Fluoride and the Future: Population Level Cognitive Enhancement

February 8, 2008 | By Julian Savulescu

Health Secretary Alan Johnson wants to fluoride to be added to England’s water supplies to tackle tooth decay.

He wants health authorities to compel water companies to add the chemical.

Fluoridation of the water is an example of human enhancement. Tooth decay is a part of the human condition but we now have the ability to prevent it through a safe, cheap, easy intervention – adding fluoride to the water. Many parts of the civilized world have been employing this strategy for decades with dramatic success. England is now debating whether to fully embrace this simple enhancement technology.

Fluoridation is the tip of the enhancement iceberg. Science is progressing fast to develop safe and effective cognitive enhancers, drugs which will improve our mental abilities. For years, people have used crude enhancers, usually to promote wakefulness, like nicotine, caffeine and amphetamines. A new generation of more effective enhancers is emerging modafenil, ritalin, Adderral and ampakines and the piracetam family of memory improvers. Students and professionals are using these to gain a competitive edge, just as athletes are doping in sport.

But once highly safe and effective cognitive enhancers are developed – as they almost surely will be – the question will arise whether they should be added to the water, like fluoride, or our cereals, like folate.

It seems likely that widespread population level cognitive enhancement will be irresistible. Studies based on removing lead, which reduces cognitive ability, from the water and paint, have estimated that a 3 point IQ increase would lead to:

Poverty rate -25%

Males in jail -25%

High school dropouts -28%

Parentless children -20%

Welfare recipiency -18%

Out-of-wedlock births -15%

The US military already employs modafenil and Ritalin for its pilots in Iraq, to improve their performance. It has a vigorous programme of developing and testing human enhancers. One spokesperson recently said:

"The world contains approximately 4.2 billion people over the age of twenty. Even a small enhancement of cognitive capacity in these individuals would probably have an impact on the world economy rivaling that of the internet."


Fluoridation may not merely be about tooth decay. It may be about the future of humanity and the drive to be better. Current enhancers are not suitable for population level distribution. But drugs to improve working memory and other select aspects of cognition may be. We may not just want whiter teeth, but to be smarter. A government which refuses to enhance its population might well be effectively disabling it. What government would refuse its citizens access to the internet?

Further resources:

ENHANCE Project website

Savulescu, J. (2006). Genetic Interventions and the Ethics of Enhancement of Human Beings. The Oxford Handbook on Bioethics. B. Steinbock. Oxford,  Oxford University Press: pp. 516-535

More downloadable resources from the Oxford Uehiro Centre for Practical Ethics

Minister Orders Fluoride to Be Added to Water, Times Online


"The two enemies of the people are criminals and government, so let us tie the second down with the chains of the Constitution so the second will not become the legalized version of the first."   Thomas Jefferson

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