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Water fluoridation as clinical malpractice

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The status of water fluoridation:
Public health measure, mass medication, or clinical malpractice?

Doug Cross, BSc, CBiol, EurProBiol, FSB
Environmental analyst

11 February 2011

Need for clarification.
Water fluoridation is described as a benign ‘public health’ intervention. It involves the administration to the public of a chemical that is claimed to have medicinal properties, in a manner that is virtually unavoidable. There is widespread public objection to what is commonly referred to as ‘mass medication’, and growing concern over the adverse effects of this non-consensual medical intervention. This lay summary for Administrators and Legal Practitioners on the legitimacy of water fluoridation within the context of dental public health management, is provided to assist clarification of the assumed permissibility of the practice in a democratic society
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All forms of fluoride administered with the intent to prevent tooth decay are medicines (drugs) in law.
The claim that fluoride stops tooth decay is one of the pillars of dental public health policy. The public refer to fluoridation as mass medication, but Governments that adopt fluoridation invariably deny that fluoridated water is a medicine. Therefore, they argue, no medicinal licence to supply the product to the public is needed. They are wrong - the status of a medicinal product is defined in law, not by administrative policy and convenience.

Case law precedents establish that fluoridated water must be classed as a medicine (drug)
A product is medicinal (a drug) if its is promoted as having the property of preventing or curing a human disease (‘medicinal by presentation’) or if is formulated knowing that it has such a property (‘medicinal by function’). Rulings in the European, Scottish and Australian Courts, amongst others, confirm this principle. In cases where drinking water is claimed to have a medicinal property, medicinal law must be invoked, and has precedence over any other arm of legislation.

Administering a drug within a public health programme is a clinical intervention.
Public health programmes may include a range of activities that are subject to different branches of law. In all cases, medicinal law takes precedence. Administering a product such as fluoride in this fashion violates the boundary between public health and clinical practice. The practice of water fluoridation falls firmly within the scope and constraints of medical law and Clinical Codes of Practice.

Clinical interventions may only be carried out by qualified individuals, personally, and with consent.
Only qualified health professionals may give another person a drug with the intent to prevent a disease. They
may only do so individually, and with the consent of the patient. Administering an unlicensed medicine, even with consent, is subject to a particularly stringent Clinical Codes of Practice, and the responsibility for any adverse effects falls firmly on the practitioner administering the substance.

Fluoridating community water supplies is clinical malpractice and unlawful.
Fluoridation is a deliberate act, designed to ensure that fluoride is administered to the greatest possible proportion of the public. Councils and water suppliers adding fluoride to drinking water under instruction from the State therefore act, even if unwillingly, as the vicarious agent of State Authorities in carrying out an unlawful act of clinical intervention on the public. Those doing so voluntarily are equally liable.

Fluoridation legislation is incompatible with medicinal law, and must be struck out.
Legislation endorsing and promoting the fluoridation of public water supplies is in breach of superior medicinal law, and is incompatible with Clinical Codes of Practice. All such legislation is unenforceable, and must be abolished. Claims for medical damage caused by exposure to this illegal practice are actionable before the Criminal and Civil Courts


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