Chiropractors call off the fight

We have been watching the legal battle between the science journalist Simon Singh and the British Chiropractic Association (BCA) for quite some time and it now appears that the show is over.

The libel case was brought against the journalist for his article in the Guardian newspaper, which described some chiropractic treatments as bogus. Rather than defend their claims to be able to treat specific childhood illnesses through spinal manipulation, the BCA chose to silence their critic. The ensuing case not only put the spotlight on dubious chiropractic treatments, it also demonstrated the need for reform in the English libel law system.

The BCA did not bring a case against the Guardian newspaper, nor did they face the allegations by accepting the Guardian’s invitation to publish a response to the article and show us the evidence to refute them (their later attempt to provide evidence was quickly torn apart as flawed, inadequate or irrelevant^1,2,3). They instead used the ridiculous English libel laws to threaten one individual with financial ruin. They were flexing their legal muscle and making an example of Simon Singh should anyone else have the audacity to express their doubts about chiropractic. In short: they were bullying.

Surprisingly, Simon Singh stood firm and defended his article. He received a tidal wave of support and also sparked a campaign to reform the English libel laws, which in their present form stifle free speech and open debate. The three major UK political parties now have the reform issue as part of their election manifestos.

Support also came from people whose course of action was to report many British chiropractors to the Advertising Standards Authority. The impact was evident in a letter issued by the McTimony Chiropractic Association, which urged its members to radically revise their web sites and advertising literature. Currently, one in four chiropractors in the UK are being investigated for misleading claims.

The original ruling in the case interpreted Singh’s use of the word bogus as meaning that chiropractors were complicit in providing therapies which they knew to be ineffective. That would have been a difficult position to defend, but the ruling was appealed and overturned, and the article was deemed to be fair comment and in the public interest.

This case and future reforms to the libel laws should allow scientists, writers and journalists the freedom to comment on unproven medical claims and expose those who advertise them. Without these freedoms, the public could be left unaware that what they are being sold as legitimate, medical treatments may actually have no proven benefit whatsoever.

On the 15th of April the BCA announced they were dropping the case. Simon Singh has lost financially and may never recover all of his costs in defending himself, but his hard work, dedication and sheer stubbornness has resulted in a win for us all.

References:
1) Chiropractic for paediatric conditions: substantial evidence? (BMJ 2009;339:b2766 )
2) A Review of The BCA’s Evidence for Chiropractic
3) The British Chiropractic Association Responds to Simon Singh

Further reading:
Simon Singh libel case dropped [The Guardian]
Chiropractors’ libel case dropped against Simon Singh [BBC]
Simon Singh wins libel battle against chiropractors [New Scientist]

Interpreting the bogus

The legal battle between the British Chiropractic Association (BCA) and the science writer Simon Singh slogs on. The BCA brought the libel case against Singh for his article in the Guardian which referred to certain chiropractic treatments as bogus (see Science misjudged).

It looks like a David and Goliath fight between the freelance journalist seeking the truth and the menacing power of an entire organisation with a lot of self interests to protect. One wouldn’t have blamed Singh if he had bowed out of the fight as soon as his mighty opponent entered the ring; this legal farce has probably cost him dearly and it is still ongoing. But the crowd is definitely on his side, cheering him on at every hook and jab, many of whom have given their support in a petition to see the English libel laws changed. One high-profile advocate is Richard Dawkins, who recently spoke at the Liberal Party conference in England calling for reforms to the law.

The latest turn of events came on the 14th of October at the Royal Courts of Justice, where Lord Justice Laws rejected the interpretation of Singh’s article by Mr Justice Eady. Eady’s interpretation was that Singh had alleged the chiropractors were knowingly practising treatments for which they knew there was no proof of efficacy. The new interpretation is that the article was fair and in the public interest, which now grants Simon Singh the right to appeal the earlier ruling.

It’s not over yet, but there is reason to be optimistic, not only for the diminutive science writer as he stands in the shadow of a mightier adversary, but for all who see this as a fight that should be fought in open debate, with good evidence as the gentlemanly weapons of choice.

Further reading:
[Times Online] Simon Singh legal victory
Jack of Kent’s blog
[The Guardian] Science writer Simon Singh wins ruling in chiropractic libel battle

Simon Singh interviewed

For those following the legal battle between the British Chiropractic Association and Simon Singh, you can hear more about it from Simon himself. In a recent interview on the Nature Podcast, he explains how this story goes beyond a personal legal case and that English libel laws are in need of reform. He argues that, as they stand, these laws present a serious threat to open scientific debate and free speech.

The interview is available for download here.

Chiro running for cover

The British Chiropractic Association (BCA) has opened up a whole can of worms and now chiropractors are struggling to contain the wriggly onslaught. By taking legal action against Simon Singh for what they call a libellous article in the Guardian newspaper, they have succeeded in attracting a very large and public spotlight onto themselves.

That was probably the last thing they wanted to happen. Their intention was most likely to silence an outspoken and respected scientist who doubted some of their claims, and thereby dissuade anybody else from having the audacity to do the same. Simon Singh and his supporters state that there is no scientific evidence for the efficacy of chiropractic spinal manipulation in treating certain disorders, such as colic and asthma. At great personal risk to himself, Simon is standing by this and will fight the case. As such, the BCA have succeeded in fanning the flames of criticism and invited even more bad publicity.

Chiropractors now have an unruly and hostile mob at their door, causing many to run for cover. The McTimoney Chiropractic Association (MCA) have called it a witch hunt, in a letter advising all their members to take urgent action and avoid the burn of the torch. On Saturday the Guardian newspaper published an article by Chris French, in which he discussed this letter and the so-called witch hunt. He reports how Witch-Hunter General Simon Perry took it upon himself to report UK chiropractors to their local trading standards offices, if they had claimed to be able to treat the specific disorders which Simon Singh referred to as bogus. In response to such pressure, MCA members are now being told to remove certain claims from their websites and other literature, so as not to risk prosecution in this campaign against them.

I came across this supposedly confidential letter from the MCA when it was first posted on the Quackometer website, but I had my doubts over its authenticity. It reads like someone whose home is on the battle lines, knowing it is just a matter of time before the place is razed to the ground and urging all inside to save themselves. If the letter is genuine, as it now appears, this is an indication that these people really are running scared.

(See also Richard Wiseman’s blog on “the missing study”)

Chiropractic under fire

Richard Brown is a chiropractor and vice-president of the British Chiropractic Association (BCA). As reported in my previous post, the BCA has taken legal action against Simon Singh for his article published in The Guardian newspaper, in which he referred to certain chiropractic treatments as “bogus” (original article was removed by The Guardian but is reproduced here). This has apparently brought some unwelcome attention upon the practice itself, and so, in its defence, Richard Brown has written an article in the New Scientist.

According to Brown, the view that spinal disorders are responsible for the majority of all diseases is an outmoded one that is held by only a minority of practitioners. Apparently most have debunked such claims, but if these modern day chiropractors are so good at debunking the old pseudo-science, why are there so many, including members of the BCA, who promote the use of therapies which are lacking scientific evidence for their efficacy, such as homoeopathy, reflexology and acupuncture (just check out their web sites)? If they want any credibility for their profession, they would do well to dissociate themselves from all treatments that do not qualify as evidence based medicine.

Brown also refers to “accepted medical interventions” which do not stand up to proper scientific scrutiny, as if this justifies leaving the back door open to every other unsubstantiated medical claim. Whatever those interventions are, they have no place in the realm of medicine. Similarly, if there are chiropractic treatments which do not show any therapeutic benefit in scientific trials, they also have no place in medicine.

His defence of chiropractic amounts to little more than stating that the practice does no harm. Apparently no deaths have ever been attributed to chiropractic in the UK, but this does leave you to wonder how many cases are reported outside of the UK and whether it is just a matter of time before one does occur within their shores.

To support the assertion that chiropractic causes no harm, Brown cites research whose findings suit his agenda, such as studies which reveal “no causative association between chiropractic manipulation and stroke”. He does not address the actual treatments labelled as bogus by Singh, such as those for colic, asthma and sleep disorders, but we can at least commend him for highlighting the appropriate mechanism by which that evidence may be found: rigorous scientific research. He should now continue reasoning like a scientist and apply the same method to the specific treatments referred to as bogus. If those criticisms were wrong, they certainly need correcting and I implore Richard Brown to go ahead and supply the evidence.

Science misjudged

Rather than showing evidence for their claims to be able to treat certain ailments, the British Chiropractic Association has instead taken legal action against Simon Singh for his article in The Guardian newspaper, in which he described specific chiropractic treatments as “bogus”.

In the preliminary hearing for this libel case against Simon, the judge’s interpretation was that Simon had not just called the treatments bogus, but that he was accusing the practitioners themselves of being dishonest by knowing of their inefficacy. Simon denies making such an implication, emphasising that his use of the word bogus referred only to the treatments.

Due to quirky English law, the onus is now on Simon to defend himself and show that what he had written was not libellous. If, as Simon says, there is no scientific evidence to suggest that these specific treatments do what they claim, it would be plain sailing through the court system, but unfortunately the judge’s interpretation makes his position much harder to defend. Simon Singh is therefore appealing against this judgement.

The story is being covered by reputable science journals, the mainstream media and it can be found across the blogosphere. Let me add my own voice to the rising crescendo of support for Simon, open scientific criticism and free debate.

To the British Chiropractic Association: Show us the scientific evidence for your claims (statistically valid, double blind medical trials performed under strict scientific conditions), not your legal might. If you have any credibility at all, that’s a good basis to start from.

You can follow this story as it develops, at Sense About Science.