Fluoride is not a medical treatment because it can be refused, a bioethical expert has informed the High Court in New Plymouth.
Professor of Biomedical Ethics at the University of Otago Professor John McMillan’s ethical analysis of fluoridation of public water supplies was yesterday tabled in support of South Taranaki District Council’s decision in December to put fluoride in Patea and Waverley’s water supplies.
In what is seen as a test case, anti-fluoride groups, represented by Christchurch-based New Health New Zealand counsel Lisa Hansen, have called for the courts to quash the council’s decision.
On Monday New Health NZ submitted the decision was unlawful because the council had no legal right to add fluoride to its water supply.
Fluoridation breached section 11 of the New Zealand Bill of Rights Act which gave people the right to refuse to undergo medical treatment, Ms Hansen said.
Yesterday following two days of extensive and opposing legal argument Justice Rodney Hansen reserved his decision on the judicial review.
The court heard from both the STDC and the attorney-general yesterday who disputed New Health’s stance.
STDC counsel Duncan Laing said the addition of fluoride was demonstrably justified in a free and democratic society. It did not breach the Bill of Rights.
This view was supported by Professor McMillan who concluded that fluoridation was not medical treatment because it could be refused, Mr Laing said.
And residents who received their council’s fluoridated water which was sent to a meter or toby at the roadside were not forced to drink it, he said.
In his submissions, Austin Powell, counsel representing the attorney-general, said a claim in Ireland was dismissed because it was found there was no obligation to consume the fluoridated water supply and it could easily be filtered from the water.
New Zealanders had the right to the highest standard of health and sometimes this might mean employing interventions to do that, Mr Powell said.
Mr Laing said the Ministry of Health supported fluoridation.
Other affidavits before the court included one from public health dentistry specialist Dr Robin Whyman who stated the most reliable scientific studies indicated that fluoridation to the levels permitted in New Zealand was both safe and effective.
His view was that fluoridation was a small adjustment in the natural mineral content in water to replicate levels that occurred naturally in many places in the world but at all times remained very low.
Taranaki District Health Board chief medical adviser Dr Gregory Simmons outlined inequalities in oral health faced by Maori and lower socio-economic groups and the potential benefits from fluoridation for residents in the two towns.
A Patea and Hawera dental surgeon, Ms Sandra Pryor, wrote of the poor state of oral health in South Taranaki she saw through 18 years of practising there.
The council had the right to add fluoride to the water supplies under the Local Government Act and the Health Act, Mr Laing argued.
The Drinking Water Standard for New Zealand 2005 stated, for oral health reasons, that the fluoride content was in the range of 0.7 to 1.0mg/litre.
Contrary to New Health’s position, the addition of fluoride did not relate to enforcement, inspection or licensing so was not a regulatory function, Mr Laird said.
Parliament’s decision to give local authorities discretion whether to fluoridate water involved a weighing up of private interests against the public good as well as a review of scientific and medical opinion.
Local decision-making on fluoridation had the support of the Nuffield Council of Bioethics. The council was the leading independent body that examined bioethical issues for medicine and biology.
The 1957 Commission of Inquiry also recommended that decisions on water fluoridation should be made by local authorities.
Dr Simmons said Patea and Waverley were among the 10 per cent of the most deprived communities in New Zealand.
The area had significantly worse tooth decay than the rest of Taranaki.