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In the matter of fluoridation of water supplies, some opponents have contended that it
compels people to take a form of medication contrary to their religious belief, or that it deprives
them of the right (as part of their personal freedom) to safeguard their health in the way they
consider best. Religious freedom embraces freedom of belief and freedom to act in accordance
with one's belief. Freedom of belief is absolute but the second, that is, freedom of action, can
only be exercised in conformity with the law. For example, certain sects may regard polygamy
as a religious duty, but the State may punish it as a crime. During prohibition in America, the
Federal Government had authority to limit the quantity of wine that could be used for sacramental
purposes.
DIRECT AND INDIRECT COMPULSION
Again, in consideration of constitutional rights of freedom it is important to distinguish
between direct compulsion upon the individual as, for example, the compulsory vaccination
against smallpox, with penalties for violation of the law, and those which are indirect, such
as fluoridation, which is incidental to a publicly provided water supply. A citizen is free to
drink whatever water he pleases, but in contrast the law takes action if he drives on the righthand
side of the street. A public utility, such as a water supply, which i s provided democratically
by law, does not give an individual or a minority the right to dictate how the water
authority will provide the supply, so long as it acts within its statutory undertaking. Such
persons are riot compelled to drink the water supply, though it would be difficult for them to
obtain an alternative supply. It must, however, be remembered that it is provided as a public
utility service and is not, in this sense, like the air we breathe. Individuals possess an
obvious right to water as one of the essentials of life, but that is not to say that they have
an equal right to receive it from a man-made system or without interruption in unlimited
quantities and of the nature and quality to suit their individual requirements or tastes. If some
persons in such a community combined to provide a public supply, but they were outvoted, it
could not be argued that their rights were not protected because they were deprived of the
water supply they wanted. Persons receiving water from a public supply system, whether the
water is fluoridated or not, are in no worse position than those who receive none at all in
this way.
Other opponents contend that fluoridation of water supplies compels them to take a 'form
of medication' or 'compulsory mass medication'—terms which have gained an emotional content
often irrespective of what they mean. The argument here largely hinges on one's conception of
what a medicine or medicament is. According to dosage, mode of administration and other
circumstances, a substance can be a nutrient, a medicine or a poison. Amounts of vitamin D
are needed as a nutrient to promote health and lack of this vitamin leads to the development of
rickets. The rickets can be cured by supplying the appropriate dose of the vitamin as a
medicine. This dose is in excess of the minute quantity required as an accessory food factor
or nutrient to prevent the condition. In still larger doses vitamin D can be poisonous, causing
abnormal calcification of bone, and even be fatal. This can be true even of pure water itself.
Again, small traces of iodine are essential to health. In districts where the water supplies
are deficient, goitre occurs. This deficiency can be made good by supplying iodine in minute
amounts as an addition to table salt. An appropriate dose of iodine can be used as a medicine,
for example, as Lugol's iodine, or as an antiseptic tincture of iodine, whereas the consumption
of iodine in still larger doses causes iodine poisoning. Similarly fluoride is an essential of
human teeth and bone. In areas where the water supply is naturally deficient in fluoride, dental
caries in children is greater than in those with approximately 1 ppm. fluoride in the water. In
an area where fluoride occurs naturally, in a higher concentration, for example 8 parts per
million, the mottling of dental fluorosis is found in children's teeth. Fluoride taken in larger
doses would cause acute or chronic poisoning depending on the dosage and mode of
administration.
Such a consideration of the matter may well lead to the conclusion that fluoride taken in a
water supply of 1 ppm. is more properly described as a nutrient than a medicament. It is found
in trace amounts in a number of foods.
Many opponents of fluoridation of the water supply are actually drinking water which
contains fluoride naturally. It can be argued with equal validity that if such individuals regard
the question as an important one, they should be prepared to seek unfluoridated water rather
than impose their preferences of this kind of water on a whole community.
In exactly the same or similar ways the problems of the introduction of smoke control
areas, accident prevention, increasing drug addiction, and many other causes of, mental and
nhvsical ill Health in the community are to be analysed.
The detailed problems of adjusting corporate responsibility to personal liberty are legion.
They go right to the heart of the matter of how far the State, besides eliminating evils, can
promote the positive good of the community. The concept of the State as the source of comprehensive
welfare causes to loom large the spectre of "interference" in the family, and other
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