iin causa} Mrs Catherine McColl (A.P.) against Strathclyde Regional Council. Edinburgh: The Court of Session, 1983. 7. NICE Citizens Council. Mandatory Public Health Measures. London: NICE, 2005 http://www.nice.org.uk/page.aspx?o=274599.

Competing interests: None declared

Competing interests: No competing interests

07 October 2007
John F Beal
Consultant in dental public health
Leeds PCT, LS16 6QG