A few days ago ‘Charles’ a chiropractor left quite an extensive comment on an post from a few months back about the Simon Singh case. Since his arguments are raised frequently I felt it would be useful to offer a response and I also decided that if I was going to compose a long response I might as well put it in a new post where it may be read (at least by someone).
So here is my response to Charles the chiropractor…
Today, Simon Singh announced that he will applying for “an oral reconsideration of his application for Permission to Appeal” after his initial application was turned down last week. For the one or two people who don’t already know; Simon is a science writer being sued by British chiropractors for an article he wrote in a newspaper over a year ago and he is asking to appeal because a judge decided in a preliminary hearing that his article meant something that he did not actually believe or intend to suggest and which makes his case very difficult to win.
I’ve been following this case since it started and I have to admit that when Simon’s initial appeal request was turned down last week, although it was somewhat predictable, it did rather dampen my spirits and lead me to reconsider whether the case was worth pursuing. It seemed to me that Simon had already done more than anyone could have been expected and it seemed like a waste to have such an excellent science writer have his time taken up by expensive legal proceedings that in all likelihood, because of the crazy UK libel laws, he would not win.
After reading Simon’s detailed explanation of why he believes this case is still worth fighting I have now completely changed my mind. If you haven’t read his explanation I suggest doing so now – the announcement is available here. It provides an excellent summary of what’s gone on and also a detailed breakdown on his reasons for fighting on and why he thinks it’s important that he continues. It also reveals that pursuing the case will not prevent Simon from carrying on his usual schedule or deprive the public of any new science books and he makes a very compelling case as to what he hopes fighting the case will achieve.
Simon Singh’s battle with the British Chiropractic Association all started over an article written for the Guardian over a year ago on 18th April 2008. Today, the article was republished on the Sense About Science website and across a whole host of magazines and blogs with the two alleged libellous sentences removed.
So I thought I’d contribute my own little bit of help by hosting it up here as well. So below is the original article that caused the whole fracas sans two sentences and if you just cannot live without seeing those immortal ‘allegedly libellous’ statements one more time then good old Jack-of-Kent has posted them up on his site. Enjoy…
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.
I suppose the first thing I should make clear is that the following post is my opinion, it does contain facts, but overall the post should be regarded as being mostly about my opinion of those facts rather than simply a collection of facts devoid of my personal opinions. As such I would think it constitutes commentary on a current event. I would normally think that such things go without saying but in light of today’s events I’m not so sure.
Today, I attended the preliminary hearing for the British Chiropractic Association (BCA) vs. Simon Singh case at the (discussed previously). This case is concerned with an article Singh wrote for the Guardian over a year ago and whether or not his comments in the article constitute libel against the BCA.
The specific paragraph that the BCA claim is based around is the following (and in particular the bolded phrases):
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.
Simon Singh is a British science journalist who aside from being a great populariser of science also happens to be the co-author of one of my favourite books ‘Trick or Treatment: Alternative Medicine on Trial‘. He is also currently being sued for libel by the British Chiropractic Association (BCA).
The BCA took exception not at his book, wherein he discussed chiropractic medicine at some length- it’s history, it’s clinical evidence and it’s problems- but at an article (and in particluar one paragraph) he wrote in April 2008 for the Guardian’s website (ironically titled ‘comment is free’). The article has since been removed from the Guardian’s website, however, a copy is now being hosted on a Russian server here (and it makes a good read!).
God knows what... 