# Consent and Water Fluoridation



## MedicSansBrains (Aug 21, 2015)

In Austin, TX there is a movement in the city council to stop fluoridating the municipal water supply. MD's argue that it is bad for the population while another argues it is good.

The arguement for it being bad is obvious; fluoride is the most corrosive and electronegative element and it's dental hygeine uses are only topical not ingested (don't swallow your toothpaste). The argument for it being good is it is the only way many people in the population get access to dental hygiene...

Those arguments aside it becomes pretty obvious to this EMT that we are dealing with the issue of consent, not fluorides validity as a dental hygiene medication. The first thing that was drilled into my head in basic school was consent, and the high-turnover and ptsd rates but anyway. I can't force a person of sound mind who is aware of the consequences to take any tx or rx.

Therefore, the argument of whether or not it is bad for you is moot. It's a legal argument because a whole population, in this case Austin Municipal of 1.25 million, is being medicated either against their will or unknowingly. I haven't heard any citizen stand up and say "I know it's there and I want my fluoride" but I guess it's possible.

So let's avoid the good for you bad for you argument and ask the question we are better suited to answer here; is this a breach of civil liberties?

Thanks!

Just so you know I say it most certainly is.


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## ERDoc (Aug 21, 2015)

No one is making you drink the water.  If you don't want to drink it, you could always buy bottled water.


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## MedicSansBrains (Aug 21, 2015)

Unfortunately not. 

- Most bottled waters are taken from municipal water supplies and resold under a new name. There is no need to mark whether or not it is fluoridated in the first place.

- What if I couldn't afford to drink all bottled water. Also, it's a very unnecessary waste.

- No eating at local restaurants because all the water they cook with is municipal water.

- Can't take showers with bottled water.

- I must have water to live.


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## Flying (Aug 21, 2015)

I'm informing my British acquaintances of this thread. This will be a blast for them.


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## ERDoc (Aug 21, 2015)

You make the comparison to what you learned in EMT school.  There is a big difference between EMT school and public health and safety.  So fluoride is the most corrosive and electronegative element?  What is the significance of that?  Do you have any idea what electronegativity is?  Have you ever seen how destructive and dangerous dihydromonoxide is?  Yet, our drinking water is full of it.  Tell me how many people you know who have been harmed by the Fluoride in the drinking water?  You said you don't want to debate whether it is good or bad yet you build your argument on just that.


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## Summit (Aug 21, 2015)

1. You don't need consent to have your water chlorinated either. Because public health.

2. Toothpaste isn't a medicine. 

3. MedicSansBrains... what a screen name.

I found this file photo:


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## MedicSansBrains (Aug 21, 2015)

Thanks for already ruining the thread with ad hominem attacks on my intelligence. I tried to frame the debate to avoid that but failed by allowing opinion on the subject to displayed in my "electronegative" comment. 

I'm sure you have some intelligent things to contribute to the question of whether or not medicating the water supply is ethical and legal, which is the debate in city councils.


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## MedicSansBrains (Aug 21, 2015)

Summit said:


> 1. You don't need consent to have your water chlorinated either. Because public health.
> 
> 2. Toothpaste isn't a medicine.
> 
> ...


Didn't say toothpaste was medicine... Also, chlorine is used to purify the water supply not medicate the population to improve dental health of a given community.


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## ERDoc (Aug 21, 2015)

I'm not sure if you are referring to me or to Summit in regards to ruining the thread but if you are referring to me, I never made any ad hominem attacks on your intelligence.  I think it is perfectly appropriate to ask if you understand a concept if you are using it as the basis of your argument.  If you want to argue ethics, it depends on which ethical model you chose to use.  The benefits far outweigh the risks and protects a large, vulnerable portion of our society who would otherwise not have access to it.  Maybe it is not necessary in utopias such as Austin but in most of the country where there are huge populations that don't have access to dental care we are looking at doing the most good for the most people.


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## Summit (Aug 21, 2015)

Chlorination is a public health measure. So is flouridation. Both are "ooh scary" electronegative halogens!

Flouridated toothpaste isn't medication. Neither is flouridated or chloridated water.


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## ERDoc (Aug 21, 2015)

Summit said:


> Chlorination is a public health measure. So is flouridation. Both are "ooh scary" electronegative halogens!
> 
> Flouridated toothpaste isn't medication. Neither is flouridated or chloridated water.



The only thing about this is that the FDA has already determined that Fluoride is a drug, which is the pitfall the OP wants you to fall into.


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## MedicSansBrains (Aug 21, 2015)

d'accord. I understand that the science can be argued both ways. I'm not interested in arguing the science because that is a lengthy process of study not debate. Not that you aren't smart and couldn't argue it thoroughly but I think it's best left to research not a chat forum. 

And yes... I do know what electronegative means... Nothing I've said would lead one to think otherwise. Your asking me that is undermining intelligence just like me asking you do you know what ad hominem means. Please don't drag my intelligence into the debate. It's not nice : (

The facts are - 

Fluoride is being added to our water supply (Austin) for the expressed purpose of improving dental health, not sanitation. The assumption I'm making is that this would make it a form of medication. 

It is being done so without the consent of the community. 

There are many other aspects to argue but the question I ask is a legal one based on these two facts with an assumption between them.


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## MedicSansBrains (Aug 21, 2015)

ERDoc said:


> The only thing about this is that the FDA has already determined that Fluoride is a drug, which is the pitfall the OP wants you to fall into.


I set no such pitfalls! Sir!


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## Summit (Aug 21, 2015)

MedicSansBrains said:


> Fluoride is being added to our water supply (Austin) for the expressed purpose of improving dental health, not sanitation. The assumption I'm making is that this would make it a form of medication.



Chlorination: Public health measure to prevent water born illness
Fluoridation: Public health measure to prevent dental caries

Both are ingested by the public.


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## MedicSansBrains (Aug 21, 2015)

Summit said:


> Chlorination: Public health measure to prevent water born illness
> Fluoridation: Public health measure to prevent dental caries
> 
> Both are ingested by the public.


True. Interesting argument and I've thought of it before. The answer I come up with is a little complex.

Chlorination is used to kill the pathogens in the water, not my stomach although it does. Fluoride is used to kill the pathogens on my teeth not the bacteria in the water.

I suppose if the fluoride was being added with the expressed purpose of water sanitation it would be a measure of public sanitation as it were. But it's not. Therefore, it's a medication being administered for the purpose of altering my bodies biochemistry.


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## MedicSansBrains (Aug 21, 2015)

That is why the FDA classifies Fluoride as a drug. I'm not aware of chlorine being used medically. Fluoride is, however. Pitfall, oops. Gotcha! Maybe not haha. Is there a logical argument against this?


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## MedicSansBrains (Aug 21, 2015)

ERDoc said:


> I'm not sure if you are referring to me or to Summit in regards to ruining the thread but if you are referring to me, I never made any ad hominem attacks on your intelligence.  I think it is perfectly appropriate to ask if you understand a concept if you are using it as the basis of your argument.  If you want to argue ethics, it depends on which ethical model you chose to use.  The benefits far outweigh the risks and protects a large, vulnerable portion of our society who would otherwise not have access to it.  Maybe it is not necessary in utopias such as Austin but in most of the country where there are huge populations that don't have access to dental care we are looking at doing the most good for the most people.


While I'm still sulking at the attack on my intelligence : ( I do understand and appreciate your argument. Most good for the most people utilitarian argument (if I'm not mistaken) is valid and makes sense. 

What about removing the ethics from it. Just the legal. Assuming fluoride is a medication, and like you said the FDA has said it is however unwise this might be, and is being administered indiscriminately wouldn't this be illegal? 

In my stupid EMT school (that doesn't teach public health..?), I was warned against this treating people who don't want treatment. I would be charged with assault and loose my license/job and be sued. 

How does this change in the context of water fluoridation? I'm not sure I understand the term "public health" and how it changes the parameters of medication administration.


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## Summit (Aug 21, 2015)

MedicSansBrains said:


> Fluoride is used to kill the pathogens on my teeth not the bacteria in the water.


Not how it works...



> Therefore, it's a medication being administered for the purpose of altering my bodies biochemistry.


It facilitates remineralization of enamel that was just demineralized by cariogenic biofilms. So it facilitates a natural reaction on the avascular porous surface of your teeth.

Hardly "altering the body's biochemistry" any more than ingested chlorine.

Both chlorine and flouride have 2ppm max limits. In some areas fluoride is naturally occurring above the 2ppm limit and is thus reduced in treatment. That is how fluoride was discovered to be useful in this public health role.


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## MedicSansBrains (Aug 21, 2015)

Ah, ok. Not a gotcha question but you are saying that it alters the bodies biochemistry, right? Not that it matters because I'm not sure what actually defines something as a medication or not. The only thing we have going on that facet is the FDA saying it is. Not sure why they say it is.

Fluoride is a naturally occuring substance in water. The medical good bad argument I've been trying to avoid comes up when discussing the allowance ppm. 2ppm is sound by most accounts in most people. However, our water supply is tested consistently at 7+ppm and in some places significantly higher. 30+ppm and beyond. Also, many special populations have been shown to be more sensitive to fluoride at lower doses. Like an allergy in laymen terms.

FDA says it's a medication. Water municipalities argue that their reason for using it is for this medicinal purpose. I don't wan't to be medicated with fluoride, however unreasonable and insane my decision is. Therefore, my rights are being infringed upon the same as if trace amounts of radiation were released into the airvents at my work because "it's a healthy dose at xxx threshold that will make you healthier for reason xxx."

Whether or not you think the same way I do about fluoridating the water supply does not mean that you or the government is allowed to force it upon me. What if I thought that adding cocaine to the water supply, a regulated FDA medication, was the answer to laziness and depression. I started a company to convince municipalities to add it to the water supply.

Cocaine is found in trace amount in our water supply also. Cocaine has limited but medicinal uses also. I don't see an argument yet making it legally sound to medicate the water supply. I see whitty points and personal attacks.


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## Summit (Aug 21, 2015)

There's plenty of things found in your water supply that are active ingredients in medications or their metabolites because they exist in amounts vastly below the threshold where it becomes a public health concern... and it is really expensive to remove them.

7ppm, not to mention 30ppm is an EPA MCLG violation! That is an ENFORCEABLE regulatory limit. That is a totally separate issue. Is your water naturally fluoridated or is your water district that incompetent?


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## MedicSansBrains (Aug 21, 2015)

It is a violation but is unfortunately not as enforceable as you'd think. The best thing would be to stop it from being added to the water supply. 

While there are traces of many medications in our water supply I'm not able to do anything about that. Forcing medicated citizens to poop and pee in a bucket and burry it (I guess) is unreasonable and also a breech of civil rights... I think. 

The fundemental difference for me is that fluoride isn't being inadvertently added to the water supply it's actively being added and there are many studies, scientists, dentists, etc that are actively speaking out against the adverse public health effects of doing so.


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## Summit (Aug 21, 2015)

Oh what a pretty little meme from these anti-vaxxer anti-science-based-medicine weirdos: http://www.collective-evolution.com/

Charles Heyd was a surgeon, a vice president, not president, and in *1936
*
I thought you wanted an honest debate?


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## MedicSansBrains (Aug 21, 2015)

lol your right. cheap trick. no meme punches will be pulled. I'm ashamed. 

Well I understand your argument. I guess you understand mine.


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## MedicSansBrains (Aug 21, 2015)

A great resource of the anti-fluoride arguments and research if anyone's interested. I have not the energy to regurgitate every finite detail on forum. 

http://www.fluoridedebate.com/conclusion.html


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## MedicSansBrains (Aug 21, 2015)

www.ada.org/public/topics/fluoride/facts-toc.html is the main source of pro-fluoride arguments


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## ERDoc (Aug 21, 2015)

MedicSansBrains said:


> www.ada.org/public/topics/fluoride/facts-toc.html is the main source of pro-fluoride arguments


So guys and girls who are experts at taking care of teeth are for something that benefits the health of teeth.  Do you find that surprising?  Do you think they might know a thing or two?  But again, you are arguing the good/bad of actually putting the fluoride in the water, not the ethics of consent.  There is also a difference between what is legal and what is ethical.  Fluoridation is legal, since it is being done.



MedicSansBrains said:


> Whether or not you think the same way I do about fluoridating the water supply does not mean that you or the government is allowed to force it upon me. What if I thought that adding cocaine to the water supply, a regulated FDA medication, was the answer to laziness and depression. I started a company to convince municipalities to add it to the water supply.



Change cocaine to haldol and I will invest every penny I have in your company and volunteer to be CEO.


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## Summit (Aug 21, 2015)

If ADA opposed fluoridation the conspiracy theorists would claim it was "all about the money" and "bad for dentistry business to have flouridated water" and call for greedy dentists to be hung.


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## Akulahawk (Aug 22, 2015)

In a manner of speaking, we all gave consent to the fluoridation of our drinking water when we elected representatives to do things, for the good of all of us, on our behalf. While I believe that the collective IQ of our elected representatives is near zero, they do at least think they're trying to do the right thing for all of us.


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## MedicSansBrains (Aug 22, 2015)

ERDoc said:


> So guys and girls who are experts at taking care of teeth are for something that benefits the health of teeth.  Do you find that surprising?  Do you think they might know a thing or two?  But again, you are arguing the good/bad of actually putting the fluoride in the water, not the ethics of consent.  There is also a difference between what is legal and what is ethical.  Fluoridation is legal, since it is being done.
> 
> 
> 
> Change cocaine to haldol and I will invest every penny I have in your company and volunteer to be CEO.



Haldol it is! haha 

No I posted links to both sides! I'm trying to be fair. Legal because it's being done is a lazy argument. Come on. 

In the end there are many other things to argue about and will kill me. I'm not so concerned about the fluoridation itself. It's the consent part that bothers me.


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## MedicSansBrains (Aug 22, 2015)

Summit said:


> If ADA opposed fluoridation the conspiracy theorists would claim it was "all about the money" and "bad for dentistry business to have flouridated water" and call for greedy dentists to be hung.


Hmmm this is true! It's all a conspiracy of the ADA!


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## Carlos Danger (Aug 22, 2015)

Interesting question, really. I think a lot of us hear these concerns and dismiss them out of hand because we assume anything coming from even the same general direction as the conspiracy theorist / anti-vax crowd is just nonsensical idiocy.

But honestly, I kind of get the point of the OP and the folks in Austin:

1. Fluoride is a drug that is being essentially forced on everyone, whether or not they want or need it. 
2. Forcing an individual to take a drug that they don't want or need is wrong. 
3. Therefore, mass fluoridation is wrong.

You might argue in favor of the utilitarian perspective on the situation ("we need to do the most good for the most people, and screw the minority") - and that's obviously the position that the government has taken on this and most issues - but that line of reasoning is fraught with problems, primarily the slippery slope.  Using utilitarian reasoning, it would be perfectly OK for the government to start putting _any_ drug they thought would be a net benefit to public health in our water, or in the air we breath. 

I doubt fluoridation is the least bit harmful to anyone, and the benefits from probably do far outweigh the costs. Still, the libertarian part of me I completely understands why people don't like it.  

So in principle I agree with the people who are against it. But I think we have much more important things to worry about our government doing.


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## Meursault (Aug 22, 2015)

Remi said:


> You might argue in favor of the utilitarian perspective on the situation ("we need to do the most good for the most people, and screw the minority")


That would probably be a better criticism if anyone were being meaningfully harmed, and no, substances that are  toxic in large single doses are not therefore chronically toxic in tiny frequent doses. And no, tooth discoloration is not meaningful harm. And no, your pineal gland is not calcifying, and that's not why you don't have psychic powers.  I'm completely fine with adulterating water and air with any demonstrably safe and sometimes beneficial substances we can get into them.

Well that was fun. What public health measure is next on the list? Is there a Consumers for Informed Lead Paint Choices?



MedicSansBrains said:


> I'm not sure I understand the term "public health".


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## Carlos Danger (Aug 22, 2015)

Meursault said:


> That would probably be a better criticism if anyone were being meaningfully harmed, and no, substances that are  toxic in large single doses are not therefore chronically toxic in tiny frequent doses. And no, tooth discoloration is not meaningful harm. And no, your pineal gland is not calcifying, and that's not why you don't have psychic powers.  I'm completely fine with adulterating water and air with any demonstrably safe and sometimes beneficial substances we can get into them.
> 
> Well that was fun. What public health measure is next on the list? Is there a Consumers for Informed Lead Paint Choices?



Who are you to decide that tooth discoloration isn't "meaningful" harm?

Actually, whether any "meaningful harm" results or not is irrelevant. Anytime an individual is forced by the government to ingest a substance that the individual doesn't want or need, that individual has been wronged. Period. If you want to live in an infantilized society where everyone relies on and trusts government bureaucrats to make such personal decisions, good for you. I and many others feel differently, and I happen to believe that we should err on the side of individual liberty.


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## Meursault (Aug 22, 2015)

Remi said:


> Anytime an individual is forced by the government to ingest a substance


Probably not the thread to get into the legitimacy of the state, so we'll gloss over that.
The gubmint provides a water supply. This _socialized_ water supply is an alternative to drilling your own well or drinking from puddles. They compel citizens to pay for it partly, but I'm guessing not entirely, by charging for water used. They use that money to provide water through a system entirely of their devising, designed based on their beliefs about what a good water supply is: mineral and pathogen content of the water, pressure, areas served, economic incentives, etc.
*They don't compel citizens to drink the water.  *
Choosing to provide a specific kind of water might be bad on other grounds, for instance, harmful or inequitable, but it can't violate individual liberties.


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## Carlos Danger (Aug 23, 2015)

Meursault said:


> *They don't compel citizens to drink the water*



Uh, OK......

In many places - and I would be pretty surprised if Austin is not one of these - zoning and the other regulations make it impossible to drill one's own well. In fact, it is virtually impossible not to drive on government roads, drink government water, use government utilities, and opt out of the "protection" provided by government police and other services. So "just don't use the utility that you were already forced to pay for if you don't want to" is not a solution.

But the government knows what is best for us and always has our interests in mind, so it's OK.


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## MedicSansBrains (Aug 23, 2015)

gubmint


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## Meursault (Aug 24, 2015)

Remi said:


> In fact, it is virtually impossible not to drive on government roads, drink government water, use government utilities, and opt out of the "protection" provided by government police and other services. So "just don't use the utility that you were already forced to pay for if you don't want to" is not a solution.


This is sort of what I meant by "getting into the legitimacy of the state". 
But for the sake of argument, let's accept that there's an effective state monopoly on water, and that that's ethically relevant. What standards should the gubmint use for supplying water?


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## Carlos Danger (Aug 24, 2015)

Meursault said:


> This is sort of what I meant by "getting into the legitimacy of the state".



Yep. You don't have to drill very far into any issue before you hit the question of "does the government even have the moral authority to be doing/regulating/taxing/forcing this"?



Meursault said:


> This is sort of what I meant by "getting into the legitimacy of the state".
> But for the sake of argument, let's accept that there's an effective state monopoly on water, and that that's ethically relevant. What standards should the gubmint use for supplying water?



Whatever standards have to be implemented to make the supply safe to drink, and to keep the whole system as efficient and cost-effective as possible. Nothing more, nothing less.

If the government feels that fluoride supplementation is such a pressing public health issue that it must get involved and supply fluoride, then supplements should be made free to those who want them. Not dumped into the entire water supply.


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## joshrunkle35 (Aug 24, 2015)

Remi said:


> Interesting question, really. I think a lot of us hear these concerns and dismiss them out of hand because we assume anything coming from even the same general direction as the conspiracy theorist / anti-vax crowd is just nonsensical idiocy.
> 
> But honestly, I kind of get the point of the OP and the folks in Austin:
> 
> ...


I agree with every word here, wholeheartedly. It's not the what, but the how and the who.


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## Meursault (Aug 24, 2015)

Remi said:


> Whatever standards have to be implemented to make the supply safe to drink, and to keep the whole system as efficient and cost-effective as possible. Nothing more, nothing less.


So the absolute minimum required to keep the water supply from being an actual public health hazard, quality-wise, but at the same time, whatever it takes to make the system optimally efficient? Is the goal high-quality cost-conscious delivery of barely drinkable water? Would it be acceptable to spend some appropriated money on improving the sensory qualities of the water, so it's not brown and reeking of chlorine?
How safe do we need to make the water supply; do we need to reduce long-term accumulation of actual toxins, like PCBs,  or just prevent waterborne epidemics?

Cost-effectiveness is a dangerous criterion: you have to specify what effects you want.


Remi said:


> If the government feels that fluoride supplementation is such a pressing public health issue that it must get involved and supply fluoride, then supplements should be made free to those who want them. Not dumped into the entire water supply.


Even if that wastes more appropriated money to accomplish less?
And to be clear, it's absolutely okay for the government to spend appropriated money on addressing the population's dental health?



joshrunkle35 said:


> It's not the what, but the how and the who.


Does changing the "who" matter? If a non-state water monopoly starts fluoridating, is that different? Are their intentions relevant?


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## Carlos Danger (Aug 24, 2015)

Meursault said:


> So the absolute minimum required to keep the water supply from being an actual public health hazard, quality-wise, but at the same time, whatever it takes to make the system optimally efficient?



I said "as efficient and cost effective as (reasonably) possible". That simply means that, in all cases, the government has a responsibility to not be wasteful. It means, for example, paying water-treatment operators a fair market wage and providing them with a safe working environment rather than lavish salaries and pensions and opulent lounges in exchange for a 30-hour work week. It means using equipment that is functional and safe, rather than "investing" in the newest gizmos because a special interest convinced local officials to do so. It means a concrete parking lot in front of the building is better than a manicured, park-like setting that costs thousands of dollars a year in landscape maintenance. 



Meursault said:


> Is the goal high-quality cost-conscious delivery of barely drinkable water?
> Would it be acceptable to spend some appropriated money on improving the sensory qualities of the water, so it's not brown and reeking of chlorine?
> How safe do we need to make the water supply; do we need to reduce long-term accumulation of actual toxins, like PCBs,  or just prevent waterborne epidemics?


Does "high-quality" water equate to "brown and reeking of chlorine", and full of known toxins, in your estimation?

Not sure what this has to do with the unnecessary addition of drugs to the entire public water supply. 



Meursault said:


> And to be clear, it's absolutely okay for the government to spend appropriated money on addressing the population's dental health?



At a local level, I think if the population overwhelmingly supports the implementation of initiatives to spend _their_ tax dollars (not tax dollars from elsewhere in the form of federal grants) providing nutritional supplements to people who want them - not forcing them on everyone - then it's fine. That's what democracy is all about.

At a federal level or even state level, no. Absolutely inappropriate.


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## Meursault (Aug 24, 2015)

Remi said:


> At a federal level or even state level, no. Absolutely inappropriate.


What changes at that level? This is a very American-politics-focused analysis, but the original question didn't require that.



Remi said:


> Does "high-quality" water equate to "brown and reeking of chlorine", and full of known toxins, in your estimation?
> 
> Not sure what this has to do with the unnecessary addition of drugs to the entire public water supply.


Unpalatable water can still be safe. But I didn't make my point clear: the state needs to decide what physical properties its water should have, and add or remove substances to give it those properties. How should it choose what those properties are?

And, if the water already contains fluoride, as a lot of water supplies do, what should be done?


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## Carlos Danger (Aug 24, 2015)

Meursault said:


> What changes at that level? This is a very American-politics-focused analysis, but the original question didn't require that.
> 
> 
> Unpalatable water can still be safe. But I didn't make my point clear: the state needs to decide what physical properties its water should have, and add or remove substances to give it those properties. How should it choose what those properties are?
> ...



I have no idea what you are getting at, but this has become a little ridiculous.

Drugs should not be added to drinking water.

The end.


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## Meursault (Aug 24, 2015)

Fair enough. We were going to have to unpack a lot of things to continue.



MedicSansBrains said:


> I'm not sure I understand the term "public health"


The end.


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## ERDoc (Aug 24, 2015)

Remi said:


> If the government feels that fluoride supplementation is such a pressing public health issue that it must get involved and supply fluoride, then supplements should be made free to those who want them. Not dumped into the entire water supply.



What about all of the kids whose parents won't get them not out of a belief against their use but just because they don't care enough to get them?  Who should pay for the dental care for people that chose not to use supplements?  Who should pay for the dental care for the kids whose parents didn't get the supplements and as a result have damage from 18+ years of no fluoride?


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## Summit (Aug 24, 2015)

ERDoc: They suffer and/or you pay via taxes. It is just the price of freedom from harmless public health measures.


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## Carlos Danger (Aug 24, 2015)

ERDoc said:


> What about all of the kids whose parents won't get them not out of a belief against their use but just because they don't care enough to get them?  Who should pay for the dental care for people that chose not to use supplements?  Who should pay for the dental care for the kids whose parents didn't get the supplements and as a result have damage from 18+ years of no fluoride?



At some point individuals just need to take responsibility for their own health and well-being, and the rest of us need to realize that the choices of others are not our responsibility, and that we do not have the moral authority to force others to do things just because we think they should do them. 

It is very unfortunate when respect for autonomy results in children being deprived by irresponsible parents. But I don't see how this issue is any different than any other out there. Parents are free to choose not to provide preventive dental / medical care and healthy food and safe environments for their kids all the time. As a society, we only interfere with that when those situations are egregious, because we recognize that there are limits to our authority to impose on the choices of others, even when those choices are bad, and even when they affect children.


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## joshrunkle35 (Aug 25, 2015)

Meursault said:


> Does changing the "who" matter? If a non-state water monopoly starts fluoridating, is that different? Are their intentions relevant?



Absolutely. There's a difference between say "Ice Mountain spring water" using fluoride (no idea whether or not they do) and the water supply using it. I have the choice of whether or not to use one. 

Nothing within 30 miles in any direction of where I live has the option of using well water. I cannot shower, wash food, etc with anything but public water, even if I choose to drink other water.

Now, before I go further, let me be very clear: I have no problem consuming fluoride in my water. I do however have a problem of the removal of choice to consume a drug under the "guise" of public health. 

It is one thing to put a drug in the water reserve that cures a malaria epidemic within an area. That is good for the entire public, as the lowered threat to other individuals also helps the rest of the public. However, that is very different from giving the entire water supply, say, a medication that lowers the risk for people to get cancer. One is good for the entire public, one is good for a portion of the public. In the case of cancer, it would be assumed that with cancer, that small portion of the public that actually gets cancer would choose to seek treatment, as most people given the choice would choose to live. Yet, putting this medication in the water supply would still be wrong, as choice and autonomy are more important than the results of treatment (yet, exceptions are made for a crisis...same reason we bring in the national guard during a crisis, but we don't use them every day).

If we can see that it would be wrong to give the whole population a medication that affects such a small amount of people who might still wish to take the drug by choice, in the case of a cancer preventative, or cancer treating drug, then what about something like fluoride? 

A large percentage of Americans today choose to have very good oral hygiene. The small percentage of people who would be helped by having fluoride in the water would, given the choice, choose not to have good oral hygiene. (Hence, why they need the fluoride) Chances are that they do not even drink water, but instead choose to drink thinks like soda - worsening the oral hygiene issue. Having poor oral hygiene can contribute to problems like heart disease, yet, it does not directly translate to something that causes a health issue that is easily spread to the rest of the public. 

If we use the same frame of thought for the usage of fluoride, we could concur that it would be beneficial to give the public water supply drugs that stop people from smoking or overeating as well, as these produce higher health costs to the medical system than poor oral hygiene. If we can see that this would be wrong, because it removes individual choice and autonomy, then we should hopefully recognize the same about fluoride.


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