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Fluorides Part II : The legal and ethical position of fluoride use in the United Kingdom water supply

Fluorine is one of those elements that can exist in a number of different chemical forms. As a radio chemist we had to use a fluorine-based compound to dissolve soils and components of soils. One form of fluorine I had to work with was hydrofluoric acid. Hydrofluoric acid is possibly one of the most scary chemicals I have ever had the mi s-pleasure to work with and I have worked with solutions of all sorts of chemicals including those containing radioactive cocktails.

We now use a chemical form of fluorine to brush our teeth with and we also add it to our drinking water. The stuff we add to our water, or should I say, the fluorine compounds that are put into our water supply by our municipal, political, industrial, medical and scientific masters do not combat dental caries or strengthen teeth enamel as they say it does. The ingestion of fluoride-containing compounds have long term insidious effects on our physical body, our neurological body, the functioning of our glands and bone matter. If governments are really worried about the state of our population's teeth e.g. dental caries, why do they legally allow such high levels of sugars in our foods and drinks? Why put in our water supply, a known carcinogen? Its as bad as using that other well known carcinogen, mercury that is injected into the bodies of our babies in the infamous 3 in 1 so-called 'vaccine jabs'. The association between autism and the use of these jabs needs to be investigated properly and ethically by non-government, non-industry, non-academic scientists. Someone please tell me what is going on?

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The fluorine added to our water supply arises from industrial wastes and worse still, these wastes also contain phosphates. Phosphates are bad news in terms of the human body because they contain elevated levels of naturally-occurring radioactive elements such as radium, thorium, polonium, radon and uranium. I enclose a few articles I pulled off the web and they are from people, sometimes scientists, dentists and medical doctors who are not owned by the government or the water industry, and they tell a different story to what is told by our main-stream media and others who are too dim or blinded by those they work for to think for themselves. Read through and make your own mind up. Phone up your local water treatment centre and ask them whether they add fluorides to the water supply. Contact your local MP or senator and ask questions why we treat water with cancer-causing chemicals that impair the body's immune system and alter our physiological response to all sorts of spiritual and environmental stimuli.

Article below is historic yet still relevant for today

"Two weeks ago it emerged that Mr Blair is backing secret moves to force water companies to fluoridate drinking water, whether they like it or not. In other words, he is proposing to mass medicate the people of this country, not, as we might imagine, to prevent some terrible, crushing health risk like Small Pox, but to improve the quality of our teeth.

Two weeks ago it emerged that Mr Blair is backing secret moves to force water companies to fluoridate drinking water, whether they like it or not. In other words, he is proposing to mass medicate the people of this country, not, as we might imagine, to prevent some terrible, crushing health risk like Small Pox, but to improve the quality of our teeth. Tooth decay is a nuisance, but it’s hardly the stuff of nightmares. Fluoride on the other hand may well be, and worse, according to countless studies around the world, it doesn't’t even work. In the United States, where 65% of people are routinely subjected to the chemical, the worst tooth decay occurs in poor neighbourhoods of the largest cities, the vast majority of which have been fluoridated for decades. And when fluoridation was stopped in parts of Finland, East Germany, Cuba and Canada, tooth decay actually decreased.

But even if it did work, drinking fluoride to prevent cavities is like swallowing bandages to cure a broken arm. The US Centre for Disease Control only recently confirmed that fluoride is useful only when applied directly, for example to teeth. So the government has opted as a solution to tooth decay, not a campaign against the undisputed culprits like fast food or sugar, but mass medication with a useless medicine. But fluoride is not just a useless medicine. It is highly toxic— so toxic in fact that in 1984, the makers of Colgate, Procter and Gamble, admitted that a small tube of their toothpaste "theoretically at least contains enough fluoride to kill a small child." Given the fact that a third of American children living in fluoridated areas have white specks, or in more serious cases, dark stripes across their teeth, a sure sign of fluoride over-dose, the implications are alarming.

Last year, the director of the University of Toronto’s Preventative Dentistry department, Dr Hardy Limeback, announced that he had profoundly corrected his pro-fluoride position having reviewed available literature. It must have taken him some time. Fluoride has been linked to cot death, eczema and Alzheimer’s. It has been shown, at low doses, to cause genetic damage. It has even been blamed by Doctors from the National Cancer Institute and the National Health Federation, for 35,000 cancer deaths every year. And because fluoride disintegrates collagen, an essential structural component in skin, muscle, ligaments and bone, big question marks are being raised over its possible contribution to arthritis, a problem that has increased by 63% since 1997, and which now affects a staggering seventy million Americans. Other reports are appearing with increasing regularity that link the accumulation of fluoride in bones to an increase in hip fractures among the elderly. The Journal of the American Medical Association reported recently that "with increasing dose of fluoride in the drinking water the hip fracture ratio increases," a view echoed by the Lancet, the Annals of Epidemiology and many other science journals.

Still further studies have linked fluoride use to hyperthyroidism (underactive thyroid glands), one of the most widespread medical problems in the US, effecting more than 20 million people and leading to fatigue, weight gain, depression and heart disease. That is scarcely surprising given that Fluoride used to be prescribed by European doctors to depress the activities of the Thyroid. But what is surprising is that fluoride was ever considered for mass medication. It has always been the source of contention. Indeed the first ever lawsuits against the US government’s Nuclear bomb programme, the so-called Manhattan Project, concerned fluoride, not radiation. What is more, the first health tests for fluoride, conducted by a Dr Dean, were designed to establish how much industry could afford to release into the environment without damaging human health. So how did it happen? In the summer of 1943, a group of New Jersey farmers reported that something was ‘burning up’ their peach trees, maiming their horses and cattle and killing their chickens. The source of their ills was a nearby DuPont factory that was producing millions of pounds of fluoride for use in the Manhattan Project. Immediately following the war, the farmers filed suit against DuPont, and without realising it, triggered alarm bells throughout the government. At the time, the Manhattan Project’s chief of fluoride toxicology studies, Professor Harold C Hodge asked his superiors if there "would be any use in making attempts to counteract the local fear of fluoride through lectures on fluoride toxicology and perhaps the usefulness of fluoride in tooth health?" As we now know, that is what happened, with the effect that fluoride was magically transformed from a killer to a panacea.

Some years later, Dr Phyllis Mullenix, formerly the head of toxicology at Forsyth Dental Center in Boston, conducted animal studies that showed fluoride was a powerful central nervous system toxin, even at low doses. Her results were published, and believing them to be original, she was startled when the US National Institute of Health rejected her conclusions out of hand and terminated her grant. In fact her research was not original. Similar studies had been carried out by dentists involved in the Manhattan project, and the results had demonstrated a ‘marked central nervous system effect’ from fluoride. A version of the study was published in 1948, but it was according to the investigative journalists who uncovered the original, ‘censored to the point of tragicomedy’. While the published version reported that the factory workers studied exhibited fewer cavities, the original reported that most of them no longer exhibited any teeth at all. Since then, the most widely known study into the benefits of water fluoridation was conducted in New Zealand between 1954 and1970, and continues to be used by fluoridation advocates. But the study failed to meet the most basic criteria for scientific objectivity, not least because the decline in tooth decay that the community in question experienced was also experienced by other non-fluoridated communities in the region. The then mayor of Auckland, Sir Dove Myer Robinson described the so-called Hastings Experiment as a ‘swindle’.

Tragically the people the British government apparently wants to help most are the very same who will be worst hit by fluoride contamination. Studies by the American Dental Association in 1957, and again by the Canadian National Research Council in 1977 have shown that "people with inadequate dietary intakes are likely to be more ‘at risk’ as a consequence of long term low-dose fluoride ingestion." The British government’s health and environment ministers, Hazel Blears and Elliot Morley, recently issued a letter in which they suggested with breathtaking arrogance that "those who remain adamantly opposed would be able to use water filters that remove fluoride or buy bottled drinking water." But why should we have to? If people want to subject their children to a highly suspect industrial poison, they are free to do so, on their own terms. That is the position of virtually every country in Europe".

The article below was taken off the NWPA website which is an excellent source of information on the somewhat dodgy rationale and use of fluorides in the UK water supply for people living in the UK. If you live outside the UK, see what is happening to your water supply. Become informed, involved and ask whose benefit are fluorides added to water..

Definition.

Two substances, hexafluorosilicic acid (H2SiF6) and sodium hexafluorosilicate (Na2SiF6) are used industrially in water fluoridation. They are known popularly both as fluorosilicates and as silicofluorides. In this analysis I have used the term silicofluorides throughout when referring to them. Sodium fluoride, (NaF) is no longer used in water fluoridation, but is registered as a medicinal substance with strictly limited applications in the UK and the European Union (EU).

Application.

The following analysis deals with the use of silicofluorides in water fluoridation in England. It also briefly reviews the situation with regard to the practice of adding sodium fluoride to milk targeted on children. It has relevance to other administrative regions within the UK, such as the Scottish Parliament and the Welsh Assembly. It is also of concern to water undertakers and any other persons or organisation involved in water fluoridation, or the addition of these chemicals to other ingestible products. Elsewhere in the EU, national legislation notwithstanding, the use of these substances and the practice of water fluoridation itself are violations of Union-wide Directives on the use of pharmaceutical products, and of reputable codes of medical ethics. Consequently, their use for fluoridating public water supplies constitutes violation of numerous Articles of the European Human Rights legislation.


The basic issues raised by the practice of water fluoridation.

The status of water fluoridation can be clarified by examining three basic statements of fact.


1. In England, fluoridation is not a permitted water treatment process under the Water Supply (Water Quality) Regulations 
2000. Its legal status in both England and in the whole of the EU is that of a medical intervention, and fluoridation cannot be reclassified as a water treatment process.

2. Silicofluorides are not authorised substances under the Codified Pharmaceuticals Directive, governing the regulation of medicinal substances that may be used for Human medication in the EU. Their use with intent to medicate the general public is therefore unlawful.

3. The administration of any medicinal product to the public is governed by strict codes of medical ethics, reinforced by recent Community-wide Human Rights legislation. The imposition of fluoridation by any State upon its citizens is a serious violation both of universally acceptable medical ethics and of established legislation protecting Human Rights, and is remediable under European legislation.

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1 - The status of fluoridation in water treatment. 
1.1 Authorised products and processes in the treatment of water for human consumption.

a) The Water Supply Regulations.

In England, Council Directive 98/83/EEC on the quality of water intended for human consumption (1)was incorporated into the English legislation as the Water Supply (Water Quality) Regulations 2000 (S.I. 3184 2000) (2) , (The equivalent Scottish legislation of 2000 also implements this Directive ).(3) This updated, and to some extent replaced, earlier provisions included in the Water Supply (Water Quality) Regulations 1989 (4), as amended by the Water Supply (Water Quality)(Amendment) Regulations 1991 .(5)

However, the relevant section of the earlier Act - sections 25 and 26 - are effectively unchanged in the 2000 Regulations, and are entirely compliant with the wording in section 31 of 98/83/EEC. In support of the 1989/91 legislation, the Government has published a 'List of products and processes approved under section 25 and 26 for use in connection with the supply of water for drinking, washing, cooking and food production purposes'. The most recent publication of this List is dated December 2001. (6)

The commonly used fluoridation chemicals are hexafluorosilicic acid H2SiF6 and, far less commonly, sodium hexafluorosilicate Na2SiF6 - these are referred to below by their familiar name 'silicofluorides'. Sodium fluoride is no longer used in water fluoridation. None of these substances, nor the process of fluoridation itself, are included as recognised products or processes in the December 2001 List.

Both the EU and the English (and Scottish) legislatures have already accepted that fluoridation is not a water treatment process. Since the process has been excluded from this category for at least a decade, any attempt now to include fluoridation as a water treatment process under an amendment to the existing Water Supply Regulations can therefore be challenged. Fluoridation has no technical role in water treatment, and its sole role is one of public medication.

b) The Water (Fluoridation) Act 1985 .

Sections 87-91 of the Water Industry Act 1991 (7) incorporate the principal provisions of the Water (Fluoridation) Act 1985 
(8) into current legislation. However, the Water Supply (Water Quality) Regulations (and its amended version) 1989/1 post-date the Water (Fluoridation) Act 1985, but do not include fluoridation as a permissible water treatment process. Fluoridation therefore cannot be defined as a water treatment process. Since the relevant authority in the existing English legislation for adding 'fluoride' to the public water supply derives from 'a written request from a District Health Authority', the action of fluoridation is clearly not aimed at water treatment, but is a purely medical intervention.

1.2 Conclusion.

Water fluoridation is not a water treatment process, and silicofluorides are not water treatment chemicals. The sole objective of their addition to the public water supply is to medicate the general public.

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2. Silicofluorides are not licensed as pharmaceutical products. 
2.1 The legal status of silicofluorides.

a) Manufacture

The manufacture of silicofluorides for use under the provisions of the Water Industry Act is controlled under BS EN 12174 and 12175.(9) It is important to understand that these merely specify the standards to which these substances must adhere in manufacture - they do not authorise their use as medicinal substances for human use. The manufacture of all medicinal substances must comply with the provisions of the 'Guide to Good Manufacturing Practices for 
Medicinal Products' (75/319/EEC) . (10) The provisions of this code are not identical to those included in the specifications of BS EN 12174/5.

b) Definition of a medicinal substance

The Codified Pharmaceuticals Directive 2001 (2001/83/EC) (11) replaces the earlier Medicines Directive 65/65/EEC , (12) incorporated into English law in the Medicines Act 1968 .(13) A major defect in 65/65/EEC was that there was no differentiation between medicinal substances, cosmetics and foods - a defect that the MCA and other Government sources invariably exploit to confuse questioners, by claiming that the use of 'fluoride' (not silicofluorides) is controlled under a range of legislation, including that relating to food and cosmetics.

Any substance marketed as a remedy or preventative for any specified medical condition is a medicinal substance under Article 
1 of this Directive. The definition of medicinal substances in 2001/83/EC is absolutely clear - i.e., 

"Any substance or combination of substances presented for treating or preventing disease in human beings or animals.

Any substance or combination of substances which may be administered to human beings or animals with a view to making a diagnosis or to restoring, correcting or modifying physiological function in human beings or animals is likewise considered a medicinal product."

Fluoridated water is presented to the public by the Health and Dental Sectors as being an effective remedy in the prevention 
or reduction of the incidence of dental caries in young children. Many dental public health officers state that it is beneficial throughout life, and virtually all over-the-counter dental preparations contain some form of added fluoride.

As a direct result of this promotion, the average person in Britain generally believes this to be so. Non-fluoridated water is not so promoted, and is not regarded by the public as having this medicinal property. Fluoridated water is therefore deliberately marketed as a product that has specific medicinal properties that are absent from non-fluoridated water.

The European Court of Justice has ruled that if a product is represented to the public so that any averagely well-informed person gains the impression that the substance might have a beneficial effect on some medical condition, then that substance is a medicine under the terms of this Directive, even if it is in fact ineffective.(14)

The concentration of 'fluoride' present in fluoridated water is that which is considered to produce the required remedial or preventative effect, particularly on juvenile tooth decay. The product as a whole is therefore a medicinal product. Dilution 
is not a relevant issue, and both the product - fluoridated water - and the active ingredients contained in it must be classified as medicinal substances under 2001/83/EC.

Silicofluorides are not included in the Community Register of Medicinal Products for Human Use ,(15) nor are they included in the Medicinal Products (Prescription and Control of Supply) Regulations 1996 (S.I. 256/1996) .(16) They are therefore unregistered medicinal products, and as such their use in medicating any human condition is unlawful, enabling legislation with respect to fluoridation notwithstanding.

c) Can silicofluorides be classed as foods or food supplements?

Within the European Community, any ingestible substance is either a food or a medicine, and the definition of 'food' includes drinks. Any ingestible product containing a medicinal substance is expressly prohibited from being classified as a 'food' (and therefore also as a drink), and must be classified as a medicine. There is an absolute prohibition on attributing to any food (or drink) any properties of preventing, treating, or curing any human disease.

Under Article 6 of the Food Supplements Directive - 2002/46/EC ,(17) no food supplement - including any mineral - may be presented to the public as having medicinal properties. Article 1.1 states that all food supplements must be delivered to the consumer in pre-packed form, unless they are registered as medicinal products under 2001/83/EC. Sodium and potassium fluoride are the only two fluorides permitted to be classed as minerals that may be used in the manufacture of food supplements. Each is registered separately. There is no presumption that it is merely the fluoride component of the substance that is a registered mineral. Neither of the two silicofluoride chemicals is registered as a mineral, nor as a medicinal product.

Fluoride of any kind, if marketed as a water fluoridation agent claiming to have a beneficial effect on tooth decay, is 
therefore expressly excluded from eligibility as a food supplement or a mineral supplement, and must be registered under 2001/83/EC. The silicofluorides therefore would not be permissible substances under the new EU regulations concerning vitamins, minerals and nutraceuticals, even if they were to be pre-packed and sold in discrete dose form.

Since there is no requirement for fluoride in any normal biochemical process in the human body, claims that some potable water supplies may be 'deficient' in fluoride has no scientific validity. In this respect, it is therefore unsound to consider fluoride - in any form - as a nutrient. Nor is it possible to 'supplement' a diet with it. Since it is purely a cumulative toxin, any additional body burden, from whatever source, merely contributes to a lifetime's accumulation and the consequent increasing challenge to normal body functioning. The inclusion of sodium and potassium fluorides as 'minerals' under the Food Supplement Directive therefore has no scientific validity.

c(i) Cosmetics

The MCA claims that the use of 'fluoride' is also controlled under regulations covering cosmetics. Article 1 of the Cosmetics Directive 1976 (76/768/EEC) (18) defines cosmetic products asany substance or preparation intended to be placed in contact with the various external parts of the human body (epidermis, hair system, nails, lips and external genital organs) or with the teeth and the mucous membranes of the oral cavity with a view exclusively or mainly to cleaning them, perfuming them, changing their appearance and/or correcting body odours and/or protecting them or keeping them in good condition.

If a preparation is marketed in a form designed to be swallowed, it cannot be classed as a cosmetic substance, and it is either a medicine, a food or a food supplement. Any cosmetic preparation that makes a medicinal claim of any sort is automatically designated as a medicinal product, and is regulated accordingly under 2001/83/EC, and not solely under 76/768/EEC. Fluoridated toothpastes that are claimed to have cariostatic properties are therefore medicines as well as cosmetic products.

Fluoridated water is routinely presented to the public as having such cariostatic properties when drunk - it therefore could not be classed solely as a cosmetic product, even when used to simply rinse the mouth. If swallowed, it becomes a medicine.

d) Silicofluorides as scheduled poisons.

In English law, both sodium fluoride and the silicofluorides are scheduled as Part II Poisons under the Poisons Act 1972.(19) A reference in that Act to a poison includes substances that contain that poison. Section 1.4 states that'Some substances in the poisons list also have medicinal uses. When sold as medicines, such substances are controlled by the Medicines Act 1968, but when sold for a non-medicinal purpose they are subject to the Poisons Act 1972.'

Part II poisons may only be sold to individual customers under strictly regulated conditions and safeguards by a qualified person (such as a pharmacist). Products containing sodium fluoride cannot be sold except within the specified products listed in S.I. 256/1996. If silicofluorides are not classified as medicinal substances and water containing them is not a medical product, as the MCA claims, then they can only be sold under the controls imposed by the Poisons Act, regardless of any authorisation under the Water Industry Act.

If, however, it is a medicine then their sale and use in fluoridated water is subject to control under 2002/83/EC. But since the MCA has refused to designate silicofluorides as medicinal substances, they remain solely Part II Poisons, and are subject to control under the Poisons Act. This is quite independent of the legislation relating to the processing and sale of potable water in England. Attempting to permit the use of silicofluorides under the Water Industry Act does not over-ride the requirements of 2001/83/EC - if the fluoridating substance is not registered as a medicinal substance under the Pharmaceuticals Directive, then its use in any product or preparation is unlawful. It is important therefore to note that no dossier on the safety ofsilicofluorides for administration to humans in the public water supply has been presented for evaluation. This is obviously of relevance to those constraints on its sale to the public under the provisions of the Poisons Act.

e) Fluoridated milk

All substances permitted to be used as a medicine in England are listed in the Medicinal Products (Prescription and Control 
of Supply) Regulations 1996 (S.I. 256/1996 ). (20) Sodium fluoride is registered in Schedule 3, part 2 only as a medicinal substance for use in dentifrices, mouthwashes and tablets for dental hygiene. Silicofluorides are not included in any Schedule of this Instrument.

However, sodium fluoride is used in Britain to fluoridate milk targeted at juveniles. A dose of approximately 2 mg of fluoride per day is administered in 190 ml of milk (The maximum permissible daily dose for an adult under SI 256/1996 is 2.2 mg) This milk appears to be recognised as a medicinal product, because parental consent is required to administer it to minors. The World Health Organisation stipulates that when fluoride is administered to minors in this way, their urine must be tested for fluoride, a requirement that appears not to be adhered to in British schools.

If sodium fluoride is used outside its authorised range of medicinal products, it reverts to its classification as a poison. Its use in milk is therefore subject to (and contravenes) the restrictions set out in the Poisons Act, a fact of which parents are almost certainly unaware. It is therefore remarkable that, regardless of this, fluoridated milk should be accepted and treated as a medicine by some British Health Authorities.

It is even more extraordinary that fluoridated water, an entirely equivalent product, marketed with the intent to medicate the identical medical condition, is permitted to contain substances that are not registered for any medicinal use whatever. In the English legislation, the silicofluorides are in fact classified solely as poisons, and are currently dispensed to the public without any regard to European legislation designed to protect the public against unlawful exposure to such substances.

2.2 Conclusions.

As used in water fluoridation, silicofluorides are not foods, food supplements, food additives or cosmetic substances. They are purely medicinal substances, and must be registered as such before they may be administered to the public with the intention to medicate against tooth decay. Both the silicofluorides and sodium fluoride are scheduled poisons, and their sale in commercial ingestible products such as water and milk violates the provisions of both the UK and EU pharmaceutical legislation and the Poisons Act.


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3. Medical ethics and human rights.

3.1 Codes of medical ethics.

a) The Convention on Human Rights and Biomedicine

The Council of Europe's Convention for the Protection of Human Rights and Dignity of the Human Being with Regard to the Application of Biology and Medicine; Convention on Human Rights and Biomedicine .(21) (for convenience below, the 'Biomedicine Convention') sets out to protect the rights of people as they are affected by the fast-changing advances in modern biology and medicine. In particular, it establishes their right to prevent the imposition of such advances by the State upon their persons. The term "human rights" refers to the principles laid down in the European Convention for the Protection of Human Rights and Fundamental Freedoms (1950).(22)

The British Government is notably one of the few in the EU that have refused to sign up to what is now the most widely adopted Code of Practice covering medical ethics within the Union. However, this failure does not absolve it from challenge under its failure to comply with recognised standards of medical ethics, as an entirely similar ethical approach to the principles of medical practice is endorsed in principle by all responsible medical professionals, in both the private and the State medical sectors.

Indeed, any medical practitioner who fails to adhere to an equivalent Code of Practice would be exposed to civil action for malpractice. The British Government's attempts to enforce fluoridation on the public, through the actions of the Medicines Control Agency and those Health Authorities pressing for the imposition of fluoridation, therefore place all parties to this action at risk under current Human Rights legislation.

b) Ethical requirements for State-sponsored medical interventions.

The following statements summarise the ethical provisions of the Biomedicine Convention as it relates to the practice of compulsory fluoridation of public water supplies.

• Fluoridation is a State-imposed medical intervention. The term "intervention" covers all medical acts, including any action performed for the purpose of preventive care. The interests of the individual take precedence over those of the State (Article 2). There is no over-riding Public Health interest that justifies fluoridation - tooth decay is neither contagious nor life- threatening. The existence of laws permitting the State to adopt policies supporting or imposingan intervention does not imply that the practices that it legitimises are themselves ethical, or that they do not infringe the personal rights of the subjects over whom the State has domain. People must be able freely to give or refuse their consent to any intervention involving their person (Article 5). Consent must be based on a full understanding by the subject of the nature and the potential consequences of fluoridation and its alternatives. Freedom to consent to an intervention also demands that such consent may be withdrawn completely at any time. Since fluoride is a cumulative toxicant, once exposed a subject cannot effectively opt out.

Conclusions

Fluoridation is a State-sponsored (and in Ireland, State-mandated) medical intervention without the express and informed consent of each legally competent member of the public. The Code of Ethics defined under the Convention on Biomedicine can be relied upon within Europe in assessing the ethical issues raised by water fluoridation. By such criteria, fluoridation represents extreme violation of medical ethics, particularly as the substances concerned have not been subjected to full appraisal and licensing under the relevant regulations of the European Community.

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3.2 Human rights issues of water fluoridation

As demonstrated above, water fluoridation is a medical intervention by the State, and not a water treatment process. It is effectively unavoidable by the majority of the public. It employs unregistered medicinal substances (but which are, in England at least, registered and controlled poisons) for which there is no mandate in the relevant medical legislation.

Administration of these substances may lead to serious medical and psychological side effects, but no clinical or epidemiological trials have been presented to formally support any application to register them as medicinal substances. The human rights issues raised by State-sponsored water fluoridation are therefore extensive.

a) The Convention on Human Rights.

The Universal Declaration of Human Rights (23) proclaimed by the General Assembly of the United Nations on 10th December 1948 led to the development of the European Convention on Human Rights and Fundamental Freedoms 1950 .(24) It came into force on 3 September 1953, and over the years has been repeatedly modified, up to the latest version, in which Protocol No. 11 (ETS No. 155) came into force on 1 November 1998. (25). The case law of the European Court of Justice governs how the rights guaranteed under the Convention are applied in the EC in accordance with the general principles of Community law. To ensure uniformity of application within theEU, the acquis communautaire is based on a common foundation of rights and obligations binding member states together. Countries wishing to have the same status and the same privileges as existing Member States must accept these rights and obligations in toto.

b) The English Human Rights Act

To a limited extent, the English Human Rights Act 1998 (26) implements the European Convention. Originally, in Britain in the 1960s the decision on whether or not to fluoridate was the responsibility of elected local authorities, and therefore clearly an official political issue. But the subsequent transfer of responsibility to unelected Area Health Authorities represented an attempt to turn it into a purely medical issue, with no overt political status.

The official Guidance Notes (27) recently issued by the British Home Office for the benefit of Government Departments provide an indication of the way that the Civil Service proposes to regard issues arising under the new legislation. Referring particularly to Articles 3 and 8 of the Act, the Guidance Notes state

56. Article 3 prohibits torture and inhuman or degrading treatment or punishment. This provision aims to protect an individual from physical and mental ill-treatment. . . . . It is relevant in a wide number of situations - . . . . failure to provide (or compulsory provision of) medical treatment . . . etc.

57. The State has positive obligations which means that it is obliged to secure the rights guaranteed by Article 3 and to prevent breaches of the Article by one private individual against another, particularly against children and other vulnerable persons. This may require the introduction of legislation. 
59. (Re) Article 3 . . . . in considering whether an act amounts to inhuman or degrading treatment, a range of factors may be relevant. For example, decisions regarding the provision of medical treatment in relation to a mentally handicapped adult may involve questions about what is acceptable in today's society.

61. Article 8 covers a wide range of issues and subjects, including . . . . consent to medical treatment

62. A public authority may not interfere with these rights except: 
• in accordance with the law; 
• and where it is necessary in a democratic society in the interests of . . . . the protection of health

64. . . . the State has positive obligations under Article 8 . . . to protect people against the activities of other private individuals which prevent the effective enjoyment of these rights.

Limitations of the Human Rights Act

Under the Human Rights Act, the validity of any oppressive enabling legislation may be challenged if it appears that the State has given itself the power to carry out a medical intervention which is incompatible with the fundamental rights of the populace, as specified for example under the provisions of the Convention on Biomedicine. So it appears that there should be an effective remedy to the injustice of compulsory fluoridation under the Human Rights Act. Regrettably, in England at least, assuming this to be the case would be a grave error. Section 25 of the Home Office Guidance Notes states,

"Where it is not possible to interpret subordinate legislation compatibly with the Convention rights, the court may quash or disapply the legislation or a provision of the legislation. But where the legislation or provision has to say what it does because of a provision of primary legislation, then . . . . a higher court can make a declaration of incompatibility."

However, it is important to note the use of the words 'may' and 'can' in this extract - no element of compulsion is denoted by this statement, nor supported by subsequent qualifying text in the Act itself. Section 6 of the Act states that an infringement is exempt if primary legislation exists that dictates that a Public Authority could not have acted differently, and the Guidance Notes make no mention that striking out oppressive existing legislation is compulsory - the Government may or may not take remedial action according to its whim. Indeed,

27. . . . . A declaration of incompatibility does not affect the validity, continuing operation or enforcement of the legislation. Nor is it binding on the parties.

With such wording there is ample scope for the State to procrastinate or avoid actually striking out existing legislation, especially s 87 of the Water Industry Act 1991 permitting water fluoridation, even if it is declared incompatible with the provisions of the Human Rights Act.

c) The European Charter of Fundamental Rights

The European Charter of Fundamental Rights (28) is entirely distinct from the European Convention on Human Rights. It is a 
separate set of rights which are to be interpreted by the judges at the European Court in Luxemburg, which will eventually become incorporated into European law, alongside the Convention on Human Rights and the English and Scottish domestic versions of it.In September 2000 the EU Justice and Home Affairs Commissioner said that the European Court of Justice would use the Charter as a reference text in reaching decisions, even if it was purely a declaratory document. With Britain's assent to the Draft, all aspects of criminal and civil law will eventually come under the control and interpretation of the European Court of Justice.

Any Parliamentary Act which is deemed to contravene the new legal framework must (and not simply 'may' as the English version of the Human Rights Act specifies) be struck down by European judges if a British citizen petitions for an end to the violation of his/her new rights under the Charter.

i) Unlawful medical intervention.

Under Article 35 of the Charter, the public can now take the Department of Health or a water undertaker to the European Court to establish their right to receive particular drugs or treatments - or, of course, to prevent them from having such treatment administered to them against their wishes. The right to health care (Article 35) includes the right to refuse health care, for whatever reason. Remedial action will not need first to go through the English courts, as do actions brought under the Human Rights Act.

So if a water company complies with a request or demand by the Government or a Health Authority to implement fluoridation policy, it will be guilty of administering an unlawful medical intervention which is prohibited by medical ethics rules such as those set out in the Convention on Biomedicine. Moreover, since the silicofluorides are unregistered as permissible medicinal substances, their use contravenes the regulations of both the Codified Pharmaceuticals Directive and the Poisons Act. This is an issue of direct personal relevance to all Board Members of a water undertaker, as well as to their 
Shareholders.

All types of fluoride antagonise iodine metabolism, leading to hypothyroidism. This has been attributed as the primary cause of skeletal fluorosis, and the initiation of a range of medical defects associated with that condition. There is increasing sound scientific evidence of the widespread incidence of damaging medical conditions induced by fluoride overload in consumers, particularly dental fluorosis, even at presently permitted levels. Article 38 could be invoked directly by any member of the public in an action against the water undertakers, for deliberately increasing their environmental exposure to fluoride by adding it as an unlawful contaminant of their product.

ii) Product liability

Since water is a consumer product, action could also be taken against water undertakers under Article 38 of the Charter, which requires that 'Union policies shall ensure a high level of consumer protection'. The fact that silicofluorides are not 
licensed as medicinal substances, despite being used as such, means that water undertakers that do fluoridate their product are at considerable risk. They have already indicated an awareness of their vulnerability by stating that they require from Government "full legal indemnity - i.e. absolute indemnity on civil liability and indemnity on strict criminal liability as far as public policy allows" if a Health Authority orders them to implement fluoridation.

Human Rights legislation protects the rights of every individual, and in the case of State medication without consent, this right is absolute unless there is an over-riding public health threat from those not so medicated. Any attempt by Government to circumvent those opposed to the practice of fluoridation by basing future action on the wishes of the majority, as expressed by a public vote, would be unlawful, as it would deprive the minority of their right to refuse medication. In such a case, fluoridating the public water supply must be deemed in violation of the Human Rights legislation. Those wishing to medicate themselves with fluoride are able to do so individually by using one of the many fluoridated dental products freely available from retail outlets. (29)

iii) Environmental protection

Under Article 37 of the Charter the public has a right to a high level of environmental protection. Apart from the deliberate contamination of drinking water, which is itself part of the human environment, more than 99% of all fluoridated water enters the wider environment, via the sewage system, without being drunk. This represents the dumping of large quantities of silicofluorides directly into the surface waters of the country, yet there has been no Environmental Risk Analysis of the issues raised by this. This is a clear failure on the part of the English and other Environment Agencies to ensure that such toxic products are not released into the environment without regulation. It clearly is not in accord with the objective of Article 37 to maintain a high level of environmental protection.

Failing to ensure that the public is not exposed to silicofluorides could also be held to be a violation of the public's right to be protected from general environmental pollution. In a more general perspective, there is a Union-wide requirement to protect vulnerable natural communities and, where possible, improve environmental conditions, under the Habitats Directive (92/43/EEC) .(30) In England, s.4 (i) of the Environment Act 1995 (31)imposes a similar requirement on the Environment Agency. Therefore the Environment Agency, Local Authorities and Councils could all be held accountable under Article 38.

3.2 Conclusions

Fluoridation violates numerous Articles of the European Human Rights legislation. Complainants have the right to appeal directly to the European Court for redress.

Action may be brought against both public medical and private water sector bodies for Human Rights violations. In addition, private sector water suppliers are vulnerable under product liability legislation, and to criminal action under the Poisons Act for administering unlicensed medicinal substances to the public.

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3.3 Recommendation

Regardless of the medicinal status of fluoride, whether it be sodium fluoride, the silicofluorides, or any other fluoride-containing substance, and irrespective of whether or not it provides the benefits claimed by its proponents, the practice of fluoridating the public water supply with the intent to medicate the populace as a whole is inconsistent with the principles of medical ethics and violates the Human Rights of the Citizens of the European Union.

Since alternative methods of adding fluoride to the diet are available to all individuals wishing to add fluoride to their own diet, and are permitted by law, the practice of water fluoridation should be declared unlawful, and prohibited throughout the European Union forthwith.

Douglas Cross, 18th January 2003.


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References (Note: All referenced internet links active as of 19 Janruary 2002)

1. http://europa.eu.int/comm/environment/water/water-drink/index_en.html2. http://www.hmso.gov.uk/si/si2000/20003184.htm
3. http://www.scotland.gov.uk/consultations/environment/wsr2-26.asp - (additional references at this site)
4. http://www.hmso.gov.uk/si/si1989/Uksi_19891147_en_2.htm
5. http://www.dwi.gov.uk/regs/si1837/1837.htm 
6. (http://www.dwi.detr.gov.uk/ccp/pdf/sos2001.pdf )
7. http://www.hmso.gov.uk/acts/acts1991/Ukpga_19910056_en_1.htm
8. No direct source found - now incorporated into the Water Industry Act - see footnote no. 7
9. (HMSO London) for details of BS specifications for heaxafluorosilicic acid and sodium hexafluorosilicate, see Tables 6.1 
and 6.2 in 'Chemistry and bioavailability of fluoride in drinking water.' Jackson PJ, Harvey PW and Young WF (July 2002). 
WRc-NSF Ltd, Henly Rd, Medmenham, Marlow, Bucks SL7 2HD, UK.
10. http://dg3.eudra.org/F2/eudralex/vol-1/pdfs-en/750319en.pdf
11. http://www.dwp.gov.uk/advisers/docs/lawvols/bluevol/a9_6001.pdf
12 . No current source found - this Directive is now replaced by 2001/83/EC.
13. No current source found.
14. For relevant rulings, see Case C-60/89, 21 March 1991, re Monteil and Samanni, European Court Reports 1991;I:1547. Case 
C219-91 28 October 1992 re Ter Voort, European Court Reports 1992;I:5485. Case C368-88 21 March 1991 re Delattre, European 
Court Reports 1991;I:1487. Case C227-82 30 November 1983 re van Bennekom, European Court Reports 1983;3883. 
15. (http://pharmacos.eudra.org/F2/register/alfregister.htm accessed 21 November 2002). 
16. http://193.120.124.98/ZZSI256Y1996.html
17. http://www.europa.eu.int/comm/food/fs/sfp/df_index_en.html
18. http://www.colipa.com/doc/the_cosmetic_directives.pdf
19. For a list of scheduled poisons and rules on sales.
20. http://193.120.124.98/ZZSI256Y199621. http://conventions.coe.int/treaty/en/treaties/html/164.htm
22. http://www.hri.org/docs/ECHR50.html
23. http://www.palestinecenter.org/cpap/documents/universal.html24. See reference no 22
25. http://www.echr.coe.int/Convention/webConvenENG.pdf.
26. http://www.hmso.gov.uk/acts/acts1998/19980042.htm
27. http://www.lcd.gov.uk/hract/guidance.htm28. http://ue.eu.int/df/docs/en/CharteEN.pdf29. See for example http://www.water.org.uk/index.php (Select option 3 - 5 July 2001- Fluoridation of water supplies)
30. http://www.ecnc.nl/doc/europe/legislat/habidire.html
31. http://www.hmso.gov.uk/acts/acts1995/Ukpga_19950025_en_1.htm

 

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