Community Water Fluoridation: Caveats to Implement Justice in Public Oral Health
Abstract
:1. Introduction: Rocket Science or Preponderance of Evidence?
2. Can CWF Be an Issue of Public Health Ethics?
3. Slanted Rungs in the Intervention Ladder
4. Three Caveats for Ethical Considerations on Community Water Fluoridation
4.1. Procedural Justice: The End Does Not Always Justify The Means
4.2. Social Contexts: Comparing Apples and Oranges
4.3. Maintenance of Trust: Good Intentions and Good Works
5. Conclusions: You Can Lead a Horse to Water, but You Cannot Make It Drink
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Acknowledgments
Conflicts of Interest
References
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Justificatory Condition | Meaning | Evaluation of Community Water Fluoridation (CWF) |
---|---|---|
Effectiveness | Interventions should protect public health effectively. | CWF has been confirmed to reduce dental caries effectively by empirical evidence [3,4,5]. |
Proportionality | The probable public health benefits should outweigh the infringed moral considerations. | Social and psychological benefits from the decrease in dental caries outweigh the harm of infringed autonomy [26]. |
Necessity/least infringement | The minimal infringement of moral considerations should have priority among other effective policies. | No other public health intervention can reduce dental caries of the general public as effectively as CWF. Milk fluoridation is also efficient with attached conditions [27] and salt fluoridation may induce hypertension as an adverse effect [25]. Fluoride supplementation holds a higher risk of harmful effects [26] and dental sealants are limited to individual beneficiaries. However, the amount of effects the infringement can affect may differ in accordance with the implementation of CWF. |
Public justification | The infringement should be explained and justified to the relevant parties. | Further consideration is required for CWF. |
Condition | Description | Application to Community Water Fluoridation (CWF) |
---|---|---|
Publicity | Rationales for decisions should be publicised and approachable. | Principles and evidence for CWF to be publicly accessible. |
Relevance | Rationales to provide a reasonable construal of how to meet varied health needs of relevant parties. | Reasonable appraisal of the evidence and practice for CWF. |
Revision | Mechanisms as a dispute resolution procedure for revisiting decisions in light of counter-arguments and further evidence. | Establishment of the procedure to re-evaluate the implementation of CWF. |
Enforcement | Voluntary or public regulation to ensure conditions suggested are satisfied. | Developing a protocol to ensure the fulfillment of three conditions in CWF. |
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Song, Y.; Kim, J. Community Water Fluoridation: Caveats to Implement Justice in Public Oral Health. Int. J. Environ. Res. Public Health 2021, 18, 2372. https://doi.org/10.3390/ijerph18052372
Song Y, Kim J. Community Water Fluoridation: Caveats to Implement Justice in Public Oral Health. International Journal of Environmental Research and Public Health. 2021; 18(5):2372. https://doi.org/10.3390/ijerph18052372
Chicago/Turabian StyleSong, Youngha, and Junhewk Kim. 2021. "Community Water Fluoridation: Caveats to Implement Justice in Public Oral Health" International Journal of Environmental Research and Public Health 18, no. 5: 2372. https://doi.org/10.3390/ijerph18052372