1. This
appeal is brought by the plaintiff, Mrs. Gladys Ryan, against an order of Mr.
Justice Kenny, dated the 31st July, 1963, dismissing, with costs, the
plaintiff’s action, in which she sought a declaration that s. 2, sub-ss.
1, 2 and 3 and ss. 3 and 4 of the Health (Fluoridation of Water Supplies) Act,
are repugnant to the Constitution and invalid.
2.
The
Health (Fluoridation of Water Supplies) Act, 1960, was passed by the Oireachtas
on the 28th day of December, 1960. In its long title the Act is expressed to be
“an Act to provide for the making by Health Authorities of arrangements
for the fluoridation of water supplied to the public by sanitary authorities
through pipes and to provide for certain other matters connected with the
matter aforesaid.”
3. Sect.
1 defines the terms “fluoridation,” “health authority,”
“the Minister” and “ sanitary authority.”
“Fluoridation” includes the addition of fluorine in any form.
“ Health authority” has the meaning assigned to it by the Health
Act, 1947, and the Health Authorities Act, 1960. “ The Minister”
means the Minister for Health. “Sanitary authority” has the same
meaning as in the Local Government (Sanitary Services) Acts, 1878 to 1952.
4. The
impugned provisions of s. 2. are textually as follows:-
5. In
the case of the piped water supplies in the Dublin Health Authority area the
analyses were carried out by the public analyst for the city and county of
Dublin. For this area the results of the analyses show that the fluorine
content is less than 0·1 parts per million except in the case of the
Balbriggan-Skerries, Rush, Barnacullia and Kiltiernan-Ballaly supplies, and in
no case is the figure of 0·2 parts per million exceeded.
6. On
the 15th May, 1962, the Minister, in exercise of his powers under ss. 2 and 4
of the Act, made the Fluoridation of Water Supplies (Dublin) Regulations, 1962
(S.I., No. 75 of 1962). These Regulations, at Art. 3, required the Dublin
health authority to arrange, in accordance with the Regulations, for the
fluoridation of the public water supplies specified in the first schedule,
being the piped water supply provided by the Corporation of Dublin and the
already-named four supplies in the Dublin Health Authority area. The amount of
fluorine which may be added to a water supply is provided for in Art. 3 in
these words:- “ The amount of fluorine which may be added to a water
supply in accordance with these Regulations shall be such that the water, after
the addition of the fluorine, shall contain not more than one part of fluorine
per million parts of water, and not less than eight-tenths of a part of
fluorine per million parts of water.”
7. At
Article 6 of the Regulations it is provided that fluorine may be added in
accordance with the Regulations either in the form of sodium fluoride or of
sodium silico fluoride, each complying with the scheduled specifications. These
specifications include a provision that neither substance shall “contain
any toxic or harmful impurities when dissolved in water.” The Regulations
also provide, at Art. 8, that the fluorine content of public water supplies
mentioned in the first schedule to the Regulations to which fluorine has been
added shall be determined daily by a colorimetric method and, in addition,
shall be determined by a distillation method at intervals not exceeding two
weeks during the period of six months after the date on which the fluorine
shall have been first so added, and thereafter .at intervals not exceeding four
weeks. For reasons subsequently stated the word “ fluorine” in the
Regulations must be interpreted as equivalent to “fluoride ion.”
8. It
should also be said that prior to the introduction of the Bill for the making
of arrangements for the fluoridation of, water supplies the Minister for
Health, pursuant to s. 98, sub-s. 3, of the Health Act, 1947, established a
Fluorine Consultative Council to advise on the following matters, viz., “
Whether with a view to reducing the incidence of dental caries it is desirable
to provide for an increased intake of fluorine, and, if the Council considers
it so desirable, to advise as to the best method of securing such an increased
intake and as to any safeguards and precautions necessary.” The report of
the Fluorine Consultative Council, dated the 20th May, 1958, refers to a dental
caries survey of about 2,000 school children carried out in Ireland in 1952
under the auspices of the Medical Research Council
(Dental
Caries in Ireland. Report of M.R.C.
1952)
and says :-“The Council is satisfied from a study of the Report on the
Dental Caries Survey and from the experience of the dental profession, as
expressed by its representatives on the Council, that there is a high incidence
of dental caries widespread in Ireland” (paragraph 2). In the Report of
the Consultative Council the term “fluoride” is used, and the
Report points out that the terms “fluoride” and
“fluorine” are interchangeable when discussing the natural
occurrence of fluorine. The Report states that the concentration of fluorides
in water is influenced by the geological strata through which the water
percolates, and it calls attention to an investigation carried out by Drum in
1948 under the auspices of the Medical Research Council into the composition of
Irish drinking waters with special reference to the distribution and
significance of fluoride
(Drum
J. A.: Scientific proceedings of the Royal Dublin Society, Vol.
25
(N.S.),
July,
1949).
Drum’s studies of some 42 waters showed that only 10 contained fluoride,
and concentrations in these ranged from 0·1 to 0·3 p.p.m.F. (parts
per million expressed as fluorine).
9. The
Report of the Consultative Council further points out that fluoride is found
naturally as a trace element in the majority of foods, e.g., in vegetables,
meat, cereals, fruit, fish, tea. Surveys carried out by McClure
(McClure,
F. J.: American Journal of Diseases of Children, Vol.
66,
362 (1939) and
Public
Health Report, Vol.
64,
1061 (1949)) refer to over 130 foods which contain fluorides. It is not
possible, the Report says, to exclude fluoride from human diets, and it adds:-
“ it is a normal constituent of bones and teeth” (paragraph 11).
The Consultative Council, having examined the possible ill effects of increased
fluoride intake, concludes its Report with the following unanimous
recommendation:- “Having considered all the information available
to
it on the relationship between fluorine and dental decay the Council is
satisfied that an increased intake of fluorine will reduce the incidence of
dental caries and that it is desirable to provide for such an increased intake.
The Council is further satisfied that the increased intake of fluorine can best
be provided by the fluoridation of public water supplies to the level of
1·0 part per million F.”
10. The
plaintiff’s originating plenary summons, naming the Attorney General as
defendant, was issued on the 1st June, 1962, and the action was at hearing
before Mr. Justice Kenny for 65 days in the months March to July, 1963. The
plaintiff resides at Grace Park Road, Drumcondra, in the City of Dublin with
her husband and their five
children,
born in the years 1950, 1952, 1956, 1959 and 1960, respectively. Her house is
connected with the public piped water supply of the Dublin Corporation, and
there is no alternative water supply for drinking and cooking. The nearest
unpiped water supply is about three miles distant at Ballymun in the County of
Dublin.
11. The
plaintiff in her evidence said that she was aware that fluorine in public water
supplies was intended to protect against dental caries [in children]. With
regard to protecting her children against dental caries she said she believed
sound nutrition was very important, and that she and her husband attended to
their children’s diet, which consisted of one hundred per cent wholemeal
bread, cheese, honey, walnuts, and an abundance of fruit and vegetables. In
addition, they did not encourage their children to eat sweets, lollipops or ice
cream, and they never had soft drinks except on Christmas Day. The plaintiff
further said that she objected to the putting of fluorine into the public water
supplies because she considered it an infringement of her parental rights, and
that it was her function to see to the children’s upbringing and to
decide what they should have to eat and drink and all other aspects of their
upbringing. Her objection as an individual was that it was an infringement of
her own personal integrity. She added that if she considered that she needed
medicine she went to the doctor and asked him and he would consider her case as
an individual and give her the dosage he would feel right. In cross-examination
she said that the putting of fluorine in the public water supply was medication
in the case of children, and while it was not intended to do anything for
adults she objected to it because she felt it might harm herself. She said her
objection was very strong, and she had very definite views about the upbringing
of children. Asked about the condition of her children’s teeth, it
appeared that her first child had 6 damaged teeth and 3 filled; the second
child, 4 decayed teeth; the third child, five first teeth decayed or showing
some signs of caries. She, however, explained that these children did not at
first have the benefit of the diet they now have. The teeth of the two youngest
children (aged 3 and 4 respectively),
who
had this diet from the beginning, were absolutely perfect.
12. In
addition to the plaintiff’s testimony there
was
a mass of scientific and medical evidence from an array of experts, summoned
both by the plaintiff and by the defendant, and the scientific literature
dealing with the subject of fluoridation over the last 30 years was referred to
and analysed by the witnesses.
13. The
plaintiff’s claim, put in general terms, rested on a submission that the
fluoridation of public water supplies in accordance with the Act constituted a
violation of her personal rights and the personal rights of her children, under
Article 40. 3, of the Constitution; a violation of the authority of the family,
under Article 41; and a violation of the family’s right of physical
education of children, under Article 42. Mr. Justice Kenny rejected all three
submissions and, in addition, held that the plaintiff’s action also
failed on two other grounds, (i) that she had no contractual right to a public
water supply, and (ii) that, in any event, a citizen who objected to
fluoridated water could, by the expenditure of a few pounds, remove all, or
almost all, the fluoride ions from the water coming through the piped water
supply.
14. The
Attorney General has said in this Court that he did not rely upon the
submission that the plaintiff had no contractual right to a public water supply
and that, though pleaded, he had not relied upon it in the High Court. He did,
however, support the correctness of the trial Judge’s view. Mr. Justice
Kenny in his judgment acknowledged that this approach might be too legalistic
and too narrow. It was accepted by the Attorney General that water is one of
the essentials of life, and that man therefore has an inherent right to it. In
the opinion of this Court it is wholly unrealistic to say to a resident in a
city the size of Dublin, who objects to using the public piped water supply,
that he can avail of alternative supplies. The answer to the question, whether
or not a citizen’s constitutional rights have been infringed by the kind
of water provided by the public water supply, should not be controlled by
technical limitations arising from the law of contract. As to the second
ground, that the plaintiff’s action failed because she could by a simple
and inexpensive device fitted to the family tap remove from the water the
fluoride ions whose presence are objected to, it is enough to say this ground
was not relied upon by the Attorney General in his defence, and this Court
would require a fuller examination than has been given to the matter in the
evidence of Dr. Fremlin before accepting it as affording, by itself, a
satisfactory answer to the plaintiff’s claim. The Court therefore
considers it its duty, as did Mr. Justice Kenny, to examine the
plaintiff’s challenge to the validity of the Act in the light of the
several articles of the Constitution which have been invoked.
15. Before
turning to this branch of the case it is, however, necessary to prefix certain
general observations with regard to the nature of this present action. The
constitutionality of a statute is, in many instances, determinable by a
consideration and interpretation of the terms of the statute itself without
reference to evidence as to their meaning or effect. Any matters necessary to
elucidate its scope in such cases are matters of which the Court can take
judicial notice. In the case of this Act, however, the Court is considering a
statute which uses scientific terminology, deals with a scientific procedure
and requires scientific knowledge to comprehend the effect of its provisions.
These are not matters which are presumed to be within the knowledge of the
Court, and, accordingly, the unconstitutionality of the Act, if it be
unconstitutional, cannot be determined except by reference to the particular
evidence which is furnished in the case. Since evidence may differ from case to
case and as scientific
knowledge
may
increase and the views of scientists alter, the Court’s determination
cannot amount to more than a decision that on the evidence produced the
plaintiff has, or has not, discharged the onus of demonstrating that the Act is
unconstitutional. It is of importance that attention should be called at the
outset to this aspect of the present case.
16. The
scientific evidence indicates that fluorine is the name of one of the chemical
elements which, in combination with other elements, is widely distributed
throughout the crust of the earth. In its pure form, uncombined with other
elements, it is a gas consisting of molecules each of which is formed by two
atoms with a neutral electrical charge. This gas does not occur naturally,
except perhaps in small quantities in vent holes of volcanoes, but it can be
produced in the laboratory by a somewhat complicated technique.
17. The
neutral atom of fluorine, is, however, subject to ionisation, that is to say,
to the addition of an extra electron to its shell, giving it a negative
electrical charge. In this form it is known as an ion, and can and does exist
as a free entity. Fluorine ions (more usually called fluoride ions), in varying
concentrations, are naturally present in many, perhaps in most, natural waters.
Where they are not present they can be supplied by the addition to the water of
any one of a number of chemical salts of fluorine which, when they are
dissolved in a weak concentration, liberate free fluoride ions into the water.
The process of adding such ions is known as fluoridation.
18. The
free fluoride ion, whether contained in water or in other substances such as
tea leaves, fish or vegetables, is readily ingested by the human body. When it
finds its way to the teeth of children, as it does, it enters into a
combination with the nascent enamel and has the effect of delaying and, to a
certain degree, of avoiding the onset of dental caries, one of the most
prevalent of human ills. The
object
of fluoridation of water which is deficient in fluoride ions is to add enough
of those ions to ensure that children who drink the water will ingest
sufficient ions to afford a measure of protection of their teeth.
19. It
is also necessary to note a change in terminology which might create confusion
in the interpretation of the statute and the evidence. In
the
earlier
literature (and even at the present time in books on inorganic chemistry) it is
customary to use the expression “fluorine” ion, but modern
biochemistry prefers the term “fluoride” ion, and often shortens
this to “fluoride” without adding the word, “ion.” The
meaning is identical - the fluorine atom in its ionised form. The Report on the
United Kingdom Mission on the Fluoridation
of
Domestic Water Supplies in North America, para. 37, states that the term
“fluoridation” has been adopted expressly instead of
“fluorinization” to make clear that the fluorine is added in the
form of the fluoride ion. The Court has adopted in this judgment the term
“fluoride” ion which is now the
more
usual terminology and which was adopted by Mr. Justice Kenny instead of the
older terminology of “fluorine” ion. Nowhere in the evidence was it
suggested that fluorine could be added to water supplies in the form of
fluorine gas or in the form
of
the
un-ionised
fluorine
atom.
20. It
will be convenient to deal separately with the three articles of the
Constitution
upon which the plaintiff rested her submission that the Act is repugnant to the
Constitution.
22. Of
the further sections of this Article, section 4 protects personal liberty,
section 5 the inviolability of the dwelling-house, section 6 freedom of
expression, the right of peaceable assembly and the right to form associations
or unions. These latter rights are expressly qualified in various ways. The
Court agrees with Mr. Justice Kenny
that
the “personal rights” mentioned in section 3, 1° are not
exhausted by the enumeration of
“
life,
person, good name, and property rights” in section 3, 2° as is,
shown by the use of the words. “in particular”; nor by the more
detached treatment of specific rights in the subsequent sections of the
Article. To attempt to make a list of all the rights which may properly fall
within the category of “personal rights” would be difficult and,
fortunately, is unnecessary in this present case.
23. It
was Mr. MacBride’s contention that among the personal rights of the
individual is to be included a right to what he called “bodily
integrity,” and this the Attorney General intimated he was prepared to
concede in the words, “a right to the integrity of the person.”
Neither counsel offered the Court any assistance as to what the limits of this
right to bodily integrity were. Mr. Justice Kenny held that a right to bodily
integrity was, among the personal rights guaranteed by the Constitution, and he
sought to define the right in these words:- “ I understand the right to
bodily integrity to mean that no mutilation of the body or any of its members
may be carried out on any citizen under authority of the law except for the
good of the whole body and that no process which is or may, as a matter of
probability, be dangerous or harmful to the life or health of the citizens or
any of them may be imposed (in the sense of being made compulsory) by an Act of
the Oireachtas.” Mr. MacBride, however, says that the Judge’s
definition is too narrow and he contends that any interference with bodily
constitution is a violation of the right. However, for the reasons which
hereinafter appear it is unnecessary to define “bodily integrity”
or the “right to the integrity of the person” or to consider to
what degree and in what circumstances the State might interfere with the right,
whether for the benefit, of the individual concerned, the common good, or by
way of punishment. The Court is not, pronouncing upon Mr. Justice Kenny’s
definition.
26. Having
read the oral evidence and the documents submitted, this Court is satisfied
that these findings are correct and cannot be challenged.
27. The
basis for the plaintiff’s complaint that bodily integrity has been
violated rests on the probability of mild or very mild mottling in the teeth of
up to 10 per cent of the children who drink the fluoridated water and on the
small deposition of fluoride ions in the skeletal frames of both children and
adults. Neither of these effects is harmful or involves any risk to health. The
effect on the teeth is demonstrably beneficial. The purpose and effect of
fluoridation is to improve children’s teeth and so, indirectly, their
health. These benefits to a great extent are carried forward into adult life.
Adults by ingesting fluoridated water obtain little or no advantage, but
neither do they suffer any disadvantages.
28. Are
these minute changes, almost imperceptible, usually beneficial, and at worst
harmless, a violation of “bodily integrity”?
29. The
Court’s answer is emphatically, “no.” Fluoride ions occur
naturally in water and in many foods. They have a beneficial effect in
assisting in the formation of sound teeth in children. The Act has for its
object where water is deficient in fluoride ions to bring it to the optimum
level by fluoridation. Fluoride ions thus added, the evidence establishes,
differ in no respect from fluoride ions naturally occurring in water. In modern
life the provision of public water supplies in cities is necessarily a
community obligation, and if water occurring naturally is deficient in some of
its wholesome elements it is the right, if not the obligation, of the community
to make good the deficiency where this can be done without harm or danger to
the public. The desirability of adding to food or water elements in which they
are deficient or removing elements which may be harmful has been widely
recognised and frequently exercised. Water is chlorinated, salt iodised,
vitamins added to margarine, flour fortified whenever these measures are shown
to be beneficial.
30. It
is beyond question that dental caries in children has become a national problem
in this State. The fact that as a disease it is not infectious or contagious
or, apparently, otherwise communicable to other persons is immaterial. It can
result not merely in damage to the teeth themselves but, through the existence
of decayed or decaying teeth, may be injurious to general health. The State is
organised for the common welfare of all its citizens and is a society arising
from man’s nature. Apart from particular expressed limitations contained
in the Constitution, the Oireachtas may not enact legislation depriving
citizens of their essential rights as human persons or as members of the
family. The State has the duty of protecting the citizens from dangers to
health in a manner not incompatible or inconsistent with the rights of those
citizens as human persons.
31. Dental
caries is no new thing. It has adversely affected generation after generation
and will continue to do so if measures are not taken. This constitutes the type
of danger from which the State has not merely the right but the duty to protect
its citizens. To deal with the problem the Oireachtas has chosen a method,
namely, the fluoridation of the public water supply. The plaintiff has failed
to refute the evidence that this is not only the most effective method but is
indeed the only effective method. The method undoubtedly does result in a
minimal interference with the constitution of the body, but such interference
is not one which in any way impairs the functions of the body or, to any extent
discernible by the ordinary person, its appearance.
32. The
Court is left in no doubt that the fluoridation of water to the extent proposed
in the Dublin Health Authority area where the plaintiff resides cannot be said
to involve physical changes which affect in any way either the wholeness or the
soundness of the body of the person concerned. The ingestion of the fluoridated
water cannot, therefore, be said to constitute an infringement of or a failure
to respect (gan cur isteach ar) the bodily integrity of the plaintiff or the
bodily integrity of her children.
33. The
Court does not accept that the fluoridation of water is, or can be described
as, the mass medication or mass administration of “drugs” through
water. It has already been pointed out that the fluoridation is a process by
which an element which naturally occurs in water is, in the case of a
particular water supply, raised to a level of concentration at which it is
found in wholesome water and that the fluoride ions thus added are not,
different in nature, or action from the fluoride ions occurring naturally in
water. This matter was examined in detail by the, Commission set, up by the
Government of New Zealand to enquire into “the Desirability or otherwise
of the Fluoridation of Public Water Supplies” and the conclusion was
reached that “fluoride is not a drug but a nutrient and fluoridation is a
process of food fortification.” It is, in the opinion of the Court, a
misuse of words to refer to this process as mass medication or mass
administration of drugs.
34. Next,
the plaintiff submits that the provisions of the Act are a usurpation of
parental authority as guaranteed under Article 41, 1:-
35. The
plaintiff’s submission was put under two heads: (a) that the State has no
right at all to interfere in the exercise of the parental authority, and (b) in
the alternative, that the Act amounts to an undue interference with parental
authority. The aspect of that authority which is in question is the authority
of the family or the parents to provide for the health of its members in the
way it thinks best. It is sought to establish, as a corollary, that parents are
entitled to omit to provide for the health of their children if they so think
fit. One of the duties of parents is certainly to ward off dangers to the
health of their children, and in the Court’s view there is nothing in the
Constitution which recognises the right of a parent to refuse to allow the
provision of measures designed to secure the health of his child when the
method of avoiding injury is one which is not fraught with danger to the child
and is within the procurement of the parent. The nature of the health problem
here involved and the effectiveness of the means available for, dealing with it
have already been referred to. There is nothing in the Act which can be said to
be a violation of the guarantee on the part of the State to protect the family
in its constitution and authority.
36. Thirdly,
the plaintiff invoked the provisions of Article 42 of the Constitution,
claiming that the legislation under review constitutes a violation of the
inalienable right of the parents to provide for the physical education of their
children. The relevant provisions of Article 42 are as follows:-
37. Mr.
MacBride contends that the provision of suitable food and drink for children is
physical education. In the Court’s view this is nurture, not education.
Education essentially is the teaching and training of a child to make the best
possible use of his inherent and potential capacities, physical, mental and
moral. To teach a child to minimise the dangers of dental caries by adequate
brushing of his teeth is physical education for it induces him to use his own
resources. To give him water of a nature calculated to minimise the danger of
dental caries is in no way to educate him, physically or otherwise, for it does
not develop his resources.
39. It
remains to consider what Mr. MacBride described as his two “technical
points” on the Act. Mr. MacBride’s first point was based upon the
terms of the definition of “fluoridation” in s. ‘1 ‘of
the Act, viz., “fluoridation includes the addition of fluorine in any
form.” Mr. MacBride says, correctly, that the element fluorine can be
found in organic compounds (that is to say, compounds in which carbon is
present), both in compounds naturally occurring in the dichapetalum family of
plants found in certain parts of Africa and in compounds which can be produced
in laboratory synthesis. He says also, and again correctly, that such organic
compounds are highly toxic. From this he argues that the Act authorises the
addition of highly poisonous organic compounds to water. Such evidence as is
contained in the documents incorporated in the case indicates that such organic
compounds are not and cannot be sources of the fluoride ion, and that their
poisonous, properties are due not to the action of the fluoride ion but to the
action of the compound molecules of which they are formed. It is not anywhere
suggested that their addition to water liberates fluoride ions, or could have
the slightest effect on dental caries, or that anyone has ever contemplated
using them as an addition to water. On the other hand, there is accepted and
undisputed evidence that a large number of inorganic salts of fluorine (calcium
fluoride, sodium fluoride, sodium silico fluoride, apatites, fluorapatite,
etc.) when dissolved in water do release the fluoride ions and that the process
of fluoridation consists in adding such compounds in appropriate quantities.
The Act deals with a technical and scientific subject, and must be construed in
the light of the scientific and technical knowledge which has been put before
the Court. Its admitted object is to decrease the incidence of dental caries by
the addition to water of fluorine in the form of the fluoride ion, the correct
meaning of fluoridation. Despite the wide and somewhat loose wording of the
definition it cannot be doubted that the word “fluoridation” is to
be given its technical and scientific meaning, except in so far as this is
clearly and expressly modified or extended by the wording of the definition,
and that the extension by the words “fluorine in any form” must be
read as “the fluoride ion as contained in or produced by any form of
chemical substance.” The reference is clearly intended to apply only to
those numerous forms of inorganic compounds which when added to water make
available the free fluoride ion or fluorine ion (if that terminology be adopted).
40. Mr.
MacBride’s second point was taken on the terms of s. 2, sub-s. 3 (a), of
the Act. The regulations made by the Minister, the section says, “shall
in particular provide for the specification of the amount of fluorine (which
shall not exceed one part by weight of fluorine per million parts of water)
which may be added to a water supply.” This means, Mr. MacBride
submitted, that the Minister may authorise the addition to any existing water
supply of 1 p.p.m.F. no matter what its natural fluoride content may already be.
41. The
Court entertains no doubt that the section plainly bears the meaning which Mr.
MacBride puts upon it and can bear no other meaning. Mr. MacBride referred to
the provision as “an error in drafting.” The Consultative Council
set up by the Minister to advise on the expediency of the fluoridation of water
recommended “the fluoridation of public water supplies to the level of
1·0 parts per million,” that is to say, fluoridation which would
bring the fluoride content up to 1·0 part per million; and, indeed, the
great weight of medical and scientific opinion fixes the optimum fluoride
content of water for countries, like Ireland, in the temperate zone at 1 p.p.m.
The Minister has already caused to be made analyses of the water supplies of
ten counties. These analyses show that in nearly all the supplies the fluoride
ion is either entirely absent or is present in such minute quantities as do not
call for consideration. At Gyles Quay in Co. Louth, however, there is a
concentration of ·55 parts per million; and at Patrickswell, a village in
Co. Limerick, a concentration of 1·0 per million. Mr. MacBride says that,
for all we know, greater concentrations may be found in waters still
unanalysed. This point on the construction of the statute was one which Mr.
MacBride made in his opening address in the High Court and again in his closing
submissions. But in the case presented on the plaintiff’s behalf over a
period of several weeks by a large number of expert witnesses evidence was not
expressly directed to the effects of consuming water of a concentration of 2
p,p.m.F. or to the more theoretical problems arising from the addition of 1
p.p.m.F. to waters (if such should be discovered in Ireland) of greater natural
fluoride concentration than 1 p.p.m. There are incidental references to the
matter, as for example (i) that at this concentration a very small proportion
of children ingesting the water might develop a faint brown marking which would
be discernible by an ordinary person and might be sufficient to impair the
appearance of a young girl; (ii) Dr. Ericsson’s statement that he found
no objectionable mottling at 2 p.p.m.F. ; and (iii) Dr. Arnold’s opinion
that even from the aesthetic point of view he would be willing to bring up his
children on water fluoridated to the extent of 2·5 p.p.m. There is no
evidence that a concentration of 2 p.p.m.F. in
water
is injurious to health.
42. This
Court, however, cannot now consider a case which the plaintiff did not make in
evidence, and did not make for the reason (one supposes) that her concern was
with the proposed fluoridation of the Dublin Corporation water supply to an
extent which, at its maximum, would bring its fluoride content to 1 p.p.m. The
trial Judge in a very full survey of the evidence made no finding upon the
point. He was not asked to make a finding. Indeed, it may be said that the
matter was passed over in such a way at the trial that he could not have been
asked to make a finding and, in truth, he was not furnished by the
plaintiff’s witnesses with the material for making a finding. This Court
must therefore decline to offer any opinion upon this last matter. The
plaintiff has failed to lay the ground in evidence for an examination of the
problem. If the question ever assumes practical importance it will be open to
investigation in future proceedings.
43. The
Court has no concern with the legislative policy of the Oireachtas. Its
function is only to examine the statute in which that policy is embodied and to
see if its provisions contravene the provisions of the Constitution. There is a
presumption that a statute is constitutional and the onus of showing that it is
unconstitutional rests on the plaintiff who attacks it. Where on the face of
the statute nothing unconstitutional appears and the attack is based on its
alleged effect, and the conclusion as to the effect has to be based on evidence
of a disputed character, a plaintiff must fully satisfy the Court that its
effect is such as he contends. In the view of the Court the evidence given in
this case shows that a concentration of one part per million is not
deleterious, and is insufficient to show that a concentration of two parts per
million is deleterious.