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British Chiropractic Association v Simon Singh

Jack of Kent

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It was reported this morning that the British Chiropractic Association is suing Simon Singh, the well known science writer, about an article in The Guardian.
 
Link to story in the Telegraph:

Doctors take Simon Singh to court

Simon Singh expected to arouse controversy when he claimed that chiropracters knowingly promoted bogus treatments for illnesses including asthma and ear infections. The bestselling author and Bafta-winning broadcaster did not, however, expect to have a High Court writ issued against him.

...

"It wasn't a decision taken lightly," says Dr Antoni Jakubowski, a member of the association's governing council. "I know that a lot of thought went into this."

Dr Jakubowski, whose patients have included the golfers Nick Faldo, Ian Woosnam and Justin Rose, adds: "It's a terrible shame he made those comments and he has been given a full opportunity to take them back. However, he hasn't."

...

"I will contest this action vigorously," says Singh, who was awarded an MBE in 2003 for services to science. "There is an important issue of freedom of speech at stake. Sadly, I cannot speak about it at this early stage because I have already engaged lawyers."
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I notice that the Torygraph article is carefully neutral about whether chiropractic actually works. The nearest to a comment on its merits it manages is that it is "a widely accepted treatment" for back pain.
 
Jack of kent said:
It was reported this morning that the British Chiropractic Association is suing Simon Singh, the well known science writer, about an article in The Guardian.
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Yes, it appears that the British Chiropractic Association is enraged that Simon Singh claimed in a Guardian Comment is Free article back in April that there was no evidence that chiropractic treatment is effective for children with non-musculoskeletal conditions. Full background to the story:
Doctors take Simon Singh to Court

Last Updated: 8:05PM BST 16 Aug 2008

Simon Singh expected to arouse controversy when he claimed that chiropracters knowingly promoted bogus treatments for illnesses including asthma and ear infections. The bestselling author and Bafta-winning broadcaster did not, however, expect to have a High Court writ issued against him.

Mandrake can disclose that the presenter of the Channel Four series The Code Book is being sued for libel by the British Chiropractic Association.
"It wasn't a decision taken lightly," says Dr Antoni Jakubowski, a member of the association's governing council. "I know that a lot of thought went into this."

Dr Jakubowski, whose patients have included the golfers Nick Faldo, Ian Woosnam and Justin Rose, adds: "It's a terrible shame he made those comments and he has been given a full opportunity to take them back. However, he hasn't."

The association has taken the unusual step of suing Singh himself rather than the newspaper that published his claims, The Guardian.
The article was about his recently published book Trick or Treatment? Alternative Medicine On Trial, in which he made various claims about the treatments offered by chiropracters.

Chiropractic is a therapeutic system based on the principle that the body can heal itself when the skeletal system is correctly aligned and the nervous system is functioning properly.

Once seen as a branch of complementary medicine, it has become an increasingly mainstream form of therapy and is now offered by many NHS trusts.

Although it has become a widely accepted treatment for acute pain and problems of the spine, such as whiplash, the evidence for applications beyond that is hotly debated.

There are ongoing studies into the usefulness of chiropractic for such problems as ear infections and infant colic and it is these which Singh was discussing in his contentious article.

Singh, who has a PhD in particle physics from Cambridge University, has written several bestselling books including Fermat's Last Theorem, which he turned into a Bafta Award-winning documentary for the BBC's Horizon programme.

"I will contest this action vigorously," says Singh, who was awarded an MBE in 2003 for services to science. "There is an important issue of freedom of speech at stake. Sadly, I cannot speak about it at this early stage because I have already engaged lawyers."

No doubt, the case will be followed closely by the practitioners of other much-maligned branches of alternative medicine, such as homeothapy, which has been trumpeted by the Prince of Wales.


http://www.telegraph.co.uk/news/newstopics/mandrake/2570744/Doctors-take-Simon-Singh-to-court.html
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Although I don’t have the original article, I’ve managed to cobble together the following excerpts from it. It wasn’t a long article, so there won’t be a great amount of text missing from between the paragraphs:
Beware the spinal trap

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.
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There’s also this from Jack of Kent which I’ve lifted from the UK Skeptics forum:
It would seem that the suit is being brought by the BCA in respect of an allegation made against them in the article. As a legal person (a company) it can maintain an action in defamation, though in my opinion such a representative body should not be able to do so (public authorities cannot sue for libel under the "Derbyshire Rule"). It would be quite fun if, by bringing this action, the BCA prompt the courts into extending this restriction to such bodies. The resulting gunshot wound to the foot may not be amenable to help by a chiropractor...

In any case, under Article 10 of the European Convention of Human Rights, there is a right to freeedom of speech. I suspect the courts, even if they do not extend the Derbyshire Rule to representative bodies like the BCA, will be loathe to restrict the freedom of speech of a scientist writing in a comment section of a quality newspaper about an important aspect of public health - that is, the treatment of children. It is exactly this sort of freedom of speech which Article 10 is there to protect.

http://www.skeptics.org.uk/forum/showthread.php?t=2707&page=2
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The story is also being covered by these blogs:

British chiropractors join the legal intimidation party
http://holfordwatch.info/2008/08/16/british-chiropractors-join-the-legal-intimidation-party/

Chiropractors try to silence Simon Singh
http://www.quackometer.net/blog/2008/08/chiropractors-try-to-silence-simon.html

Chiropractors sue Simon Singh – prefer legal action to evidence
http://gimpyblog.wordpress.com/2008...-simon-singh-prefer-legal-action-to-evidence/


And this is the original JREF thread which prompted this thread:

NZ Chiropractors vs NZ Medical Journal
http://www.internationalskeptics.com/forums/showthread.php?t=120817

Well worth a read.
 
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Blue Wode said:
There’s also this from Jack of Kent which I’ve lifted from the UK Skeptics forum:
It would seem that the suit is being brought by the BCA in respect of an allegation made against them in the article. As a legal person (a company) it can maintain an action in defamation, though in my opinion such a representative body should not be able to do so (public authorities cannot sue for libel under the "Derbyshire Rule"). It would be quite fun if, by bringing this action, the BCA prompt the courts into extending this restriction to such bodies. The resulting gunshot wound to the foot may not be amenable to help by a chiropractor...

In any case, under Article 10 of the European Convention of Human Rights, there is a right to freeedom of speech. I suspect the courts, even if they do not extend the Derbyshire Rule to representative bodies like the BCA, will be loathe to restrict the freedom of speech of a scientist writing in a comment section of a quality newspaper about an important aspect of public health - that is, the treatment of children. It is exactly this sort of freedom of speech which Article 10 is there to protect.
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Perhaps also relevant here is this story from Friday's Guardian: Labour warned over limits to free expression

UN report says terror and libel laws are interfering with human rights

The government has been accused of creating laws that have a chilling effect on freedom of expression in the UK in a sharply critical report from the United Nations' committee on human rights. The report calls for the reform of Britain's libel laws and controls introduced under recent terrorism laws.

...

Among the problems identified, the UN says:
...
· Libel laws should be reformed to end so-called "libel tourism", whereby wealthy foreigners have gone to the high court to sue over articles that would not warrant action in their own country.

...

The committee also warns that, in the age of the internet, Britain's unduly restrictive libel laws create the danger of affecting freedom of expression worldwide, contrary to a UN covenant on civil and political rights which guarantees the right to freedom of speech and to exchange ideas and information "regardless of borders".
...
The UK government has been urged to consider "a so-called 'public figure' exception", which would require a would-be claimant to prove actual malice by a publisher or author. This would apply in cases involving public officials and prominent public figures, as currently exists in the US, where a public figure can only sue for libel if he or she can demonstrate malice, recklessness or indifference to the truth.
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Unfortunately,
"libel lawyers in this country have remained insouciant to the deficiencies highlighted by the UN."
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Would a "public figure exception" include bodies such as the BCA?
 
Mojo said:
Would a "public figure exception" include bodies such as the BCA?
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Yeah, probably -it tends to attach to anything that is in the public interest IIRC.

I can't see anything in the original article which wouldn't be covered by justification(truth) or fair comment. The former may be harder to prove, but it certainly seems to tick all the boxes for the latter anyway - it's opinion based on true fact, malice isn't the motivating factor, and it's unquestionably in the public interest.

I genuinely can't see how they hope to win this, or even to come out of it looking good. I find the decision to issue a writ absolutely mystifying TBH.

Going for Singh directly, rather than issuing against the Guardian is a rather telling act though.
 
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I understand that the statement which the BCA claims to be defamatory is within the text quoted by Blue Wode.
 
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I heard about this a couple of weeks back but was sworn to secrecy. I think it will be a cause celebre, and will open a debate about evidence which the BCA thought it had won. It's not pleasant for Simon but he is very positive and well supported.
 
Rocko said:
Going for Singh directly, rather than issuing against the Guardian is a rather telling act though.
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Might it have something to do with the fact that the Grauniad has removed the offending article form its website?
 
Mojo said:
Might it have something to do with the fact that the Grauniad has removed the offending article form its website?
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I doubt it. The BCA will be wanting a retraction, ie an apology and statement that the article was wrong. Removing it won't do that. My guess is that they don't want to fight the Grauniad because it has money, and they do want to destroy Simon. It's personal.
 
Asolepius said:
I doubt it. The BCA will be wanting a retraction, ie an apology and statement that the article was wrong. Removing it won't do that. My guess is that they don't want to fight the Grauniad because it has money, and they do want to destroy Simon. It's personal.
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I agree.
 
The original article in its entirety (presumably it's OK to post it on a US forum):

Beware the spinal trap

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

• Simon Singh
• The Guardian,
• Saturday April 19 2008
• Article history

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? 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.

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 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.

I can confidently label these treatments as bogus 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 Professor 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.

Bearing all of this in mind, 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.


• Simon Singh is the co-author of Trick or Treatment? Alternative Medicine on Trial

www.simonsingh.net

About this article
This article appeared in the Guardian on Saturday April 19 2008 on p26 of the Comment & debate section. It was last updated at 00:06 on April 19 2008.
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http://svetlana14s.narod.ru/Simon_Singhs_silenced_paper.html

(With thanks to the person who posted the link in the comments section of the Quackometer's blog post)

ETA. Not sure if the long comments section will load properly.
 
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Thanks. I can't see how the BCA can claim that Singh misrepresents the evidence. Everyone of his claims seems to be backed up by peer-reviewed evidence or documents from the BCA website. Maybe they will argue that his interpretation of the evidence is wrong, but being wrong isn't the same as libel which is knowingly making a false claim.
Anyway, Singh is far ruder about chiropractors in his 'Trick or Treatment' book, so why haven't they sued over that? I think the personal revenge theory is credible at this stage.
 
Some Legal Pointers

As the claimant (new English legal term for "plaintiff") is the British Chiropractic Association, one must focus on the direct statement made about them.

The claim appears to be that of libel. In English law this usually means that the statement lowers the reputation of the claimant.

So it appears to me that the BCA must show that the statement made directly about them lowers their reputation.

Generally speaking, there are three defences to a libel suit:

1. The statement was made with privilege
2. The statement was a fair comment
3. The statement was one of fact which can be justified.

As an English media and communications lawyer, I am watching this case with keen interest.
 
Mojo said:
Perhaps they should be suing themselves.
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That thought crossed my mind!

This should not be a legal matter. The court is not the appropriate place to test claims of this kind.

It is always annoying when the Woos try and use "legal muscle" to close down debates and prevent scrutiny.
 
If there is anyone posting here who is in contact with Dr Singh (NoAm usage in calling someone with a PhD, a Doctor), can you see if there is a way of supporting him either financially or morally in this case?
 
Mojo said:
Might it have something to do with the fact that the Grauniad has removed the offending article form its website?
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Yeah, possibly - insofar as they may have said "take it down or we'll sue you". But given the article was published in their paper version and I don't think they've formally retracted/apologised for it, you'd really expect them to go for the publishers as well if they felt libelled. Either their reputation has been lowered or it hasn't, IYSWIM. Removal of an offending article instead of court proceedings might be applicable in cases of innocent dissemination, but that doesn't apply here.

It also makes me wonder how strong they actually think their case is.

As it stands, to me it just smacks either of a vendetta or done in the hope Singh will fold due to the personal nature of the threat.

Edit: Or, basically, what Asolepius and Jack of Kent said above. That'll teach me to leave replies half written whilst I pop out.
 
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Jack of kent said:
As an English media and communications lawyer, I am watching this case with keen interest.
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Cool - out of interest, what's your take on the logic behind this? Do you think they've got a case at all? I can't see they've a leg to stand on, personally, but this sounds like more your area than mine.

And what do you reckon are the chances this will actually make it to court?
 
It is good to see that there will finally be some kind of contest with profound results. It is sad that it will be a legal contest in which the best lawyers and expert witnesses can usually win. Unfortunately, only the legal pathway has the profound results.

Dr. Singh has my support and best wishes.
 
Rocko said:
Cool - out of interest, what's your take on the logic behind this? Do you think they've got a case at all? I can't see they've a leg to stand on, personally, but this sounds like more your area than mine.

And what do you reckon are the chances this will actually make it to court?
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I am sure they will say that not having a leg to stand on can be cured by skeletal massage! Everything else seems amenable to chiropractic...

The strength of a legal case is always difficult to assess from a newspaper report. If the BCA have external lawyers, one would presume that the claim form has been issued means that they think the case has some merits.

English libel law also favours the claimant. Once it has been established that the comment is defamatory (ie lowers the reputation of the claimant), it is for the defendant to show that a defence applies. This is expensive and complex. It is also very unfair. That is why charlatans and crooks often use English libel laws - Robert Maxwell, Jeffrey Archer, David Irving, Jonathan Aitken, etc.

As for whether this would go to court, from the newspaper report, it is really difficult to say. It seems a claim form has been issued. The next stage would be for a Defence to be served. It would appear this has not happened yet.

Once the parties set out their respective cases, then the case will either be withdrawn, settled, or go to court. However, few cases of any kind get to court - only about 1% of claim forms lead to trial dates.

One thing in English litigation is very different from US litigation. Over here, the loser has to pay both sides' legal costs. If this case goes to court then there will be a highly expensive legal bill for either Dr Singh or the BCA.

I will keep this thread updated with developments - and also on my own blog jackofkent DOT blogspot DOTcom (as a Newbie here, I can't embed the link!).
 
I am at the same time animated and worried by this development. Animated because, at last there will be public scrutiny of chiropractic, which has become embedded in the culture and widely accepted as main stream medicine - which it isn't. I am worried by what Jack says; the courts should be the place to test evidence, but when it comes to science they are not. Scientific evidence is routinely abused by lawyers, especially on matters of probability. Present company excepted of course Jack.
 
Rocko said:
As it stands, to me it just smacks either of a vendetta or done in the hope Singh will fold due to the personal nature of the threat.
QUOTE]

If the BCA or their lawyers are not very confident of a win, going after Singh rather than the newspaper has the advantage that if they lost, they wouldn't have a major media outlet which has been forced to prove that chiropractic practice is mostly woo.

If it doesn't go to court, I hope the reasons and any payments which are given in settlement are disclosed.
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Acleron said:
If the BCA or their lawyers are not very confident of a win, going after Singh rather than the newspaper has the advantage that if they lost, they wouldn't have a major media outlet which has been forced to prove that chiropractic practice is mostly woo.
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They may also have thought that, as a private individual rather than a national newspaper, he's less likely to be able to afford to defend the claim.
 
Asolepius said:
Scientific evidence is routinely abused by lawyers, especially on matters of probability. Present company excepted of course Jack.
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None taken! Any lawyer with the slightest grasp of science is off making a fortune in patent litigation!

I have long argued that (apart from in patent litigation) the Court room, with all the complex and counter-intuitive rules of evidence and procedure, is simply not an efficient forum for testing any scientific claims.

For example, most of the recent English miscarriages of justice have come down to the Court not properly asssessing scientific evidence.

A legal win for rationalism and skepticism is always a nice bonus (the Dover trial comes to mind), but such wins are sadly not inevitable.
 
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I honestly can't see what the case is about - has Singh actually said anything even slightly bordering on untrue?

From the BCA website:

BCA said:
As children grow, chiropractic can help not only with the strains caused by the rough and tumble of life but also with some of the problems that children can suffer in their first years:
Colic – sleeping and feeding problems – frequent ear infections – asthma – prolonged crying.
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Chiropractic techniques can help with colic, ear infections and asthma? Really? They'll be happy to produce the evidence then. Oh wait.....
 
Worm said:
I honestly can't see what the case is about - has Singh actually said anything even slightly bordering on untrue?

From the BCA website:


Chiropractic techniques can help with colic, ear infections and asthma? Really? They'll be happy to produce the evidence then. Oh wait.....
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The issue is what constitutes evidence. If you look hard enough you can find a crappy study somewhere in the world that looks positive. The courts are not interested in ethics, they only look at the letter of the law. The BCA's lawyer will argue that one single poor quality study is evidence, and Simon's lawyer will argue (presumably) that that's not how science works. It all depends on whether a judge can see the difference. That of course depends on getting a suitably experienced judge in the first place. A few years ago I took out an action against a business partner and the court scheduled it before a matrimonial judge!

But as Jack said earlier this is not very likely to get to court, although you always have to behave as if it will.
 
lionking said:
Truth is a pretty good defence. All power to Simon Singh's arm.
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BUt that depends on how you define "Knowingly"

They are performing potentialy dangerous procedures that are proveably ineffective at doing anything, but they might well not know or accept things like double blind trials.
 
ponderingturtle said:
BUt that depends on how you define "Knowingly"

They are performing potentialy dangerous procedures that are proveably ineffective at doing anything, but they might well not know or accept things like double blind trials.
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I don't think they are pretending to be that stupid. They will have an extremely hard time convincing any judge, however detached from reality, that they have never heard of a DB RCT. But I take your point in another sense. They will argue that their idea of evidence is perfectly reasonable so they are not `knowingly' promoting ineffective treatment. Again I think they are on a loser here as, if they try that in public, they will have to expose the poverty of their knowledge about medical research.
 
Asolepius said:
I don't think they are pretending to be that stupid. They will have an extremely hard time convincing any judge, however detached from reality, that they have never heard of a DB RCT. But I take your point in another sense. They will argue that their idea of evidence is perfectly reasonable so they are not `knowingly' promoting ineffective treatment. Again I think they are on a loser here as, if they try that in public, they will have to expose the poverty of their knowledge about medical research.
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That is possible, but if Singh has to prove in court that they are full of ****, then that could well be harder to prove.

As he has to prove what they know, it seems not unlikely that it could turn badly for him.
 
God forbid that they should appear ignorant as well as incompetent....
 
We are getting quite speculative here, especially as we don't know the details of the BCA claim. But they are forced to resort to the evidence issue. If they choose not to do that, and instead base the claim on whether they knew the evidence was bad, they abandon all credibility for their practice.
 
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