Consent and Water Fluoridation

[Carlos Danger]

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.

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.

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.

 

[Meursault]

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.

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?

 

[Carlos Danger]

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?

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

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.

 

[Meursault]

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

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

The end.

 

[ERDoc]

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?

 

[Summit]

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

 

[Carlos Danger]

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.

 

[joshrunkle35]

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.