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Chiropractors taking a pumelling in scientific stoush

Simon Singh, a British science journalist who has become a cause célèbre since being sued by chiropractors for having the temerity to question the evidence base for their practices, is visiting Australia, and is due to speak in Sydney tomorrow night, fresh from the Adelaide Festival of Ideas.

You can read more about Singh’s stoush with the chiropractors here, in the latest British Medical Journal.

Meanwhile, Michael Vagg, a member of Australian Skeptics, has written the following account for Croakey:

“The well regarded UK science writer Simon Singh published an article in The Guardian newspaper last year to coincide with Chiropractic Awareness Week.

In the article he wrote that the British Chiropractic Association (BCA) ‘happily promotes bogus treatments’ in that it recommends chiropractic treatment for conditions such as infantile colic and asthma.

Singh went on to detail the lack of scientific evidence to support these claims in his article.

He based much of the article on a book he had co-authored with Professor Edzard Ernst, a Professor of Complementary Medicine in the UK entitled Trick or Treatment: The Undeniable Facts About Alternative Medicine. The BCA, rather than backing up its claims of efficacy with scientific evidence, sued Singh for libel.

Events escalated after the preliminary hearing for the case took place in May of this year. The presiding magistrate Sir David Eady, was required to rule on the meaning of the objectionable words, and decided to interpret the phrase ‘happily promotes bogus treatments’ as meaning that Singh was alleging he could prove that the BCA knowingly and dishonestly promoted treatments which it knew to be ineffective. Neither Singh nor the BCA had understood the phrase to mean what the judge decided it meant.

The BCA appears to be angling for a court win similar to the decision of the USA Supreme Court against in the American Medical Association in 1990 where the AMA was forced to stop discouraging the public from using chiropractors.

This was on the basis of restraint of trade, rather than on the basis of convincing scientific evidence of the effectiveness of chiropractic.

A major libel payout against Singh would have an enormous negative effect on journalists reporting the steady stream of negative studies which have been published in high-quality journals for years now, many of them ironically funded by the National Centre for Complementary and Alternative Medicine (NCCAM) in the US.

Newsweek magazine recently reported that NCCAM has spent over $US2.5 billion over the last decade researched alternative medical treatments and has failed to have even one modality proven to be effective for a single condition or symptom at a level which would encourage mainstream adoption of the treatment.

After it appeared Singh might have to settle as his case had become unwinnable, the online community weighed in.

In early June a group of bloggers and scientists began inundating the Advertising Standards Authority with complaints about individual websites and the claims made thereon. The result was stunning. Within a week, bloggers had laid complaints against over 500 websites, and hundreds of them had been either taken down or modified.

The legal blogger Jack of Kent described it as the ‘Quacklash’. The regulatory scrutiny of treatment claims of chiropractic was dramatically increased, and the processing of the complaints lodged with the Advertising Standards Authority will probably lead to increased examination of the claims of chiropractic treatment to treat such conditions as infantile colic, asthma, frequent crying and ear infections.

The Sense About Science charity has launched a campaign entitled Keep Libel Laws Out of Science, and began with an online petition demanding changes to the British libel laws to protect scientific debate. At present the petition has over 12000 signatories, including celebrities such as Stephen Fry and Ricky Gervais, as well as a galaxy of scientists from the most eminent Nobel laureates to undergraduate students.

Encouraged by the support, Singh has announced that he intends to appeal the controversial preliminary decision, and will continue to fight the action.

For its part, the BCA has sent a circular to its members ‘strongly encouraging’ them to review their advertising materials and remove claims such as those subject to legal action. This has also been done by some other smaller professional bodies such as the United Chiroparctic Association and the McTimoney Chiropractic Association in the UK. The BCA has also published its scientific evidence in support of its claims. A typical response from medical professionals is found in Prof David Colquhuon’s Improbable Science blog here. Suffice to say that Simon Singh’s defence of Fair Comment is looking fairer by the week.

The overriding principle at stake in this imbroglio is that journalists should not be threatened with legal action (note that Singh himself was sued, not the Guardian) for making justifiable comments, particularly in an arena like scientific debate where the self-correcting process of aggressive peer review allows for a far more robust consensus of the truth to be arrived at compared to politics or economics.”

Comments 6

  1. Jase the Bold says:

    Simon Singh you are a brave and perhaps foolish man to take on the cult of Big Alternative Medicine. There are a lot of people with a lot to lose if science and accountability are allowed to creep into the regulation of these industries. Modern society seeks a quick and easy fix for everything, and alternative therapies harness this unrealistic craving with little scientific backbone, and immunity to the scrutiny of the scientific and legal realms. I personally have seen 2 patients who suffered pathological fractures of the cervical spine in the hands of Chiropractors, due to underlying undiagnosed metastatic bony disease. Both subsequently died. Accountability zero.

  2. Zeno says:

    Excellent summary!

    Just a minor correction…a few of us have reported chiropractors to their statutory regulatory body, the General Chiropractic Council (GCC), not the Advertising Standards Authority. The ASA have no jurisdiction over website claims, per se, but the GCC’s Code of Conduct (which all chiros have to abide by as a legal condition of their registration) says that all claims made but be in accordance with the ASA guidance. The ASA only accept good, scientific evidence and that chiros must personally hold that evidence!

    For more information, see my blog (www.zenosblog.com) or the other main complainant, Simon’s (www.adventuresinnonsense.blogspot.com).

  3. Jon Hunt says:

    Hmm…. I don’t think it is the chiropractor’s fault that they had bony metastasis! The problem was that the patient didn’t seek help from a medical practitioner, not the chiro themselves, although whether it should have been diagnosed clinically by the chiro would be a moot point.

  4. Imaginative nickname says:

    After extensive medical testing failed to show any reason why I should have suffered a stroke at 24, the only plausible reason I was left with was a visit to the chiropractor 30 hours prior to the event.

    I have often, REPEAT often wondered how these people can sleep at night when they can turn up to work next day and potentially ruin someones life.

  5. Jase the Bold says:

    Re John Hunts comment- the point is not that someone is to blame for a patient having disseminated cancer, rather that if a “Health Professional” claims to have the ability to cure a patients condition, he should legally be required to have the knowledge, skills and resources to work out what the ACTUAL diagnosis is, rather than uneducated guesswork. Every medical practioner knows that diagnostics is the foundation of medicine. If you have no diagnosis you dont know what you’re treating. To claim the ability to treat a problem without a diagnosis is fraudulent.

    Re Imaginitive Nickname’s comment- sadly, the picture you describe is a well-documented life-threatening complication of cervical-spine “manipulation” performed by Chiropractors known as Vertebral Artery Dissection (injury and blockage of the Vertebral Artery, a major neck artery which supplies the brainstem). This is one reason why legitimate mainstream practitioners such as Physiotherapists avoid this practice. Were you able to seek medicolegal compensation for the disability the Chiropractor caused you?

  6. Imaginative nickname says:

    As my neurologist relays, half his patients descend into negativity and half rise and become more positive after a stroke. I felt that in pursuing the later and often more difficult approach, I would be ill served by a potentially length court battle that focussed on what I had lost and cloud the newly found perspectives I had garnered. Some people understand this, and others, including my some of my own family, do not. But at the end of the day, it was my situation and I felt and still feel it was the best choice.

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