Publication date:
4 December 2024
In February 2024, the High Court directed the Director-General of Health to assess whether each of the 14 directions to fluoridate one or more water supplies made in 2022 were, in terms of section 5 of the New Zealand Bill of Rights Act 1990 (NZBORA), a reasonable limit on the right to refuse medical treatment.
The Director-General considers that each of the 14 directions is a justified limitation, and has reconfirmed each of the directions.
The Director-General considers that:
- due to the high prevalence and the potential for lifelong impacts of poor oral health, the oral health benefits gained from community water fluoridation are sufficiently important to justify the curtailment of the right.
- according to the available scientific evidence, water fluoridation within the optimal range provides protection against dental caries, so there is a rational connection between community water fluoridation and public health goals related to oral health.
- community water fluoridation is an effective public health measure and impairs the right no more than is reasonably necessary, when fluoridation is kept within the optimum range, to achieve oral health benefits for a whole community.
- taking into account the effectiveness of community water fluoridation as a public health measure, and its benefits in particular for the communities that need it most, and that the scientific evidence shows water fluoridation at optimal levels is safe and does not give rise to significant health risks, the limit on the right is in due proportion to the importance of the overall objective.
The documents that supported this analysis and reconsideration are:
- Memo to the Director-General of Health: New Zealand Bill of Rights Act 1990 analysis for 14 fluoridation directions (PDF, 3.73 MB)
- Appendix 1: The Public Health Agency (PHA) analysis of the 14 directions under the NZBORA (PDF, 1.08 MB)
- Appendix 2: The Manatū Hauora Ministry of Health (the Ministry) update on the scientific evidence relating to community water fluoridation
- Appendix 3: New Health New Zealand Inc. (New Health) comments on the scientific evidence and draft NZBORA analysis (PDF, 302 KB)
- Appendix 4: The PHA response to New Health’s comments (PDF, 824 KB)
- Appendix 5: Additional information on recent publications (PDF, 1.09 MB)
Letters to local authorities informing them of this decision are available below.
Key redaction codes:
- S 9(2)(a) to protect the privacy of natural persons.
