Totally Bogus

I've blogged at some length in the past in support of Simon Singh against the strangely litigious, not-as-cuddly-as-you'd-expect-and-not-exactly-happy-to-debate-the-issues British Chiropractic Association so I won't retread all the same ground here.

Suffice to say that my t-shirt, with an extended definition of the word, 'bogus' arrived today and if you're similarly inclined you can get one here.

If you're wondering what the hell it is I'm going on about... there's plenty more reading on the subject and Sense About Science is as good a place as any to start.

Thanks Carl Irwin... whoever you are...

A comment from someone called Mojo on my last post (Chiro-bullies) pointed me in the direction of this ruling from the Advertising Standards Authority who have upheld a complaint against a chiropractic practice for, amongst other things, implying they could treat colic.

It's worth reading. Go on. Then come back.

The bit I find most interesting is this:

We considered that, whilst some of the studies indicated that further research was worth pursuing, in particular in relation to the chiropractic relief of colic, we had not seen robust clinical evidence to support the claim that chiropractic could treat IBS, colic and learning difficulties.

On these points the ad breached CAP Code clauses 3.1 (Substantiation), 7.1 (Truthfulness) and 50.1 (Health and Beauty Products and Therapies).

Now, I'm not a lawyer but surely this casts a really interesting light on the case currently being brought by the Britsh Chiropractic Association against Simon Singh.

I'm trying to keep my thoughts in order here... so I'm going to walk myself through this in baby steps... apologies if you're already familiar with the case and feel I'm just retreading old ground.

I'll start with a rough timeline of events...
1: The British Chiropractic Association produced a leaflet, Happy Families, in which it claimed chiropractic was an appropriate treatment for colic.

2: Simon Singh wrote about this and described the claim (alongside some others) as bogus. (A term he went on to define in the next paragraph.)

3: The BCA sued Simon Singh for libel contending, it seems, that the phrase "happily promoting bogus treatments" meant "knowingly promoting treatments they knew to be bogus". (I don't think that was SS's meaning at all... something I thought was clear from the way in which he defined his terms within the article.)

4: Justice Eady's ruling at the preliminary hearing means that the focus of the case is not whether or not the claims are true, but whether or not they were dishonestly made. (Oh dear.)

5: In the meantime - I'm not sure when - Carl Irwin & Associates (a chiropractic practice based in Edgware) have placed their advert in a magazine mentioning, amongst other things, colic.

6: Someone has complained about the advert and the ASA have upheld the complaint. Carl Irwin & Associates are not allowed to run the ad as it stands again and have been told (amongst other things) not to mention the treatment of colic in future ads.

This much, I believe we know. But I'll continue by offering a few of my thoughts about how this could affect things...
7: Having a complaint against you upheld by the ASA is not good for your business or its reputation.

8: The BCA is a professional body whose role is to look after the best interests of its members. It is not in the interests of its members to have the ASA rule against them.

9: In light of the ASA ruling, it seems to me that when the BCA produced the Happy Families leaflet they were in effect giving their members bad advice - however sincerely meant it was at the time. Surely the BCA should now make best efforts to correct it. I think the only responsible action would be to tell their members not to make such claims because they cannot be substantiated. This is the only responsible thing to do until there is new evidence that can substantiate such claims. To not do so would be to fail to act in the best interests of their members.

10: Which surely means that, even if they believed the claims made in the leaflet at the time, don't they now have to concede that the information was, dare I say it, bogus?

11: Which in turn makes their lawsuit against Simon Singh look, if nothing else, petty. Rather than suing him for - as they see it - calling them liars, they should be acknowledging that he was right - the claims are not substantiated - and offering him thanks for pointing out the falsehood of their well-intentioned but incorrect belief.

12: Had they seen Singh's point at the time, they could have corrected themselves earlier and offered better advice to their members earlier. By failing to do so and filing their libel action they were failing to act in their members' best interests. The longer their leaflet was out there promoting unsubstantiated claims - and even if the leaflet was withdrawn - the longer it remained uncorrected - the longer they were doing their members' a disservice.


I really don't see how they can fulfil their role of serving their members' best interests and not warn them against advertising their services as an appropriate treatment for colic, having previously suggested they could. To not do so would surely be to let their members - and their patients - down. How that can be squared with suing someone who simply tried to point out the fallacy of the claim is beyond me.

Chiro-Bullies

The Simon Singh meeting last night was strangely enjoyable. I say 'strangely' because while it obviously would have been far better if it hadn't been necessary the event was simultaneously informative, funny, heart-warming and energising. When a large crowd turns out for something like that, if nothing else, it confirms that you're not mad for thinking the way you do.

If you're interested there's a decent summary of the evening on the New Humanist website and the New Scientist piece ("there was a sense last night that we are at the start of something important") is good also. I was, inevitably, far and away the least informed of the speakers. Nick Cohen, Dr. Evan Harris MP. and Simon Singh were all fantastic in different ways. This really isn't about one case - Simon just happens to be the unfortunate soul at the centre of this particular whirlwind - there's a far wider issue at work and for freedom of speech to prevail both here and abroad it's obvious that Britain's libel laws need to be changed.

I'm tempted to write up everything I learned last night but it would turn into a 100,000 word dissertation if I'm not careful and there are bound to be far better sources of information out there for things like this. Suffice to say that when an Icelandic bank can bully a Danish newspaper into silence by using English courts something is clearly wrong with our system. Google the phrase 'libel tourism' if you really want to see how bad it is or read this article from the Times for a snapshot of the frankly embarrassing situation we're in.

Anyway... I don't think I expressed myself as clearly as I'd have liked last night and with the benefit of some sleep I thought it would be worth clarifying what I think about the situation in specific and general terms. (That said Jack of Kent remains the best source of information for this case - go and subscribe.)

Here's a thing. A couple of weeks ago I genuinely didn't know that chiropractic was a form of alternative medicine. I just thought it was another word for - or a distinct branch of - physiotherapy. I really did. I mean, they help your bad back by manipulating your bad back don't they? Don't they? If you've read America Unchained you'll know that my first director, Stef, was forced to leave the film because of a bad back. You'll also know that before her health forced her to leave, we were forced to take some not-really desirable detours so that she could visit a succession of chiropractors. Well at the time, I genuinely believed she was seeing what I would call 'proper-doctors.' I'm embarrassed by this gap in my knowledge.

Now I'm not suggesting that alternative therapy doesn't work at all. If it floats your boat that's great. My personal belief is that half an hour of kindness has a greater placebo effect than 7 minutes with your GP... and oddly, I reckon paying for it, increases the effect even more. But that's only really applicable to illnesses of the basic will-sort-themselves-out-eventually variety.

I think it's hugely concerning that the British Chiropractic Association produced a leaflet suggesting that chiropractic treatments were an appropriate way of dealing with colic or childhood asthma. I mean... if you're treating colic you're talking about treating babies. And if you're talking about manipulating the spine and/or joints of babies I think it's natural to be concerned. It makes me wince just thinking about the manipulation of a fully grown adult's, developed spine... but a baby's? Seriously? (Maybe there's some other chiropractic treatment that doesn't involve that sort of thing, in which case some clarification would be great. As would a new definition of chiropractic.)

Anyway, I only know about this leaflet having been produced (I believe it has since been withdrawn) because of this law suit and the attention it has brought to the case. If they hadn't sued Simon for libel, I wouldn't know anything about this. I'd still be under the more positive impression that they were 'proper-doctors-for-when-you-have-a-bad-back'. More fool them.

Of course there are other ways they could have reacted. Now, I'm not a doctor or a chiropractor or a baby so I don't know whether chiropractic offers a genuine treatment for these childhood complaints. I know what my gut instinct (and basic, layman's knowledge of how the body works) tells me... but putting that aside and entertaining both possibilities... here's how I think a reasonable organisation should behave:

1) If there is evidence for chiropractic being an effective treatment for colic and/or childhood asthma: Put the evidence forward and engage in a debate on the subject. No matter what side of the debate you fall on I can't honestly see an argument against this course of action. If you wholeheartedly believe that chiropractic offers an effective treatment how could you want less investigation of its efficacy? Who would possibly argue for less enquiry into something that involves manipulating babies' bones? More research = More information = Better treatment.

2) If the evidence suggests it isn't an effective treatment for colic and/or childhood asthma: Then surely you have to withdraw the leaflet and apologise. When a supermarket sells something that has the potential to be dangerous - say, a faulty kettle - they don't just stop selling it, they also make best efforts to ensure that anyone who's bought one returns it. This normally involves some pretty big adverts in national newspapers. If I was responsible for advertising a medical treatment that I later realised wasn't proven and could be dangerous I'd feel a huge responsibility to publicise and correct any misinformation that might be out there.

As far as I know, the BCA haven't taken either of these steps. (As I said above, I believe that the leaflet has been withdrawn but I have no idea if that is as a consequence of anything having been written about it or for some other reason.)

What they have done is sue a science writer who wrote an article offering his opinion on such practices. In doing so, they don't just intimidate one man, the message they send is that they do not welcome critical investigation of what they do. Which seems ridiculous to me because a) critical investigation of things is how science and medicine move forward and b) surely anything relating to medical treatment - especially treatment of children - should be open to scrutiny as a matter of public interest.

Who are chiropractors? What do you think they think? I imagine them to largely be of the caring, woolly, liberal type. (All adjectives I'd be happy to carry myself.) I think that's certainly the image they would choose to project. Which, to me, makes the BCA's decision to sue for defamation a mistake. It has changed the way I feel not just about what they do but also who they are.

No matter what you think about chiropractic, whether you dismiss the entirety of it as hogwash, believe it can sort out your bad back or believe it can cure 95% of illnesses in men, women and children alike, I simply can't see an argument for trying to silence its critics. It seems to me that an organisation that would best represent its members by encouraging debate has done them all a huge disservice by instead resorting to libel law; the blunt weapon of the bully.






EDIT: to add that Nick Cohen has since blogged on the subject also:
http://nickcohen.net/2009/05/20/simon-singh-and-the-battle-for-free-speech/