Hot on the heals of New Zealand Chiropractors trying to silence David Colquhoun and the The New Zealand Medical Journal, we learn today in the Telegraph that the British Chiropractic Association has issued a writ against Simon Singh for an article he wrote in the Guardian entitled Beware the Spinal Trap. ‘Dr’ Antoni Jakubowski of the BCA said that this was not a decision they were taking lightly. If justice is forthcoming, it will be a decision they regret.
The original article is no loner available on the Guardian site, but here are some excerpts that so offended the chiropractors.
This is Chiropractic Awareness Week. So let’s be aware. How about some awareness that may prevent harm and help you make truly informed choices? Some practitioners claim it is a cure-all but research suggests chiropractic therapy can be lethal.
First, you might be surprised to know that the founder of chiropractic therapy, Daniel David Palmer, wrote that, “99% of all diseases are caused by displaced vertebrae”. In the 1860s, Palmer began to develop his theory that the spine was involved in almost every illness because the spinal cord connects the brain to the rest of the body. Therefore any misalignment could cause a problem in distant parts of the body.You might think that modern chiropractors restrict themselves to treating back problems, but in fact they still possess some quite wacky ideas. The fundamentalists argue that they can cure anything. And even the more moderate chiropractors have ideas above their station. The British Chiropractic Association claims that their members can help treat children with colic, sleeping and feeding problems, frequent ear infections, asthma and prolonged crying, even though there is not a jot of evidence. This organisation is the respectable face of the chiropractic profession and yet it happily promotes bogus treatments.
But what about chiropractic in the context of treating back problems? Manipulating the spine can cure some problems, but results are mixed. To be fair, conventional approaches, such as physiotherapy, also struggle to treat back problems with any consistency. Nevertheless, conventional therapy is still preferable because of the serious dangers associated with chiropractic
I will leave you with one message for Chiropractic Awareness Week – if spinal manipulation were a drug with such serious adverse effects and so little demonstrable benefit, then it would almost certainly have been taken off the market.
There is nothing here that cannot be defended by evidence or is fair opinion. The chiropractors will not want you to know that they are peddling useless therapies based on ridiculous pseudoscience and all with the risk of serious injury to you.
This is a disgrace and I hope it backfires massively and is the start of the end of this massive fraud on the public.
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This is going to be big. The story is being covered in…
The full original article can now be found on this Russian server (Thanks, Svetlana)
http://svetlana14s.narod.ru/Simon_Singhs_silenced_paper.html
and Gimpy’s fuller analysis with references for each claim…
a day at the pharmacy blog covers it too now.
Presumably Singh's original article (which I don't remember reading) will now propagate through the internet? I for one would like to read it!
Does the writ cover just the Grauniad article, or does it take aim more widely, such as at Singh & Ernst's recent book?
No, it looks like they are going after Simon for his Guardian artcile and not, as is usual, taking on the Guardian itself.
His book with Edzard Ernst demolished any credibility that Chiropractic might have. My guess is that this is legal action designed purely for revenge and intimidation. It is an utterly dispicable action from a trade with no scruples.
I just can’t see how they think they’re going to win that action. As you’ve said, there’s nothing in there I can see that wouldn’t be covered either by the defences of justification or fair comment on a matter of public interest.
The only outcome I can see of this is plenty of coverage of a case in which chiropractic loses a libel action over claims it has little to no effect.
I’m at a loss as to why they’ve launched this suit. I’d like to think it’s because they’re so besotted with what they do they genuinely think it’s libellous.
Sadly, I think if that were the case they’d have sued the Guardian, not Singh directly. Doing that makes me think it’s a petty, blatant attempt to silence a critic rather than a last-ditch legal attempt to right a wrong.
If this makes it to court, I can’t see how it can possibly go well for them though. An extraordinary decision.
Singh’s original article?
No problem!
Look at here:
http://svetlana14s.narod.ru/Simon_Singhs_silenced_paper.html
Full text! 😉
The repeat:
http://svetlana14s.narod.ru/Simon_Singhs_silenced_paper.html
I want to be in court when this is on! How on earth do they think they can possibly win? Whoever made this decision in the BCA should be nominated for a Nobel prize for contribution to the understanding of science!
This is dreadful news. The BCA have a chance to invest in science here and, instead, have decided to show off their legal department.
What is wrong with chiros doing what they are good at. Sure, treating chronic LBP is a little dull but it is what some science says works.
For manipulators to treat outside their evidence base is shocking – it’s michael phelps doing gymnastics.
Once again I find myself ashamed of CAMs.
JH
I cure my bad back with exercise (once the torment has subsided suffiently, aided by ibuprofen). A physio did manipulate my thoracic vertebra which has made a major difference to the one between my shoulder blades. But it is actually pressups which keep it under control. My back pain is therefore, like much, a condition due to modern life. I don’t earn my living by manual labour so I must invent manual labour to stop my body falling into decreptitude. Would that a had a body that didn’t need me to run the hamster wheel, but I haven’t. As a side effect I feel so much better when I am active in so many ways, I wonder why I ever stop.
Or I could pay a chiropractor of osteopath a great deal of money to endanger my health…
I am going to be following this case keenly. I am an English media and communications lawyer as well as a skeptic/blogger.
The actual claim form and defence have not been published yet. It is thereby difficult to know exactly what will be the question before the Court. Newspaper reports are notoriously bad sources for such information.
That said, the case appears to be one of libel. This means the BCA have to show that something Simon Singh said lowers their reputation – that they have been defamed.
Once defamation has been established, the onus will be on Simon Singh to show that a defence applies. The usual defences are privilege, fair comment, and justification.
This “reverse” burden of proof is why libel litigation often seems unfair. Moroeover, as English courts award costs to the winning side, should this case get to court for trial, one of the two sides is going to have an awful legal bill.
This combination of reverse burden of proof and incredible costs risk has meant that English libel trials have often been used by crooks and charlatans – Robert Maxwell, Jeffrey Archer, Jonathan Aitken, David Irving, etc.
In my view, this is a misconceived and disproportionate attempt by the BCA to close down debate on a matter of incredible public interest – the sickness of children and public health.
I am going to blog on developments in this case. So watch my blog…
My first update is at:
http://jackofkent.blogspot.com/2008/08/on-simon-singh-against-chiroprators.html
Jack
Peter – you hit the nail on the head.
I would like to think that most manipulators do as I do – treat, give exercises and discharge. I use your actual example – I tell my patients that they should do this for themselves rather than pay me to do it!
We’re not all blood sucking bastards. Most, yes – but not all!
JH
Over 60 years ago, the Doctor of Osteopathy school was opened essentially to serve Jewish guys who could not get into regular medical school.
Out of that first class of Osteopaths emerged the “father of all chiropractors” who founded the first school of chiropracty.
You folks call them Osteopaths, I think?
The DOs became suddenly important during WWII when the Navy could not get enough MDs. It started accepting DO’s and allowing them to prescribe and enjoy full professional privileges.
But, chiropractors continued to be rather fringe bunch with no standards of care. Has not changed to this day.
No “standards of care” means they will stay on the crackpot fringe.
It really is becoming a consistent pattern on the part of the CAM-mongers.
Whatever the state of the evidence (or lack of it) for their individual arts this does shine a fairly bright light on their approach to the normal processes of sifting and judging evidence and drawing conclusions from that evidence.
This is becoming the story rather than the evidence itself.
Why has “The Guardian” removed Simon Singh’s article from its issue?
Why?
Who can answer my question?
Hi Svetlana
At this stage, only the Guardian, and perhaps the BCA, will know for certain. Blue Wode has asked the Guardian, but they’re not telling.
From the outside, there could be a number of reasons.
However, in general terms, it was either a voluntary or an involuntary act.
And also it may, or it may not, be related to the fact that the BCA are not suing the Guardian.
Beyond that, I am afraid, there is only speculation (for now).
Hmm… Well…
It resembles the proverbial London fog 😉
Thank you, Jack of Kent.
One important question arises. Well, the quacks have taken legal action against Singh.
When does the action proceeding start?
Generally I asked it not for nothing.
Could we make them to call away their lawsuit against Singh, i.e. to nolle the case? Can we find such instrument of influence on them? There are the lawyers among quackbasters. Can they recommend something for this aim?
It would be right!
The quacks tried already to silence the quackbasters, for example, they tried to silence David Colquhoun and then – to kill Quackometer. But we stoped them. Now the situation is more difficult. But probably can we stop them this time too?
Chiropractic therapy focuses on the relationship between the body’s structure — mainly the spine — and the body’s function.Chiropractic therapy is used most often to treat musculoskeletal conditions — problems with the muscles, joints, bones, and connective tissue such as cartilage, ligaments, and tendons……
x-ray fluorescence said:
“Chiropractic therapy focuses on the relationship…”
“the relationship between the body’s structure and the body’s function”
“used most often to treat”
These are weasel marketing phrases that convey no scientific or medical meaning and they’ll fool no one here.
Zeno says: “These are weasel marketing phrases that convey no scientific or medical meaning and they’ll fool no one here” referring to:
“Chiropractic therapy focuses on the relationship…”
“the relationship between the body’s structure and the body’s function”
“used most often to treat”
Chiropractic therapy, as does physiotherapy, focuses on the relation between structure and function. In fact as does podiatry, some orthodontic, some maxillo-facial, most orthopeadic, as in fact do pretty much all surgical procedures. That these statements sound like “weasel marketing phrases that convey no scientific or medical meaning” has a lot to do with your lack of appreciation of the statement’s meaning and significance. Zeno, I suspect that the paradigm you use and subscribe to, views structure to be more stand-alone than we do. The chiropractic paradigm looks at structure as predisposing function and function as redefining structure. Also please note at this stage that the functions we would be interested in are biomechanical, biochemical and psychological (and before you hilariously intimate that we are “now claiming to be psychotherapists or dieticians” we don’t , we just claim to have an intrest in these fields and accept that these functions interact with biomechanical function and with eachother). Appreciating these relationships and having an intimate understanding of them are key in solving the types of problems chiropractors consider to be within their remit. To intimate that chiropractors claim to cure all illnesses is just ricidulous and only serves to feed simplistic preconceptions so as to sway the debate in numbers rather than content and truth. Chiropractors treat conditions which are caused by structural damage extensive enough to cause pain but no so extensive as to not be responsive to functional changes. Yes, this indeed means that chiropractors are interested in those situations where pain is the result of dysfunction and it also means that they are not when the pain is caused by structures so badly damaged that the only reasonable approach is to handle the situation with pharmacopea or surgery. When pain is not secondary to dysfunction chiropractors are again not interested as these problems are either so low down the scale that they do not warrant the treatment and cost incurred or the pain is organic in origin which is the remit of another profession alltogether.
Our professional remit is defined by the nature of the relationship between structure and function of each and every case presenting to us. So, not quite “weasel marketing phrases”, just a concept that is outside of your day-to-day, which I appreciate. I just hope you aren’t claiming that “what you don’t know/are comfortable with isn’t worthwhile knowing”.
That they “will fool no-one here” has more to do with the blind leading the blind, something not quite out of the ordinary in the world of blogging…
Stefaan Vossen
Relax.
I think you misunderstood the thrust of the argument here. We can indeed probably all agree that most forms of medical care try to put their efforts into a broader context, and that chiropractic may have a place in treating, as you say, pain conditions. These will in turn of course also affect the person’s overall well-being.
In this limited scope, the phrases mentioned are certainly not weasel words. When, however, a chiropractic starts to extrapolate the dislocation-vs.-wellbeing logic towards treating cholics and asthma, then there is something wrong. Because then “the relationship between structure and function” is simply unproven” and the assertion that “something is used to treat” does not mean it also works.
“Knocking on wood is often used to improves chances of luck.” – Certainly true. But certainly of no effect. In marketing, those are weasel words – not outright wrong, but not applicable. Non sequiturs. Misleading. And in health, misleading someone is especially unethical.
To come back to the point: Sceptics don’t usually have much to complain about chiropractics that stick to what’s known to work. It’s when they get pseudoscientific when we get this itching in our fingers.
Why couldnt a chiropractor be effective if they used the same techniques as a physiotherapist does and adds osteo techniques and spinal manipulation? It isn’t right to say all chiropractors practice the same way (using pseudoscience bullshit).
Anonymous – you miss the point. There may well be chirpopractors who practice within what can be evidenced. But the claims about being able to treat childhood illnesses, such as asthma, come right from the top. This would suggest a profession unconcerned about evidence.
Why just chiropractic? Have a look at the evidence avaialble for the treatments used in osteopathy or paediatric physiotherapy. Most would not convince the skeptic. I think chropractic is a profession that offers a range of treatments for a range on conditions. In some cases there is compelling evidence of effectiveness in others the evidence may not be so convincing. This however is the case for all health professionals
Ok… do not lump paediatric physiotherapy in there. What we do is evidence based… check out the Journal of Developmental Medicine and Child Neurology… We are not claiming to be able to fix anyone – we just try and offer skills and expertise so parents and caregivers can facilitate participation, and limit disability… anyone who says you need to pay for something to be adjusted regularly (and can’t teach you to do it yourself) is likely full of shit.
I don’t think the evidence for chiro is in the slightest bit ‘compelling’! It is, at best, down in the noise. And that’s just for lower back pain. As LCN points out, many chiros claim they can treat asthma, colic, etc and there is not one jot of evidence for any of that.
If all the hullabaloo at least results in a more rational approach among chiropractors, it is justified. Invariably, the alternative medicine people misrepresent such debates as between an intellectually elite and arrogant scientific community versus that ‘good ol’ chiropractic down the road’.
Zeno- actually the evidence for low back pain is quite strong. Back pain still represents the condition most commonly treated by osteopaths and chiropractors in the UK. Evidence reviews have led to guidelines such as those produced by NICE, the Royal College of General Practitioners and the European back pain guidelines recommending manipulation by chiropractors and osteopaths. In other areas such as cranial osteopathy and paediatrics there is certainly less evidence of effectiveness and a need for further research.
If you want to be critical thats fine but please be fair otherwise your objectivity and motives are open to question.
If you want to be critical thats fine but please be fair!
Anonymous
I don't think that the evidence for chiro for low back pain can in any way be considered 'quite strong' unless you take all the poor quality trials into account as well as the ones that had a high risk of bias. I suspect that where we will have to disagree is in what we consider good evidence.
At best, chiro is as ineffective as most other interventions, including physiotherapy.
However, considering the plethora of claims made by chiropractors, I would have expected more than just some evidence for its efficacy for back pain. Where's the evidence for the following (the numbers give an idea of just how many chiros make claims for each condition):
Colic 29%
Whiplash 25%
Bed wetting 23%
Infection 19%
Asthma 18%
Arthritis 18%
Feeding problems 15%
RSI 11%
Hyperactivity 8%
PMS 7%
Sleeping problems 6%
Menstrual problems 3%
ADHD 3%
Vertigo 2%
Tinnitus 1%
Dyslexia 1%
Eczema 1%
Some of the even more bizarre claims include: ADD, OCD, Tourettes, Emphysema and Hay fever.
I'm sure you'll be aware of the criticism of the recent NICE guidelines:
http://www.dcscience.net/?p=1516
http://www.dcscience.net/?p=1542
http://www.dcscience.net/?p=1593
…and many others.
So when do we start attacking the Osteopaths and Physiotherapists?
Which study produced the results of the conditions listed above?
So when do we start attacking the Osteopaths and Physiotherapists?
Which study provided the results listed above?
Zena: Oh, I think our critical eyes will gaze in the direction of the osteopaths in the not too distant future! Not sure about physios – are they not bone fide in general? I don't know.
I'm more than willing to do the same for osteopaths as I've just done for the chiropractors: my complaint against 523 chiros landed on the desk of the GCC this morning! See http://www.zenosblog.com/2009/06/omnibus-complaint-to-general.html.
It was my research that got the figures in my last post.
Surely we should be looking at the Osteopaths and Physio's and the evidence that they have to support their claims too? Why just the Chiros? Is it because they took on Singh?
Why have all the Osteopaths site suddenly disappeared and the Genereal Osteopathic Council site changed?
Let me think…nope, can't come up with any reason, bogus or otherwise.
Latest statement from BCA on Simon Singh case http://www.chiropractic-uk.co.uk/gfx/uploads/textbox/Singh/BCA%20Statement%20170609.pdf
How sad that all this intelligence, and all this passion for knowledge and truth is dampened!
Some of the people on here are clearly passionate about what they do and think, but I cannot but feel saddened by the trail of inaccuracy and blatant disregard for the facts.
The bogosity of chiropractic was never on trial here, whether the BCA is happy to promote something bogus on the other hand was.
There never was a scientific debate, there only ever was dejection at Mr. Singh's inability to play by the rules of public and scientific decency. I expect this to soon become clear to those who "support" Mr. Singh's case, and walk a mile for fear of being associated to such juvenile behaviour. Or maybe there should be no rules, maybe we shouldn't come to expect decency? How sad taht would be.
I will never forget the day my statistics professor was proven wrong by a polite well-spoken gentleman. He rose, went to the man and shook his hand and thanked him profusely, stating "today I have become a little less wrong about life, what a magnificent day it is!"
I thank Singh for publishing his conclusions, and within the arena he considered, based on the papers he considered, I would have been a little less wrong too, had I not already known it. As do most chiropractors. Maybe it is time for people to ask some more interesting questions? "Why do they still put it (the treatment of colic etc.) on their websites?" I hear you ask. Because chiropractors are people too (although it does seem from this website that we are mainly monsters, childmolesters and murderers)and like most clinicians do not always have the time to be au-fait with the latest research. We try, but as they say; errore humanum est. Not that that is any excuse, but neither is it proof of fallacy.
Finally, I think it is wonderful that the chiropractic profession in the UK is having to think about itself. I believe that it will come to some very interesting conclusions.
Regards,
Stefaan Vossen
Is it not time that these so-called alternative practitioners produced some evidence to support their claims. Anecdotal evidence is worth very little. What is needed is some clinical trials but I will eat my hat if we ever see any such evidence
Myles Lawless
Hello Myles,
clinical trials require standardisation. The chiropractic profession lacks the degree of standardisation required to provide meaningful trials. Blinding, shamming are all significant problems for this professional group due to the nature of the practice. Chiropractic is not synonimous to a practice, it is an approach to achieving results. Medicine has never been put to the test, its methods however have. Similarly testing “chiropractic” is not really possible unless “chiropractic” becomes synonimous with a practice. I am not argueing that this state of affairs is OK, just that it is the observation that leads to your request being difficult/impossible at this moment in time to satisfy.
Kind regards,
Stefaan
Well, if it is impossible at this moment in time to prove that what chiropractors do is efficacious, then how about stopping and researching until they can?
Or at least being open and honest about whether or not they can treat asthma and cholics?
“I’m sorry, Sir, I cannot at this time tell you whether my new burger sauce is toxic. Just go on eating, we’ll find out eventually.”
Great work ethics.
“Daniel David Palmer, wrote that, “99% of all diseases are caused by displaced vertebrae”” Sure, but lets remember early medicine generally included many claims that turned out to be incorrect and overly ambitious. This is not a strong argument against the possible value of modern chiropractic practises. It’s not my experience that chiropractors treat their efforts as a cure-all, by the way. That’s not to say some people aren’t being over treated or treated without cause, that there aren’t any chiropractors reckless of all science and evidence. However, my experience is chiropractic can be helpful with neck and back pain, discomfort and impaired movement particularly. I also find wrist pain and weakness can be treatment with significant, and my posture improves noticeably after back treatments. No chiropractor ever told me they could treat anything that wasn’t obviously related to the spine or skeleton.