NZ Green Party
Mass medication: the debate rages on and on

I see in today’s Sunday Star Times that the Government is rethinking its plans to force bread makers to put folic acid into all of our bread supplies. This comes after a Chilean report that shows increased incidence of cancer since they started requiring that wheat flour be fortified with folic acid some years ago.

Good on the Government for pausing to consider. The fact that 13.8% of boys and 8.2% of girls ages between five and eight in NZ would end up exceeding the upper level of intake if we go this way may be putting more kiwis at risk than those such a programme would protect. (I don’t know this for fact.)

The real irony here for me is that most of our “mass medication” regimes do not consit of medicines at all – but rather dietary supplements, which allopathy often scoffs at!

This debate applies to things like fluoridation and to a lessor extent to mass vaccination programmes, and I think will continue to divide communities for generations to come. Vaccinations can be opted out of easily, but fluoridation in water, folic acid in bread, vitamin D in Milk (USA),and  iodine in salt (many countries); all these things are much harder to opt out of without going to great expense.

What do you think? It is always a question of balancing probabilities based on the latest science, which itself could change, against personal choice, against issues of the common good. And all this has to be thought out over the long term. A bit like global warming, really.

37 thoughts on “Mass medication: the debate rages on and on

  1. This is your old mates Labour idea. Despicable.

    Glad we agree it needs be booted, Frog, although I find it odd you’re now coming over all pro-choice when it comes to letting people choose their own food.

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  2. Good. I agree with you.

    Looking forward to your consistency in advocating pro-choice when it comes to food….

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  3. BluePeter said: I find it odd you’re now coming over all pro-choice when it comes to letting people choose their own food.

    The Greens have never been anti-choice re food. Where the Greens propose restrictions is in what food can be sold in schools and what food can be advertised during children’s television viewing hours.

    That’s not stopping families having KFC and Coke every night if that is what they choose, although we obviously wouldn’t recommend it.

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  4. It amazes me that the Right seems only to be coming aware of this issue now! Shows just how effective those blinkers are.

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  5. >>the Right seems only to be coming aware of this issue now!

    It appears Labour tried to sneak it through in the dying days of the LabGreen regime. A last act from the bunker, if you will.

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  6. BP, as the date on Sue Kedgley’s media release I linked to reveals, the Greens had been opposing this, and trying to encourage public opposition, since 2006. The Nats were remarkably quiet, until now.

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  7. The Greens have never been anti-choice re food. Where the Greens propose restrictions is in what food can be sold in schools

    lol, and yet a restriction denies choice in the context to which that restriction applies :P .

    Allopathy! Now someones showing their colours. Using a term coined by the homeopathic quacks! “Allopathy” has long recognised the importance of a correct diet and the vitality of obtaining the correct nutrients. Dietry suppliments in this context, and esspecially in the context of iodised salt, is doing exactly what “allopathy” subscribes; bringing the nutrient intake to the required level.
    If some age groups would exceed their upper limit then decrease the amount in their or change what products it is targeted through. Fortify coffee prehaps :P .

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  8. Coffee’s already fortified with everything I need :-)
    I struggle to see how the choices children make over foods they purchase themselves can be fair, when they are subject to powerful advertising influences. Choice? I don’t think so.

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  9. Greenfly,
    That is the same arguement used by feminists against female circumcision in africa: they claim, “it is irrelivant that they want to do this to themselves, it is irrelivant that the girls gain status from this procedure, it is irrelivant that in this procedure they are the ones whom control the men, etc, etc. it is irrelivant because they are brainwashed by their culture.” and yet they fail to recognise that it applies equally well to themselves.
    The children have a choice between things they see advertised and things they dont see advertised. they will buy depending on their preference. How that preference is shapped is irrelivant. That said, i do actually agree with eliminating the advertising in childrens watching hours.

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  10. sapient – granted, but..
    as you yourself attest, it somehow ain’t fair, the ‘balance’ between ‘things they see advertised and things they dont see advertised’. Eliminating advertising during children’s watching hours, as you favour, points to your support for the idea that there is a difference between ‘choice’ and ‘fair choice’. Finding that balance is the tricky bit. Equal budgets and air-time for McDonalds and their opponents perhaps?

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  11. What do you think? It is always a question of balancing probabilities based on the latest science

    Good to hear. I hope that the Greens take this sanely and rationally, and balance the evidence for and against. At the moment there isn’t a scientific consensus on the issue, which would lend against taking a strong position either way.

    Perhaps the Government should be fortifying something women 17- 40 consume more than the rest of the population? Low fat milk, perhaps?

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  12. sailing close to the wind in your final paragraph george!

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  13. Greenfly,
    Nowhere do I mention it being not fair. It may indeed not be, but fairness is a very subjective concept which i dont give a toss about.
    I support removing the advertising during childrens tv hours because it influences the children and, by extension, the parents to buy food packed full of sugar and empty calories which ultimatly leads to the degridation of public health and increases the strain on the public health system in addition to decreasing economic and social productivity. Such advertising costs society more than it benefits; significnatly so. Humans do not have free will, we are mearly machines which react to our environment, its all inputs and outputs. Insofar as we can be said to have choice, choice influenced by advertising is no different than choice influenced by other environmental and social factors.

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  14. sapient – you say that the way a child’s preference is shaped is irrelevent.
    I believe it is important and should be considered when deciding, for example, what to stock a school canteen with, before letting them free to ‘choose’ their lunchtime snacks.
    I’m surprised to read that you ‘don’t give a toss about fairness’ – why not? Would you sit idly by while something unfair happens to a dependent of yours?
    You say also that ‘choice influenced by advertising is no different than choice influenced by environmental and social factors’ which makes me wonder why the advertising industry would bother to do what they do.
    The influence, say, of an environmental factor, such as colour is substantialy different in the case of a contrived, targeted one, such as the sugar-based food industries use of a breakfast cereal with bright rainbow colours etc to excite children .. over the natural situation, where sugar is brown.

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  15. “over the natural situation, where sugar is brown.”

    Damn white sugar, keeping the brown sugar down :)

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  16. # greenfly Says:
    May 17th, 2009 at 1:31 pm

    > Eliminating advertising during children’s watching hours, as you favour, points to your support for the idea that there is a difference between ‘choice’ and ‘fair choice’. Finding that balance is the tricky bit. Equal budgets and air-time for McDonalds and their opponents perhaps?

    perfect balance is impossible. But reducing the amount of advertising (such as by taxing it) should get us closer to the balance, simply because there will be less advertising in comparison to the amount of information and ideas form other sources.

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  17. “over the natural situation, where sugar is brown.”

    that’s something I’ve been wondering about. what do they actually do to brown sugar to make it white?

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  18. Greenfly,
    Am listening to JH’s NZRADIO post atm, so my attentions abit split, but:
    Fairness is a subjective concept, what is fair is detirmined by an individuals values. On one hand it may not be fair (under one persons conceptions) for a poor person to have a flat tax, but on the other hand the poor people also use the vast majrity of social services and are being vastly subsidise by the rich whom not only pay much much more under a flat tax but even more than that under the present progressive system, that can be said to be fair or not fair depending on your views. I dont care about such a subjective and circumstancial concepts such as fairness; I care about what is beneficial for the functioning of society.
    All actons performed by humans are perfomed as a consequence of a perceived stimulas. Opinions and desires are shapped by what one encounters. Companies spend money on advertising because advertising influences opinions and because of that it influences the choices that people make and encourages them to use their product. I am not saying that advertising has no influence on the choice made but that all choices are informed by experiance, be it advertising or a health nurse, it is experiance that informs choice. The choice may be for a different product but the qualities of the choice process are no different; it is still just as ‘free’ as if there was no advertising.

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  19. sapient – ‘choice’ for children, the same as for adults?
    (whistles nonchalantly)

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  20. Both follow a process of reasoning as to if the benefits outweigh the costs, both reason in the same manner. The only difference is that older individuals may think more logically in that reasoning and the reasoning may have a better foundation due to increased knowledge. But then again, most adults dont really exceed an average 14 year olds ability to reason; scary, huh?

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  21. If those younger individuals think less logically and have a poorer foundation due to less knowledge, do the older have a responsibility to guide the younger in their choices?

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  22. Greenfly,
    One cannot derive an ought from a is without another ought.
    But, accepting that the more rational may have a duty to the less rational to guide them, I fail to see your point as I explicitly stated that I do support limiting advertising and limiting certain foods in school tuck shops; my origional post was mearly pointing out the contradiction within toads post.

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  23. georgedarroch said: I hope that the Greens take this sanely and rationally, and balance the evidence for and against. At the moment there isn’t a scientific consensus on the issue, which would lend against taking a strong position either way.

    But George, there is an underlying principle here, which is, regardless of the medical evidence, is it acceptable to mass-medicate people agaisnt their will (or cause them considerableinconvenience to avoid the mass-medication)?

    I agree that policy should be evidence-based. But it also needs to be principle-based. For that reason, despite my acceptance that the balance of scientific evidence likely favours water fluoridation, I oppose it.

    There are other ways to achieve the objective, like the use of public education campaigns re diet and dietary supplements.

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  24. So is this stuff going to be put in all flour, or just in pre packaged bread?
    Can we still make our own bread without this crap in the flour?

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  25. # Shunda barunda Says:
    May 17th, 2009 at 7:08 pm

    > So is this stuff going to be put in all flour, or just in pre packaged bread?
    > Can we still make our own bread without this crap in the flour?

    My understanding is that you can use ordinary flour if you are not a commercial bakery, but that bakeries will have to use this flour unless all their other ingredients are certified organic. That sounds really weird now that I word it like that.

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  26. shunda – when you’ve come to terms with the folic acid that might be in your bread, have a think about the pesticides, fungicides and rodentacides that are nestled in there.
    When it comes to making choices about your daily bread, all I can say is:
    use your loaf :-)

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  27. fly, Raid-cloud four points off the starboard quarter…..say, these Kiwi’s should have been kids in the sixties (not). They drilled all our teeth out and filled them with Mercury – that’s right!
    ….a long and austere programme of absolute dumbflummery…

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  28. http://en.wikipedia.org/wiki/Folate

    New Zealand is actually mentioned in this wiki article. Apparently there will be a requirement for a certain level of folate in bread, but it doesn’t specify how this level must be achieved. I take this to mean that natural methods to increase the folate levels in bread may be used – it doesn’t have to be through the use of fortified flour.

    I suspect that the reports of increased levels of cancer reported by Chile might be associated with the means by which they are fortifying their wheat flour.

    This is a complex subject, but one thing I don’t like is the term “mass-medication”. These supplements are not medicines.

    Trevor.

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  29. First do no harm.
    If in doubt do nothing.
    It is not so much what you stick in the food.
    It is all the other junk it comes to mix with along the way.

    We are injesting dangerous cocktails of chemicals.

    All in the name of progress.

    In the mean time the cancer figures go through the roof.

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  30. And the rate of Neural Tube Defects drops in countries with folate fortification.

    Sometimes it is a balance between taking action which will reduce some harm and might increase others, or taking no action knowing that this will harm some.

    Trevor.

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  31. Sapient

    “Both follow a process of reasoning as to if the benefits outweigh the costs, both reason in the same manner. The only difference is that older individuals may think more logically in that reasoning and the reasoning may have a better foundation due to increased knowledge.”

    Sorry but there is scant psychological evidence for either global rationality in human decision making or for the fact that reasoning is the same in adults and children. The idea that human behaviour is governed by a rational (somehow defined) balancing of benefits and costs is either a tautology or experimentally falsified some time ago.

    If what you are saying is that children make choices and so do adults – that’s self-evidently true. But beyond that, the rational human is an experimental dud. Embarassing but seems to be the case. That is not say that we are not capable of logic, simply that most decisions are governed by rules of thumb. Calling that rational because of limited time is moving rapidly down the tautology route in my humble opinion.

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  32. jgg,
    Well, actually, I was saying that neither of them make choices; causality renders true choice and free-will impossible :P .
    No, neither children nor adults are logical in their decision making, this is the reason much economics fails. But to not be logical is not to not be rational. Humans do make rational decisions; even a someone with downs-syndrome will not perform an action they want to perform if the know that will result, with short delay, in a reaction which is more undesirable than the desirable consequences of the action. Their understanding of the relationships and judgements based on this are not bound by logic, but they still weigh up the perceived costs and benefits.
    You say most decisions are governed by rules of thumb, this is true; heuristics are used in almost every decision. heuristics are rational in that they allow a faster response with less use of resources than would result in full cognitive processes. heuristics are derived from past experiances and past thoughts, this is rational. Even a rat will act rationally based on heuristics once it has learnt that pushign the button will release food but also shock them such that they will only poush the butten when they are sufficently hungry that it jsutifies the shock.

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  33. I have to agree with JGG.

    Your premise that human beings make rational decisions fails since it can’t be tested via experimentation, it fails as a scientific hypothesis.

    “Humans do make rational decisions; even a someone with downs-syndrome will not perform an action they want to perform if the know that will result, with short delay, in a reaction which is more undesirable than the desirable consequences of the action”

    The above hypothesis again can’t be proven via experimentation.

    “heuristics are rational in that they allow a faster response with less use of resources than would result in full cognitive processes”

    Again there is no truth to the above statement. Heuristics provide no guarentee of an optimal solution to the given problem. We use Heuristics because its not possible to calculate the optimal solution, this could be because we lack the processing power or we lack the information.

    A better postion is that human beings make favourable decisions given the avaliable processing power and avaliable information, the outcome of that decision may or may not be the most optimal. I fail to see how you have then taken the above and concluded that human beings make rational decisions unless you have defined rational to mean something other than what I and JGG believe it to be.

    Note I believe a truely rational decision is one which results in the most favourable outcome for the individual making the decision. This is very dependent on processing power and perfect information.

    BTW rats make irrational decisions every day, they involve a peice of cheese and a spring loaded trap. The unfavourable outcome of getting the cheese for the rat is death.

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  34. >>>rats make irrational decisions every day, they involve a peice of cheese and a spring loaded trap.

    Hmm.. so an irrational decision is, inter alia, one which does not take account of all the known consequences? But whose to say that the particular unfortunate rats are aware of the deadly function of the spring loaded trap? :)

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