Howard Cohen and David Locker

It is our contention that water fluoridation, by the very nature of the way it is administered, engenders a number of moral dilemmas that do not admit to any easy solution. In this paper, we attempt to elucidate the particular problems posed by this public health initiative, according to the principles of bioethics.

… Ethically, it cannot be argued that past benefits, by themselves, justify continuing the practice of fluoridation. This position presumes the constancy of the environment in which policy decisions are made. Questions of public health policy are relative, not absolute, and different stages of human progress not only will have, but ought to have, different needs and different means of meeting those needs. Standards regarding the optimal level of fluoride in the water supply were developed on the basis of epidemiological data collected more than 50 years ago. There is a need for new guidelines for water fluoridation that are based on sound, up-to-date science and sound ethics. In this context, we would argue that sound ethics presupposes sound science.