British Chiropractic Association v Simon Singh

[shuttlt]

Why? The libel case isn't about whether chiropractic is true or not. Surely so long as he didn't claim that the BCA knowingly promoted stuff that didn't work, he'd be fine. It's a bit of a waste fo a writer to go through an experience like this and not turn it into a book.

[Blue Wode]

Lifted from Simon Singh’s latest e-newsletter (not yet online at http://www.simonsingh.net):

Quote:

Newsletter 35
Festival of Ideas
12 July, 2009


1. Application to Appeal
2. Heading Down Under

1. Application to Appeal

Unlike recent newsletters, I will try to avoid filling this one with lots of tedious legal details. However, I will mention that the Application to Appeal has been lodged and I am now waiting for the result. For more news and information about my libel case, you can visit the Sense About Science website or follow any of the insightful and entertaining bloggers who are covering the subject. The most recent media coverage was in the Daily Mail and there is also an interview I gave to the Nature podcast.
http://www.guardian.co.uk/science/20...-bca-mca-singh
http://www.dailymail.co.uk/debate/ar...ee-speech.html
http://nature.edgeboss.net/download/...29.mp3?ewk13=1

Most important of all (if you have not done it already), please sign and support the libel reform campaign and encourage others to join the list of 15,000 names.
http://www.senseaboutscience.org.uk/...e/project/333/


2. Heading Down Under

I am currently in Adelaide, where I am taking part in the Festival of Ideas. I have already spoken at a couple of events, and have two more to come on Sunday. You can find out more details at the festival website or my website. I am also giving a talk on Tuesday in Adelaide about risk and probability, which is an event sponsored by the Royal Institution of Australia. I will also be speaking in Sydney on July 15.
http://www.simonsingh.com/Simon_Lectures.php
http://www.adelaidefestivalofideas.com.au/
http://riskprobabilityandgambling.eventbrite.com/
http://skeptics.meetup.com/163/calendar/10746110/

[Blue Wode]

The latest from Jack of Kent:

Why BCA v Singh Matters To Me
http://jackofkent.blogspot.com/2009/...ers-to-me.html

[Blue Wode]

With Simon Singh visiting Adelaide and Sydney at the moment, it’s worth bearing in mind that back in October 2008 the Australian Medical Association warned against child chiropractic care:

Quote:

“Parents are wasting money on unnecessary chiropractic care for young children which is not achieving any medical result, says the Australian Medical Association (AMA). Early chiropractic treatment for children under 10 is "quite inappropriate", says AMA state president Peter Ford, because there is no medical evidence to suggest it works. Dr Ford urged parents concerned about their child's spine to consult a doctor or pediatrician and, if necessary, a specialist.”

More…
http://www.news.com.au/adelaidenow/s...8-2682,00.html

And a few months before that, the Chiropractors’ Registration Board of Victoria (Australia) proposed new chiropractic standards “that attacked core beliefs and practices of subluxation-based chiropractic”:

Quote:

“The draft document, which is intended to apply to children up to the age of about 13, states that "Non-indicated, unreliable and invalid diagnostic tools, instruments or methods and unnecessary diagnostic imaging procedures are to be avoided." It specifies:

(1) Routine radiographic examination and re-examination of pediatric patients is not recommended without clear clinical justification. X-ray examinations should not be performed solely for the detection of biomechanical disorders of the spine, such as vertebral subluxations, postural analysis or for the monitoring of spinal curves or posture, unless for monitoring progressive scoliosis;
(2) The use of . . . surface electromyography (SEMG) or thermography, is not considered appropriate in the diagnosis of childhood conditions;
(3) There is currently an overwhelming lack of good quality scientific evidence to support the use of spinal manipulation in the treatment of most "Type O" conditions. "Type O" stands for organic/visceral disorders (diseases) as opposed to "type M" (musculoskeletal/biomechanical disorders).

SEMG and thermography have no legitimate diagnostic value, but many subluxation-based chiropractors use them to sell patients long courses of unnecessary treatment.”

http://www.ncahf.org/digest09/09-05.html

[AndyD]

Vaguely related...

Another article covering Singh's "Trick or treatment" talk in Sydney.

Quote:

Alternative medicine on trial

Alternative medicine will be put on trial when leading UK science commentator and best-selling author Dr Simon Singh speaks at Sydney Ideas this Wednesday.

In his University of Sydney lecture titled, "Trick or Treatment? Alternative Medicine on Trial", Dr Singh will explore the claims made by practitioners of alternative medicines such as homeopathy, acupuncture and herbal remedies and will attempt to separate fact from myth.....

[Blue Wode]

Thanks to a member of ASKE, the full text of the science and libel articles in the latest issue of the British Medical Journal (BMJ) which addressed the BCA/Singh affair can now be found online here:
http://musicweaver.users.btopenworld...e-articles.htm

They include the pieces by Fiona Godlee (BMJ Editor), Richard Brown (Vice-President of the BCA), and Professor Edzard Ernst.

ETA -

Former UK chiropractor: "...readers of the Quackometer blog are more aware of the hole Tony Metcalfe and Richard Browne are digging for the chiropractic profession than BCA members". See here:
http://chiropracticlive.com/chiropra...te-bca-v-sing/

[BillyJoe]

Originally Posted by AndyD

Another article covering Singh's "Trick or treatment" talk in Sydney.
Alternative medicine on trial

The article is surrounded by ads for altMed quackery.

[Blue Wode]

Via Dr*T at Thinking Is Dangerous blogspot this morning:

Quote:

According to a letter shown to this blog, the General Chiropractic Council has written to complainants and chiropractors saying that it can not cope with the number of complaints it has received (590 last month compared with 40 per year).

The GCC have stated that

Quote:

it will be necessary to increase our regulatory staff capacity before we issue formal notification of any complaints relating to chiropractic websites

The lack of staff will delay the commencement of the formal process until September 2009. The increase in complaints was due to the British Chiropractic Association's attempt to silence criticism about claims for chiropractic being an evidence-free zone.

If the BCA had been a bit less foolish, it could have avoided this whole debacle, but it appears that it was spoiling for a fight, and is looking pretty groggy.

http://thinking-is-dangerous.blogspo...unable-to.html

[AndyD]

Quote:

Former UK chiropractor: "...readers of the Quackometer blog are more aware of the hole Tony Metcalfe and Richard Browne are digging for the chiropractic profession than BCA members". See here:
http://chiropracticlive.com/chiropra...te-bca-v-sing/

Lanigan's blog is an interesting mix. I really don't know what to make of it.

He appears to be enjoying the skeptical attacks on his profession, posting some blog articles verbatim as he did here, apparently because he has a bone to pick with the regulators and I guess he sees these skeptical attacks as a vidication of his doubts about those who rule over his colleagues. But he also appears to be among those very chiropractors the skeptics are most concerned about.

In this article, he seems to equate vitalistic chiropractic with religion, essentially arguing that if the patient has faith in it, then it works.

Meanwhile some commenters on that same post seem to dismiss McTimoney as unworthy of being called chiropractic - apparently not sharing the view that "if the patient has faith in it, then it works" - but not necessarily realising their own hypocrisy.

[AndyD]

Quote:

Via Dr*T at Thinking Is Dangerous blogspot this morning:

The Quackometer has more on the GCC's back-breaking overload.

[Blue Wode]

Originally Posted by AndyD

The Quackometer has more on the GCC's back-breaking overload.

Interesting to read in that link that lecanardnoir has complained about four officers of the BCA for misrepresenting evidence:

Quote:

The GCC Indicative Sanctions Guidance notes for the Professional Conduct Committee suggests that misrepresenting evidence is not looked kindly upon:

Quote:

This term is used to describe a range of misconduct from presenting misleading information in publications to dishonesty in clinical trials. Such behaviour undermines the trust that both the public and the profession have in chiropractic as a science, regardless of whether this leads to direct harm of patients. Because it has the potential to have far reaching consequences, this type of dishonesty is particularly serious.

[AndyD]

Quote:

Interesting to read in that link that lecanardnoir has complained about four officers of the BCA for misrepresenting evidence:

Yes. This comes, I understand, after Ernst's "demolition" of the plethora in BMJ where he suggested that the BCA "apparently knew" about contrary evidence not included in their list...

Quote:

The omissions are all the more curious as the association apparently knew of these articles. The association commented on our review that was based on this research, and the articles were part of Hawk et al’s review cited in the association’s list of evidence.

Ernst (BMJ)

Based on this, Le Canard thought it warranted its own complaint. As I understand it.


EDIT: forget it. No edit now.

[BillyJoe]

Chiropractic does not cure or treat, it merely helps

This blog shows some changes being made to the wording on some chiropractic websites...

http://thinking-is-dangerous.blogspo...actic-has.html

The new wording is in bold and old wording in brackets.
We start with the title and then a section on period pain (dysmenorrhea):

Quote:

Chiropractic has never cured anyone of anything.

Quote:

When helping (treating) women who suffer from dysmenorrhea, the majority of chiropractors address only problems located in the areas directly involved in causing the symptoms. In a study conducted to establish which styles of Chiropractic care (treatments) are most frequently used by chiropractors for dysmenorrhea, manipulation was used in 100% of the cases.

Quote:

A chiropractor’s role is to normalise the functions of the body by correcting spinal problems. The rationale behind the chiropractic management (treatment) of women suffering from dysmenorrhea is to deal with (treat) its spinal and skeletal aspect.

Chiropractic provides the mechanisms through which dysmenorrheic women can be relieved of their pain in a drug-free environment and even go on to live a life free of period pain.

So, chiropractic helps the body heal itself?
What will they do when they realise that that claim cannot stand up to scrutiny any better than their original claim?

BJ

[Rolfe]

That first bolded sentence is a bit of a facer!

Well, everything "helps the body heal itself" when you really get down to it. Nothing works on a corpse! So I don't see what's so different about this set of claims. Oh, it doesn't cure and it doesn't treat, but then they talk about relieving pain and living lives almost pain-free? What's that but a claim to treat or cure, just dressed up different?

Rolfe.

[BenBurch]

Rolfe,

I don't EVEN think chiropractic does anything at all other than prolong lower back pain.

-Ben

[shuttlt]

This is just a retread of what Palmers son did at the beginning of the 20th century. Chiropractors were getting taken to court all over the US for practicisng medicine without a license. The whole 'we don't treat disease, we help the body heal itself' explanation was cooked up at that time as a defence strategy.

[BillyJoe]

The point is that, if clincal trials show that chiropractic makes no difference, it doesn't matter whether they call it "curing", "treating", "managing", "dealing with", or "helping".
If chiropractic makes no difference, it makes no difference. Period.

[BenBurch]

I think a careful, fully-controlled trial would show that universally they act to prolong and worsen many things, and have the exact same effect as placebo on many others.

Chiropractic needs to be made illegal.

[BillyJoe]

Quote:

Chiropractic has never cured anyone of anything. If we go looking for the named condition that Chiropractic can be applied to and produce change in we will find ourselves in a merry-go-round of symptoms, loosing sight of the whole because of an obsession with the parts. So the question of What can Chiropractic Cure should be changed to "How" can Chiropractic Assist? The answer is simple. A well functioning mind and body has a greater opportunity to heal, repair and function than a poorly functioning one. A well functioning mind and body depends to a significant degree on a well functioning spine and nerve system. This is Chiropractic's contribution. People find that chiropractic's ability to produce better spine and nerve system function changes their life expression. There are thousands of symptoms and conditions that chiropractic has been associated with helping, however don't ask "Can Chiropractic Cure this or that condition" - instead ask "If my mind and body was functioning better through Chiropractic would I be better placed to handle this condition?"

But, if the evidence is that chiropractic doesn't make a difference, this change in thinking about what chiropractic does, or how it is supposed to work, or how it is supposed to help, makes no difference either.
Forget about mechanism, if it doesn't work, it doesn't work.

[Blue Wode]

Quote:

Chiropractic has never cured anyone of anything. If we go looking for the named condition that Chiropractic can be applied to and produce change in we will find ourselves in a merry-go-round of symptoms, loosing sight of the whole because of an obsession with the parts. So the question of What can Chiropractic Cure should be changed to "How" can Chiropractic Assist? The answer is simple. A well functioning mind and body has a greater opportunity to heal, repair and function than a poorly functioning one. A well functioning mind and body depends to a significant degree on a well functioning spine and nerve system. This is Chiropractic's contribution. People find that chiropractic's ability to produce better spine and nerve system function changes their life expression. There are thousands of symptoms and conditions that chiropractic has been associated with helping, however don't ask "Can Chiropractic Cure this or that condition" - instead ask "If my mind and body was functioning better through Chiropractic would I be better placed to handle this condition?"

If the above were true, then you'd expect chiropractors' longevity to be on a par with (at the very least) that of the general population. Sadly, however, this 2004 survey found that the mean ages at death of chiropractors was below the national average of 76.9 years, and below their medical doctor counterparts of 81.5 years:
http://www.jcca-online.org/client/cc...3-P217-224.pdf

[Rolfe]

Yes, but how do you tell the best hairdresser in town? The one with the worst haircut! You can't do chiropractic manipulation on yourself.

It's a thought. I wonder what the uptake of chiropractic care is among chiropractors themselves? Do they all go to a colleague for that regular maintenance treatment they tout to their patients?

Enquiring minds want to know.

Rolfe.

[Blue Wode]

Originally Posted by Rolfe

You can't do chiropractic manipulation on yourself.

Apparently you can:

Quote:

"...self adjusting is demonstrated in the video/DVD for the single person..."

Do-it-yourself Chiropractic Care
http://www.home-chiropractic.com/

Bearing in mind that chiropractors are prone to cultish behaviour, I'm in agreement with this:

Quote:

If anyone benefits from living the “chiropractic lifestyle” it should be chiropractors themselves. Who else would be the best living examples
of the health and longevity benefits of chiropractic care if not chiropractors themselves?

http://www.jcca-online.org/client/cc...3-P217-224.pdf

[shuttlt]

Originally Posted by BillyJoe

Forget about mechanism, if it doesn't work, it doesn't work.

It occurs to me that if you could pin vitalists down to what it means in practical terms for a technique to work, or not work in a vitalist context it would be a very great improvement.

[Blue Wode]

David Colquhoun comments on the BMJ's recent editorial and articles on the BCA v. Singh case:

Quote:

We are dealing with fantasists. Worse still, we are dealing with fantasists whose income depends on defending their fantasies. You can point out to your heart’s content that “subluxations” are figment of the chiropractors’ imagination, but they don’t give a damn. They aren’t interested in what’s true and what isn’t.

More...
http://www.dcscience.net/?p=1882

[BillyJoe]

BW,

That interesting link sent me off on interesting link after interesting link so that it was only by luck that I found my way back again through cyberspace to where it all started with that interesting link.

BTW, thanks for sending the info from the BMJ a week or so ago. That also sent me off on an interesting journey through cyberspace though, on that occasion, I never found my way back to the source, hence this (I was going to say belated, but I hate that world for some reason) thank-you note.

BJ

[AndyD]

David asks in his comments which parts the BMJ lawyers might find libelous. I can't comment on his blog but I'd assume...

Quote:

You can point out to your heart’s content that “subluxations” are figment of the chiropractors’ imagination, but they don’t give a damn. They aren’t interested in what’s true and what isn’t.

...could be construed as a statement of fact.

But then, I'm not a lawyer and since it doesn't target an individual or specific organisation, perhaps it can't be defamatory.

[Blue Wode]

Fiona Godlee, editor of the BMJ, has now allowed free access to the relevant articles and responses covering the libel case:
http://www.bmj.com/cgi/content/full/339/jul08_4/b2766

[Mojo]

OT: I see Milgrom has replied, and is now accusing Shang et al of cherry-picking. Perhaps he hasn't seen the comprehensive rebuttal of this accusation Paul Wilson published in homeopathy.

/OT

[Blue Wode]

Lionel Milgrom has had a third response published today, along with responses from David Colquhoun and Edzard Ernst:
http://www.bmj.com/cgi/eletters/339/...4/b2783#216881

Unfortunately, the BMJ's lawyers have censored parts of DC's response, but your can compare the altered response with his original one here:
http://www.dcscience.net/?p=1882

[Mojo]

Lionel has now fulfilled Godwin's law:

Originally Posted by Lionel Milgrom

Indeed, ten years later, voices were raised within the nursing profession concerning EBM’s intolerance of therapeutic pluralism in healthcare systems [5]

...

5. Holmes D, Murray SJ, Perron A, Rail G. Deconstructing the evidence- based discourse in health sciences: Truth, power, and fascism. International Journal of Evidence Based Healthcare 2006;4:180.

[Pipirr]

That Holmes paper was the reason I originally signed up on the JREF forum. Randi had mentioned it in the commentary.

You know, there is a good case to be made for moving away from EBM...

[Pipirr]

A little more on the fallout from the BCA libel case.

Nick Cohen argues in The Observer that UK libel laws have effectively silenced UK academics that could expose financial shenanigans in the City.

Quote:

But they are not going to speak out for a reason readers of this column will guess: Johnson and his colleagues fear being hauled before the libel courts. Academics have noted the willingness of the judiciary to allow believers in "alternative" chiropractic therapy to sue science writer Simon Singh, and can imagine all too graphically what would happen to them. Chiropractors are small-time operators working from suburban offices, one said. Bankers have the most expensive lawyers in the City on call. If his colleagues were to hint that a bank was risking its investors' money, they would be hammered.

[BillyJoe]

The following is an explanation of the situation described in that article (as summarised in above quote):

Quote:

the average British judge does not believe that free debate in the marketplace of the mind will expose "wrong opinions and practices". He believes they must be suppressed because he retains the fear of the old European aristocracy that the masses cannot see through dangerous ideas and bad arguments. To speak plainly, if I may, the judiciary has an elite suspicion of democracy and the price of its elitism is becoming too high for this impoverished country to bear.

The judiciary is killing free speech which is the central tenet of democracy.

[Blue Wode]

Warning: The spin in the quote below might make you giddy…

Lifted from page 10 of the World Federation of Chiropractic’s Quarterly Report (June 2009):

Quote:

The BCA, accused of being deliberately dishonest, sued for libel and won in a High Court ruling on May 7, 2009. However, the BCA is not doing as well in the court of public opinion, where Singh and supporters are establishing the perception that the BCA is trying to block scientific debate through legal action.

As a result multiple complaints have been laid against chiropractors with the General Chiropractic Council for breach of its standards on advertising relative to information appearing on websites of BCA members.

Good luck to the BCA as it continues to confront resourceful opponents while it seeks to promote chiropractic on a level playing field with the medical profession. This means, for example, that controlled trials remain the gold standard in research but are not a prerequisite for medical, chiropractic or other health care practice—the great majority of which is not supported by good controlled trial evidence.

http://www.wfc.org/Website/wfc/Graph...QWR%20June.pdf

Other interesting snippets -

From p.4

Quote:

Invited experts Briggance, Branson and Hawk asked what Bram Briggance PhD from California called the one big question from the point of view of all other stakeholders in national healthcare systems – “what is the value of chiropractic?”

The answer given, the core value of chiropractic, was conservative, cost-effective, *patient-approved* spine care.

No mention of evidence-based care.

From p.6:

Quote:

WFC Honor Awards for outstanding lifetime contributions to the international growth of the chiropractic profession went to Dr. David Cassidy of Toronto, one of the profession’s leading researchers, and to Dr. Arlan Fuhr, President of Activator Methods, for his contributions to the fields of both chiropractic technique and clinical research.

Interestingly, David Cassidy’s integrity was recently called into question by a chiropractic victim's mother, Sharon Mathiason. It's worth a read:
http://www.chirowatch.com/Chiro-stro...120stroke.html

There's more criticism of Cassidy’s research methods here,
http://www.sciencebasedmedicine.org/?p=170

and a critique of Activator methods here:
http://www.chirobase.org/06DD/activator.html

[Blue Wode]

Zeno on "The somewhat muted support for the BCA by the World Federation of Chiropractic":
http://www.zenosblog.com/2009/07/som...-by-world.html

[Deetee]

Nothing to add except my encouragement, and the desire to see this thread outstrip the evolution thread in responses, so it now ranks as #1!

[ponderingturtle]

I don't think it goes by number of replies though, but latest reply.

[Blue Wode]

BCA Vice-President, Richard Brown, responds to Edzard Ernst in the BMJ today:
http://www.bmj.com/cgi/eletters/339/...4/b2766#217334

[volatile]

Why is he still repeating the "We weren't allowed to reply in the Guardian" line?

[Lothian]

He says "The BCA .... supports high quality research which objectively informs and evolves the evidence base and would exhort chiropractors to modify their practices where conclusive evidence demonstrates ineffectiveness or a real risk of serious adverse events. "

Can he explain why high quality evidence demonstrates ineffectiveness was not passed to the court. Perhaps their support is theoretical and not practical.