Dear Editor, 

The recent rejection by the IMO AGM of a motion calling on the Department of Health to reverse its current policy of public water fluoridation (IMT, May 2, 2014) raises a critical question of medical ethics.

The health risks of fluoridated water in Ireland have been highlighted by a growing band of campaigners whose concerns are rooted in, and supported by, credible evidence from several countries, where the implementation of a fluoridation policy has been rejected on medical and ethical grounds.

Arguments for the benefit of fluoridation centre on perceptions of improved protection against dental decay, but ignore the reported findings of the WHO that show no discernible difference in the rates of dental decay between countries that add fluoride to drinking water and those that do not.

Ireland continues to ignore the reasons why 98 per cent of Europe refuses to support a policy of water fluoridation, and the recent support by the IMO AGM for the continued implementation of state-imposed fluoridation should be a matter of ethical concern for all practising physicians.

The Irish Expert Body (IEB) bases its current support for the policy of fluoridation on perceptions of safety at public water levels of 0.6-0.8 mg/L. This perception fails to account for the fact that a lifelong ingestion of public fluoridated water, in addition to its ubiquitous presence in widely consumed commercial foods, like beverages, teas, ice creams and soy products, may give rise to levels that exceed optimum safety, and thereby raise the risk of toxic effects, involving skeletal structures, thyroid tissue, reproductive organs and neurological systems in adults and children.

The US Agency for Toxic Substances and Disease Registry lists fluoride as among the top 20 of 275 substances that pose the most significant threat to human health, a statement that questions our official assertions about fluoride safety.

An earlier Harvard study conceded the possibility of adverse effects of fluoride exposure on children’s neurological development, and a recent report in The Lancet (March 2014) lists Fluoride as a “reclassified developmental neurotoxin”.

The authors of this report state “our very great concern that children worldwide are being exposed to unrecognised toxic chemicals that are silently eroding intelligence, disrupting behaviour, truncating future achievements and damaging society”.

The ethics of state-sanctioned mass medication, and its support by the IMO, contradicts our acknowledged commitment to the ideal of practising ‘preventative medicine’, and questions our declared support for the principle of primum non nocere.

Where is the physician who will impose a lifelong prescription for an untested potentially toxic substance, without proven clinical benefit, on a patient he/she has never met, interviewed or examined?

Such dubious behaviour would extract appropriate censure from the licensing authority of the physician involved, on the basis that it is unscientific, unscrupulous, unethical, and therefore unacceptable.

The European Court of Justice, in 2005, declared that no ‘medicinal product’ defined as “any substance prescribed for treating or preventing disease in human beings”, may be given to consumers without appropriate risk assessments, taking into account the variations of fluoride sensitivity in high-risk groups, such as infants, the elderly, those with diabetes, or people with thyroid or kidney disorders, or those with nutritional deficiencies.

The European Commission’s Scientific Committee for Health and Environmental Risk (SCHER) has reported that the toxicity of hexafluorosilic acid used for water fluoridation in Ireland, and its hexafluorosilicate compounds, are unknown and incompletely investigated.

The continued mandatory policy of public water fluoridation is in breach of European law, and councillors who are hoping for public support in the forthcoming elections should clarify their stand on this very important question of state-supported mass medication with fluoride.

Dr Neville Wilson,

The Leinster Clinic,

Maynooth.