Respectful Insolence

A while back, I wrote about the grievous miscarriage of justice that occurred to Simon Singh in the form of a ruling against him in the libel suit brought against him by the British Chiropractic Association. Suffice it to say, that the BCA is using the U.K.’s exceedingly plaintiff-friendly libel laws to silence legitimate criticism of the dubious practices of its members. This resulted in a campaign from the British pro-science organization Sense About Science to Keep Libel Laws Out of Science.

free debate

Now, I learn that, true to Internet tradition, the attempt to suppress information or punish someone for utilizing his free speech rights is boomeranging, as it nearly always does. Dozens of blogs and websites are reprinting a lawyer-sanitized version of Singh’s original article, which lack a couple of sentences, namely the allegedly defamatory sentences plus one other that I can’t for the life of me figure out why the lawyers removed. Personally, I don’t see the point of using the lawyer-scrubbed version, and here’s why. The very point of commenting on this libel case is to point out how outrageously illogical and illiberal Judge Eady’s ruling on the meaning of “bogus” in the context of the article is. How can readers know what all the fuss is about if a lawyer-sanitized version of the article is all that they can see? How can they judge for themselves. That’s why I believe that the full original article should be published. Again, context is critical, and my readers should see what the BCA is suing over and, in the context of the article, be shown how ridiculous it was of Judge Eady to define “bogus” the way Singh used the word as claiming that what Singh meant was that the BCA is intentionally deceiving the public. As Jack of Kent also tells us, these sentences are already published on the BCA website. So what is the point of a scrubbed version? None at all, and it risks providing the impression that Judge Eady’s interpretation was correct.

So read and judge for yourself if Judge Eady made a reasonable ruling. Is this article libelous? I don’t think so. The sentences everyone else is excluding are in bold:

————–

NOTE ADDED AFTER PUBLICATION: At the request of Sense About Science, I have removed the original version. They inform me that by reposting this I am potentially putting Simon Singh at risk for further action. This to me seems ridiculous, but then English libel law is ridiculous. The last thing I want to do is to cause Singh any trouble; so I have reluctantly acceded to SAS’s request. The original can still be found here.

Beware the spinal trap

Some practitioners claim it is a cure-all but research suggests chiropractic therapy can be lethal

Simon Singh
The Guardian, Original version published Saturday April 19 2008
Edited version published July 29, 2009

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.

In fact, Palmer’s first chiropractic intervention supposedly cured a man who had been profoundly deaf for 17 years. His second treatment was equally strange, because he claimed that he treated a patient with heart trouble by correcting a displaced vertebra.

You might think that modern chiropractors restrict themselves to treating back problems, but in fact some still possess quite wacky ideas. The fundamentalists argue that they can cure anything, including helping treat children with colic, sleeping and feeding problems, frequent ear infections, asthma and prolonged crying – even though there is not a jot of evidence.

I can confidently label these assertions as utter nonsense because I have co-authored a book about alternative medicine with the world’s first professor of complementary medicine, Edzard Ernst. He learned chiropractic techniques himself and used them as a doctor. This is when he began to see the need for some critical evaluation. Among other projects, he examined the evidence from 70 trials exploring the benefits of chiropractic therapy in conditions unrelated to the back. He found no evidence to suggest that chiropractors could treat any such conditions.

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.

In 2001, a systematic review of five studies revealed that roughly half of all chiropractic patients experience temporary adverse effects, such as pain, numbness, stiffness, dizziness and headaches. These are relatively minor effects, but the frequency is very high, and this has to be weighed against the limited benefit offered by chiropractors.

More worryingly, the hallmark technique of the chiropractor, known as high-velocity, low-amplitude thrust, carries much more significant risks. This involves pushing joints beyond their natural range of motion by applying a short, sharp force. Although this is a safe procedure for most patients, others can suffer dislocations and fractures.

Worse still, manipulation of the neck can damage the vertebral arteries, which supply blood to the brain. So-called vertebral dissection can ultimately cut off the blood supply, which in turn can lead to a stroke and even death. Because there is usually a delay between the vertebral dissection and the blockage of blood to the brain, the link between chiropractic and strokes went unnoticed for many years. Recently, however, it has been possible to identify cases where spinal manipulation has certainly been the cause of vertebral dissection.

Laurie Mathiason was a 20-year-old Canadian waitress who visited a chiropractor 21 times between 1997 and 1998 to relieve her low-back pain. On her penultimate visit she complained of stiffness in her neck. That evening she began dropping plates at the restaurant, so she returned to the chiropractor. As the chiropractor manipulated her neck, Mathiason began to cry, her eyes started to roll, she foamed at the mouth and her body began to convulse. She was rushed to hospital, slipped into a coma and died three days later. At the inquest, the coroner declared: “Laurie died of a ruptured vertebral artery, which occurred in association with a chiropractic manipulation of the neck.”

This case is not unique. In Canada alone there have been several other women who have died after receiving chiropractic therapy, and Edzard Ernst has identified about 700 cases of serious complications among the medical literature. This should be a major concern for health officials, particularly as under-reporting will mean that the actual number of cases is much higher.

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.


Simon Singh is a science writer in London and the co-author, with Edzard Ernst, of Trick or Treatment? Alternative Medicine on Trial. This is an edited version of an article published in The Guardian for which Singh is being personally sued for libel by the British Chiropractic Association.

Comments

  1. #1 Bob O'H
    July 29, 2009

    Personally, I’m going to join this movement, except that I’m going to leave the sentences in

    Just to be clear – you are aware that you could also be sued? English and Welsh libel laws have a ridiculously long reach.

  2. #2 Zeno
    July 29, 2009

    Small correction: MediaWatch is a censorship organisation, but MediaWatchWatch is a free-speech counter organisation. The link you gave is to the correct website, but the text is wrong!

  3. #3 WScott
    July 29, 2009

    On a tangent: I’m curious to hear your opinion of osteopathic manipulative medicine? It seems to me (not a doctor) sorta like a “real medicine” version of what chiropractic claims to do. I know a couple people who have been greatly helped by it, tho I recognize that’s just anecdotal. But OMM doesn’t seem to get a lot of attention. Just curious.

  4. #4 Colin
    July 29, 2009

    Bob, I think America passed a law a few years ago that means that British libel accusations don’t have any power over americans or something like that, so I think Orac’s fine. But anyway, the BCA is getting so much crap for their insane decision to sue Simon Singh that I highly doubt that they’ll make their situation any worse. At the moment they claim that they’re not censoring free speech and peer comment on their evidence, which would be a difficult point to argue if they start shouting down bloggers.

    That being said, when I repost the article later this evening on my blog (solidarity and all that), I may take the lawyered version because I don’t have Orac’s steel balls.

  5. #5 truthspeaker
    July 29, 2009

    Thanks for posting the uncut version, orac.

  6. #6 PP
    July 29, 2009

    Great that you posted the original article!

  7. #7 neilo
    July 29, 2009

    Where’s the bold print? I don’t see it!!

  8. #8 truthspeaker
    July 29, 2009

    It’s both bolded and italicized.

  9. #9 spudbeach
    July 29, 2009

    Thank you for leaving the bold parts in. The irony of the first three sentences is just delicious, and on scienceblogs, rather mild.

    In any reasonable legal system, there wouldn’t be any issue. The BCA is just huddling around their mommy’s skirts, saying that the big bad bully hurt their feelings. Unfortunately, hurting feelings and livelihoods is the only way to advance medicine or any science.

  10. #10 troy
    July 29, 2009

    I believe we (U.S.) passed a law in 1776 to the effect of “Suckit Limeies!” This was written at about 11pm on the evening of the signing of the declaration of independence, at a local pub..

  11. #11 Chris
    July 29, 2009

    troy, I would sincerely hope you take a refresher course in US History. The Declaration of Independence was not a law (check out the first word). Also note that the freedom of speech bit was put into an amendment of the constitution. Do you know when the constitution was ratified?

    Here is some additional reading: ‘Libel Tourism’: When Freedom of Speech Takes a Holiday:

    Ms. Ehrenfeld rallied prominent champions of free speech to her cause, including the American Library Association, the Association of American Publishers and the PEN American Center. She also set to work trying to change American law. The New York State Legislature passed a bill that some are calling “Rachel’s law,” which blocks enforcement of libel judgments from countries that provide less free-speech protection than the United States. Gov. David Paterson signed it on May 1….A similar, bipartisan bill has been introduced in Congress. The federal bill would extend protection to the entire country. It would also allow American authors and publishers to countersue, and if a jury found that the foreign suit was an attempt to suppress protected speech, it could award treble damages. There is little opposition to it — and Congress should pass it before it adjourns later this month.

  12. #12 Richard
    July 29, 2009

    I can’t believe they sued him over this. How cowardly and dishonorable. Their actions taint the whole “profession”.

    Thanks, Orac, for posting the uneditied version.

  13. #13 Dangerous Bacon
    July 29, 2009

    “I can’t believe they sued him over this. How cowardly and dishonorable. Their actions taint the whole “profession”.”

    It’s been tainted before by threats of legal action to silence free speech. One example: a patients’ advocacy group organized on behalf of victims of stroke caused by chiropractic manipulation placed ads on buses in two Connecticut cities. The ads sought to raise awareness of harm caused by chiropractic treatment. One chiropractic group, Terry Rondberg’s World Chiropractic Alliance, had this bizarre response:

    “We’re not afraid to confront our enemies or those who are being used as pawns in this battle. We will use every avenue open to us — from public relations to lawsuits — to hold those responsible for the attacks accountable for their actions.”

    A copy of the letter sent to the Greater Bridgeport Transit Authority may be viewed on the WCA website at http://www.worldchiropracticalliance.org.

    The problem of anti-chiropractic discrimination goes much deeper than the buses in Bridgeport. It has become a campaign of misinformation that must no longer be ignored or tolerated. “This is like a hate crime committed against our profession,” said Rondberg. “The WCA won’t stand for it. We’re not going to allow these rabid anti-chiropractic groups to disguise their libel as ‘free speech.’ If they’re going to scream fire in a crowded theater, we’re going to hose them down for good.”

    Rondberg likened the battle to the civil rights movement of the ‘60s (citing the case of Rosa Parks).”

    http://www.worldchiropracticalliance.org/news/busads2.htm

    In the end no lawsuit was filed, but this incident shows that Americans are not immune from being harassed in a similar fashion to that endured by Simon Singh.

  14. #14 jpf
    July 30, 2009

    Chiropracty: the Scientology of Medicine.*

    * Dear World Chiropractic Alliance, please don’t sue me or send chiropractors around to my house to break my spine.

  15. #15 Jack of Kent
    July 30, 2009

    Excellent post.

  16. #16 NickS
    July 30, 2009

    “In the end no lawsuit was filed, but this incident shows that Americans are not immune from being harassed in a similar fashion to that endured by Simon Singh.”

    That is unless they’re zerged with endless swarms of public debunking…

  17. #17 skeptical scientist
    July 30, 2009

    To expand on the excerpt Chris posted from “Libel Tourism”: New York State, Illinois, and other jurisdictions passed similar laws to protect citizens from libel tourism. Congress has not yet passed a similar law – the law mentioned in that article was the Free Speech Protection Act of 2008 which apparently was still in committee at the end of the last legislative session. It has also been reintroduced in the current session; let’s hope it passes this time.

  18. #18 skepsci
    July 30, 2009

    P.S. I’m not sure where Orac lives, so I don’t know if he gets any protection from any of these laws, but he shouldn’t assume he’s safe from legal action.

  19. #19 skepsci
    July 30, 2009

    P.S. I’m not sure where Orac lives, so I don’t know if he gets any protection from any of these laws, but he shouldn’t assume he’s safe from legal action.

  20. #20 Orac
    July 30, 2009

    I don’t, even though I live in the good ol’ USA.

    However, that being said, I think the risk is pretty low. British bloggers reposting the two “defamatory” sentences are taking a far bigger risk than I am. That’s why I admire them. It takes real balls to blog about these things in the U.K. I don’t know if I’d have the guts if I lived, say, in London.

  21. #21 NZSceptic
    July 30, 2009

    This story about British singer Annie Lennox is interesting – especially the quote below.

    http://www.telegraph.co.uk/culture/music/4639351/Annie-Lennox-dont-mess-with-the-missionary-woman.html

    {‘She was limping on those protests, and she still has that limp today. But she is grateful to be walking at all, because last August she had surgery on her spine. Sounds scary, I say. ‘Didn’t have time to be scared because it happened so quickly. I had a bulged disc and I went to see a chiropractor who popped it out and damaged a nerve. I’ve never had so much pain. A thing called drop foot. My left leg was paralysed, basically. I couldn’t move my toes. I was in Mexico City attending the international HIV/Aids conference. Had to cancel everything and get home. Got an MRI scan and at the end of that week I had surgery. They had to scrape the bone to make more space. Some people were, like, “Don’t do the surgery. It’s too risky,” but I thought, “I don’t want to be disabled.” I was warned the surgery could go wrong and had to sign a liability waiver. I made a decision to just do it and not freak myself out.’}

    – So, a chiropractor clearly did something that caused Annie Lennox’s condition to worsen dramatically yet, amazingly, she says she is thankful. In fact, her testimonial appears on this US chiropathic home page. http://www.denver-chiropractic.com/
    I’m assuming he must be the one who caused her to end up in hospital, but can’t be sure of course. Well anyway, as they say in England, there’s nought as queer as folk – and that’s something Simon Singh is finding out right now!

  22. #22 Paul Browne
    July 30, 2009

    Orac “Now, I learn that, true to Internet tradition, the attempt to suppress information or punish someone for utilizing his free speech rights is boomeranging, as it nearly always does.”

    Too true!

    My favourite reaction was in June when another chiropractic organization called the McTimoney Chiropractors who in response to the Simon Singh case sent around a rather hysterical e-mail to its members urging them to remove a wide range of claims from their websites. The e-mail tells you a lot about what they are all about. Andy Lewis at the quackometer blog has the details

    http://www.quackometer.net/blog/2009/06/chiropractors-told-to-take-down-their.html

  23. #23 Andrew Dodds
    July 30, 2009

    skepsci –

    No, Orac’s safe, it’s just that I’ll probably be sued for reading it and being British..

    The problem is that although UK libel laws are extremely unfair, they also work in favour of the upper/political classes, making it pretty difficult to repeal or modify.

  24. #24 Kismet
    July 30, 2009

    I don’t even know what the hell is wrong with implying (based on the evidence!) that they intentionally deceive the public? The other option is that they’re stupid or incompetent. The former, intentionally lying, may be even a more generous interpretation.

    Am I going to be sued?

  25. #25 Heraclides
    July 30, 2009

    NZSceptic, there’s one of these twits running adverts in a local rag along anti-vaccine lines, etc. Basically he picks a recent health scare and tries to “anti” it whatever way he can, implying (of course) that his therapy is the “solution”. Recent efforts include “the swine flu vaccine you can have today” and a tilt at the Canterbury measles outbreak where he tries to strongly imply that the health organisations are lying about the effectiveness of the vaccine.

  26. #26 John Bureau
    July 30, 2009

    It never ceases to amaze me how medical writers seemingly intent on informing and protecting the public about the evil and danger of chiropractic care, can be so tunnel visioned about the considerably greater and more frequent harm caused by orthodox medicine. I am not familiar with tort and libel laws in the UK, being Canadian, but where I practice, the malpractice insurance premium I pay is one tenth of what my medical friends pay for the identical coverage. So whose care is riskier, I wonder??

    and speaking of “twits running adverts along anti-vaccine lines”, you might want to write about the inconvenient fact that the US government pays $millions per year to victims of vaccination-related reactions. Is this a frivolous and gratuitous expense on their part, or the acknowledgement of an actual risk in that procedure? I wonder who the twits really are!

    but to be more specific about chiropractic risks and benefits, since 1957 no fewer than 64 peer-reviewed studies have shown that chiropractic care for back and neck problems was more effective than physiotherapy, pharmacotherapy and surgery, and resulted in lesser recovery times, short time off-work, more complete return to function and less relapse. Do you need the references or is it more convenient for you to ignore them?

    and recent review of the literature available have shown that the risk of stroke after a chiropractic visit is no greater than after a medical visit, a massage, a hair appointment, etc. It all has to do with the individual patient’s habits, genetics and lifestyle predisposing them to having a stroke in the wrong place. But I suppose it makes for better newscopy to warn the public to “beware” of chiropractors, rather than of that extra serving of greasy fish and chips.

    I realize yellow journalism is a beloved tradition in Britain, and how much fun it is for little boys to play with fire, fan the flames of sensationalism and generate a lot of smoke. But that’s how little boys get burned. I would suggest you try some balanced blogging for a change.

    John Bureau DC, Waterloo & Ohsweken, Ontario, Canada

  27. #27 Paul Browne
    July 30, 2009

    John Bureau, no doubt there will soon be several poster’s along to refute your claims, for a start if you read Simon Singhs piece you will notice that the claims that he refers to as bogus all involve “chiropractic therapy in conditions unrelated to the back”.

    We could argue all evening over whether all the statements Simon made in his Guardian piece were correct, and no doubt we will, but that would be missing the point. The issue is not whether Simon Sing was right, but rather the use by the British Chiropractic Association of the libel laws to attack a writer who has criticised them.

    You raise the issue of vaccine safety, well anti-vaccine campaigners have made many serious and untrue allegations against individual vaccine scientists, regulators and vaccine advocated…some of them no doubt libellous. How many have been sued for libel? Sure Wakefield facing a GMC hearing, but that’s about the way he practiced science and medicine, not about his claims concerning vaccines.

    So why are anti-vaccine campaigners not being sued? Simply because to do so would only give the (false) impression that vaccine manufacturers are trying to cover something up and silence their opponents. The BCA has done exactly that (though in their case there is ample evidence that Simon’s statements regarding the lack of evidence for their claims about treatments are substantially true) relying on a twisted definition of the word “bogus” which puts the defendant in British libel cases in the position of having to prove what the mindset of the person making the “bogus” claim was. The whole thing stinks and the BCA absolutely deserve every ounce of turd in the shitstorm they’ve stirred up.

  28. #28 John Bureau
    July 30, 2009

    Paul Browne: thanks for your comments.
    1. I can handle comments from the peanut gallery. My experience with chiropractic critics is that it’s best to let them talk, as sooner or later they put their jackbooted foot in their mouth.
    2. it is unfortunate, but a sad reflection of the political mindset that the most effective (and legal) way to deal with antisocial and gratuitous detractors is to throw the book at them. I agree with you: it stinks, but lest we all conviently forget, the BCA is not the one who started the turdfest. it is more than disingenuous to ramble on uninformedly about the alleged safety of the care provided by a profession, only to complain afterward about being taken to task on account of pesky concerns like libel laws.

    If you can’t handle the “shitstorm”, don’t jump in with both feet and splash other people.

    John Bureau DC, Waterloo & Ohsweken, Ontario, Canada.

  29. #29 Todd W.
    July 30, 2009

    @John Bureau

    and speaking of “twits running adverts along anti-vaccine lines”, you might want to write about the inconvenient fact that the US government pays $millions per year to victims of vaccination-related reactions. Is this a frivolous and gratuitous expense on their part, or the acknowledgement of an actual risk in that procedure? I wonder who the twits really are!

    You could answer your own question by doing a little investigating. The CDC has a nice history of the National Vaccine Injury Compensation Program, including the reasons for its creation. (http://www.hhs.gov/nvpo/factsheets/fs_tableIV_doc1.htm)

    Rather than go over the program here, I’ll let that link speak for itself. As with all medical interventions, vaccines carry risks, however rare they may be. The VICP enables parents to receive compensation without the delays and costs of the tort system (legal fees are paid for by the government, and the cases do not have to compete for time with non-vaccine tort cases), acknowledges that some individuals will have adverse reactions and ensures that the supply of vaccines will not suffer. Bear in mind, also, that the VICP is an alternative to the tort system. Claimants may still opt to file suit against the company, if they so choose.

    At any rate, read the CDC’s info on the program. A little research beforehand, rather than parroting the anti-vax fringe, would save you from looking ignorant of the topic.

  30. #30 Todd W.
    July 30, 2009

    @John Bureau

    lest we all conviently forget, the BCA is not the one who started the turdfest.

    Actually, they did start it by making claims that were not supported by science. Note that the primary focus of Singh’s article is on the use of chiropractic for non-back or neck related issues (“colic, sleeping and feeding problems, frequent ear infections, asthma and prolonged crying”).

  31. #31 Heraclides
    July 30, 2009

    where I practice, the malpractice insurance premium I pay is one tenth of what my medical friends pay for the identical coverage. So whose care is riskier, I wonder??

    Misleading, I suspect. If chiropractors don’t file malpractice events then the information won’t be there for insurance companies to base risk on.

  32. #32 G.Shelley
    July 30, 2009

    If vaccines were worthless and based on a totally discredited concept about how the body works, then any talk about their adverse reactions might be relevant. However, unlike chiropractic, they actually work, so there is a cost/benefit ration which can be worked out.

  33. #33 Kismet
    July 30, 2009

    Way to go John Bureau (@26)! You could have hardly put more fallacies in your opening paragraphs, IDK, but to me it reads like a nice conglomerate of tu quoque/strawmen fallacies.

  34. #34 John Bureau
    July 30, 2009

    Heraclides:

    my original post @26: “where I practice, the malpractice insurance premium I pay is one tenth of what my medical friends pay for the identical coverage. So whose care is riskier, I wonder??”

    Your reply @31: “Misleading, I suspect. If chiropractors don’t file malpractice events then the information won’t be there for insurance companies to base risk on.”

    My Comment: “Uninformed, I observe. Chiropractors in all Canadian provinces have to carry malpractice insurance, and none as so wealthy as to strangely fail to “file malpractice events”, never mind settle privately.

    One foot in the mouth already.

    John Bureau DC, Waterloo & Ohsweken, Ontario, Canada.

  35. #35 John Bureau
    July 30, 2009

    Kismet:

    Your post @33: “Way to go John Bureau (@26)! You could have hardly put more fallacies in your opening paragraphs, IDK, but to me it reads like a nice conglomerate of tu quoque/strawmen fallacies.”

    My reply: I will not pretend to have your acumen, and to have like you committed to memory the myriad ways with latin names to obfuscate and split hairs. But if you care to elaborate, I think many here would be delighted with your detailed assessment.

    However, I suspect the worst fallacy here is to pretend that this sort of intellectual exercise impresses anyone who’s not already convinced of the pre-ordained conclusion, to wit:

    G.Shelley @32: “… However, unlike chiropractic, they actually work”. A priori assertion.

    Far from me to quell and denigrate your debating skills, but some of us have actual jobs that keep us otherwise occupied. However, I’ll convey to my patients your impressions and observations that what I do doesn’t actually work, and let them decide for themselves what sort of name (latin or plain English) they wish to give your argument. I suspect it will involve intestinal functions and farm animals…

    Regards.

    John Bureau DC, Waterloo & Ohsweken, Ontario, Canada.

  36. #36 Heraclides
    July 30, 2009

    34: You didn’t reply to what I wrote and twisted my words, in fact. I didn’t say anything about carrying insurance (in fact I assumed you did because you said earlier that you did!), I wrote about filing malpractice events, which is nothing to do “settling privately” or other legal matters, but reporting on clinical events as hospitals, etc. are required to.

    Your foot’s in your own mouth, I think ;-) Then again, you’re reading like a troll so I’m going to quit while I’m ahead ;-)

  37. #37 T. Bruce McNeely
    July 30, 2009

    John Bureau, DC:
    I thought your numbers for malpractice insurance premiums were a little off (“where I practice, the malpractice insurance premium I pay is one tenth of what my medical friends pay for the identical coverage”) so I did some checking. For chiropractors malpractice insurance,
    a Canadian Insurance company (Axa) quotes rates for 2008 of $2,600 for the year ($2,000,000 Per Claim/$4,000,000 Aggregate). For a Family Physician in Ontario involved in office practice only (you know, like a chiropractor – i.e. no obstetrics, anesthesia, surgical assists or ER shifts), unlimited coverage is offered at $2040 a year.
    Ten times? Not so much.

  38. #38 spudbeach
    July 31, 2009

    Re Malpractice Insurance Rates:

    Technically, malpractice does not arise from injuries proximately caused by treatment. Rather, malpractice only arises from treatment causing injuries where the treatment is not the standard of care for the profession.

    So, let’s work this through:
    A chiropractor does a totally worthless* neck twisting for treatment of childhood asthma,** and in the process, causes a stroke. While any reasonable person would say that that was malpractice, the law doesn’t, because the chiropractor can line up a whole bunch of his buddies, who, eager to keep their meal ticket, say “that’s just what I would do!”. Since the worthless treatment that caused the problem is “standard of care”, no liability. Further, all the MD’s are excluded from testifying since they are not of the same profession.

    Does that sound like something you want to actually be _proud_ of, John Bureau?

    Rather than talking of reality filtered through the law, how about talking about physics, chemistry, biology, physiology or pathology, none of which lend any credence to talk of “subluxations” or any of the other drivel of chiropractic. (Yes, I do want to see your references, so I can demolish them. Are any of them placebo controlled? Any with sham chiropractic? [sorry for the redundancy])

    As to the benefits of real medicine (i.e., vaccines, surgery, etc.) that you seem so eager to disparage: Explain, if you will, what the heck happened to smallpox? Why haven’t I seen any polio floating around in the US, when my parents had several childhood friends die from it in the 40’s? Why are measles outbreaks traced back to un-vaccinated groups? Why is breast cancer potentially survivable now, rather than the death sentence it was in the 19th century? Why can my father, who fell down and hit his head at the age of 76, still entertain his grandchildren and beat me at bridge, if not for neurosurgery? Should I have called a chiropractor? Or maybe a faith healer? [oops — sorry for the redundancy again.]

    Why am I so angry now? Because this is the first time I’ve had a real live DC in a situation where I can ask questions. I’ve bitten my tongue more times that I care to think about when exposed to neighbors saying “I’m taking my newborn to the chiropractor” or “I swear by chiropractic” or “I’ve been seeing my chiropractor weekly for three years, and it really helps”. I’d love to hear some answers now, oh unwise DC that dared to wade into a rational blog.

    * (i.e., unsupported by _any_ evidence, either empirical or theoretical based on physics, chemistry, biology, or physiology)

    ** (Yes, DC’s do treat asthma: see here for some pretty pathetic studies, none of which appear to have even a “no treatment” group, much less a placebo group. Oh, except one, from the NEJM, which showed no benefit.)

  39. #39 Paul Browne
    July 31, 2009

    ” I agree with you: it stinks, but lest we all conviently forget, the BCA is not the one who started the turdfest. it is more than disingenuous to ramble on uninformedly about the alleged safety of the care provided by a profession, only to complain afterward about being taken to task on account of pesky concerns like libel laws.

    If you can’t handle the “shitstorm”, don’t jump in with both feet and splash other people.”

    LOL!

    Firstly Simon Singh is a very well informed science writer who authored excellent books on a range of scientific topics (mostly concerning mathematics, hence his approach to data or the lack thereof) before turning to the issue of alternative medicine. He is certainly no Jenny McCarthy!

    Secondly I would venture that it was the BCA who jumped in feet first when they decided to pick a fight with him on such thin grounds. Remember what is at issue here is not that chiropracters were making claims for treatments for which they had no evidence, that much is to all intents and purposes undisputed, but whether they knew that they were making claims for which there was no sound evidence.

    The BCA is in a bad position, if this geso to trial and they win they will have had to prove that a large number of their members are deluded and/or ignorant (not aware that their claims had no basis in fact), and if they loose…

  40. #40 Joe
    August 1, 2009

    @ John Bureau, DC,

    We know that chiros cause strokes:
    http://www.ptjournal.org/cgi/content/full/79/1/50

    http://stroke.ahajournals.org/cgi/content/full/32/5/1054

    What we don’t know is “how many” because basic knowledge of anatomy and physiology tells us that many victims suffer and die without any linkage to chiropractic. It is only recently that neurologists have learned to ask survivors if they had a recent, chiro neck-snap.

    Bring on your “67 articles” showing the safety of neck manipulation. But, strip-out the ones in substandard magazines (e.g., Spine, JMPT, etc.) that regularly publish twaddle.

    Please include the articles that demonstrate benefit over safer procedures. I assert that there are no benefits over safer procedures. That is the real problem with the chro neck-snap.

    I am certain that you cannot provide reliable evidence that the, potentially deadly, neck-snap is a good trade-off for headache (or any other illness). Go ahead, prove me wrong.

  41. #42 Joe
    August 1, 2009

    Singh’s appeal was denied, there is analysis of his further options here http://jackofkent.blogspot.com/2009/08/simons-choice.html

  42. #43 Chris' Wills
    August 2, 2009

    Judge Eady has prior form for these types of rulings.

    If you’re rich or famous then he is the judge you want to rule on your libel/defamation claim.

    Facts and reality don’t dare enter his courtroom.

    If you aren’t famous/rich then judge eady says you’ve no right to privacy, especially if you are a blogger.

  43. #44 houston chiropractic
    December 14, 2009

    I love reading your article. I follow every article you post about the British Chiropractic Association. Wish the you continue posting about that topic. I want to know what is will happen to BCA.

  44. #45 Chris
    December 14, 2009

    To keep up what will happen to the BCA you should follow this lawyer’s blog:
    http://jackofkent.blogspot.com/

    Right now there is a movement to change the libel laws in England.

  45. #46 ChiroUndergorund
    September 8, 2010

    To say that Malpractice Insurance Rates are not effected by the rate of injury is ridiculous. It has everything to do with that. That’s why heart surgeons pay $100K – $200 every year for Malpractice insurance…way more people are injured from medical errors than they are from a chiropractic adjustment. …which is why chiropractors have been deemed the honor of being one of the safest of all health care professionals to date.

  46. #47 Chris
    September 8, 2010

    Aren’t you a little late to this party? By (going by the malpractice insurance discussion) at least a year?

    Another thread to close.

  47. #48 Chiropractor Solicitor
    September 28, 2010

    Because of the nature of a chiropractors work, the area of the body which he deals with are extremely sensitive and

  48. #49 Chiropractor Solicitor
    September 28, 2010

    Because of the nature of a chiropractors work, the area of the body which he deals with are extremely sensitive and

  49. #50 Chiropractor Solicitor
    September 28, 2010

    Because of the nature of a chiropractors work, the area of the body which he deals with are extremely sensitive and

  50. #51 Dr. Vanderloop, D.C.
    December 30, 2010

    I can’t believe they sued him over this. How cowardly and dishonorable. Thanks for posting the unedited version.

    Dr. Vanderloop, D.C.
    Houston Chiropractor

  51. #52 Back Pain Dallas
    February 19, 2011

    It seems to me that faults lies on both sides. Singh was truthful in some ways about clearly bogus claims but then the tone of his article lead the reader to believe that all Chiropractors are running around purposefully deceiving the public. I just got back from a trip to my Chiropractor and wouldn’t be sitting here comfortably at my desk without his professional care.

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