Jeffrey A. Singer
The Utah legislature passed and sent a bill that bans local governments from adding fluoride to public drinking water to Governor Cox’s desk. The governor intends to sign the bill. The Utah Dental Association opposes the ban and is calling on the governor to veto it.
According to the Centers for Disease Control and Prevention, drinking fluoridated water reduces cavities in both adults and children by 25 percent. The US Department of Health and Human Services advises an “optimal concentration” of 0.7 milligrams of fluoride per liter of water (0.7 ppm). Levels exceeding 4.0 ppm may lead to dental and skeletal fluorosis, resulting in mottled tooth enamel and brittle bones.
While 0.7 ppm of fluoride in the water supply is safe, dentists do not recommend fluoride supplements for children under six months of age. Recent studies have associated high levels of fluoride ingestion with reduced IQ in children.
In 1901, a Colorado dentist named Frederick McKay discovered that fluoride was associated with reduced tooth decay. In 1945, Grand Rapids, MI, became the first municipality to add it to its public drinking water. By the 1960s, fluoridated water had become widespread throughout the country.
Nowadays, people can obtain fluoride to prevent tooth decay in many other forms. Consumers can purchase bottled water containing fluoride, over-the-counter mouthwashes containing fluoride, and fluoride varnish from dentists and, in some states, pharmacists. Dentists can also prescribe fluoride supplements. And, of course, many toothpaste products contain fluoride.
In my forthcoming book, Your Body, Your Health Care, I write:
In the context of the clinician-patient relationship, autonomy means that health care practitioners must respect their patients’ decision-making capacity and their right to make their own decisions regarding their care, regardless of practitioners’ recommendations. Autonomy means a patient has both liberty and agency (the capacity to act purposefully).
We take respect for patient autonomy and the doctrine of informed consent for granted in modern times. Yet countless people died or suffered great harm over the centuries before these precepts became the norm. And, while autonomy is now an inalienable feature of the relationship between people and their health care providers, it receives short shrift in the relationship between people and their government. The context might be different, but the principle is the same.
Fluoride offers significant benefits. However, the government should not force-feed it to its residents. It violates the doctrine of informed consent. Adults have the right to make their own healthcare decisions, and those who opt not to take fluoride supplements do not infringe on the rights of others. People who wish to take advantage of fluoride’s benefits have many other ways to obtain it besides the public water supply.
Utah’s lawmakers were right to prevent local governments from adding fluoride to public drinking water.
In explaining his intention to sign the bill, Governor Cox told reporters, “[I]t’s got to be a really high bar for me if we’re going to require people to be medicated by their government.” I applaud the governor for saying that.
Check out my forthcoming book, Your Body, Your Health Care, for release on April 8. You can register to attend a Cato forum on the book here, in person or online.