Bioethics and Health Care

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Recommended: Water fluoridation controversy

INTRODUCTION:

The controversy with community water fluoridation arises from moral, ethical, political and safety concerns with respect to water fluoridation. As far back as 1930, there was a relationship inversely between the levels of fluoride in drinking water and existence of dental caries. Any practice like fluoridation, which uses the public water supply to deliver the medicine violated the medical ethics. The ethical issues associated with the water fluoridation include- balancing risks and benefits, presence of any other interventions with the same outcome, the role of consent. Fluoridation violates the principle of informed consent. On the other hand, in public health practice the principle of beneficence has more weight than the principle of autonomy.

There were two objections because the fluoridation of water has some undesirable side effects such as development of Down syndrome and Cancer in the areas where fluoridated water is supplied. Apart from this, the second objection was allied to it being a compulsory medication. Opponents insist compulsory community water fluoridation violates the ethical principle of autonomy. Objection due to suspicion of more amount of fluoride which leads to cancer is justifiable with the ethical principle of Non-maleficence. However, it is not actually based on scientific aspects. The second objection i.e. compulsory medication is related to the principle “autonomy” this demonstrates the controversy between the principle of autonomy and positive effects of community water fluoridation (beneficence).

However, in Britain (1985), the report of the working committee on fluoridation of water and cancer has no evidence in development of cancer in association with fluoridation of water. An...

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Harris, J. The Ethics of Fluoridation. Centre for Social Ethics and Policy, University of Manchester.

Howrad C, D. L. (2001). The Science and Ethics of Water Fluoridation. Journal of Canadian Dental Association, 67(10), 578-580.

K. Anand, N. B., D. Moorthy, S. K. Kapoor, R. Sankar, C. S. Pandav. (2002). Ethical Issues in Public Health Policy. The National Medical Journal of India, 15(2), 97-100.

Stilwell WF, E. N., Stainton PVE. (1957). Commission of Inquiry on the Fluoridation of Public Water Supplies. Wellington.

Susheela AK, K. A., Bhatnagar M, Bahadur. (1993). Prevalence of endemic fluorosis with gastro intestinal manifestations in people living in some North-Indian villages. Fluoride, 26(2), 97-104.

. Water Fluoridation in New Zealand. An Analysis and Monitoring Report. (1994). Wellington: Public Health Commission Rangapu Hauora Tumatanui.

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