[bpsdb] As I write this, science writer Simon Singh is at the Royal Courts of Justice in London fighting his corner in the preliminary hearing of the British Chiropractic Association's libel case against him. Legal blogger Jack of Kent has been providing expert analysis of the case, and is at the court providing regular updates via his Twitter feed, @JackOfKent.

The BCA sued in response to allegations made in Singh's book, "Trick or Treatment" and in a Guardian article (since removed, but available on a Russian mirror) called "Beware the spinal trap". Singh criticised Chiropractors - and specifically the BCA - for making claims about the treatment that simply can't be backed up with any clinical evidence, while downplaying the risks involved with joint manipulation.

While I couldn't find the claims that Singh referred to on their website today, a PDF titled "What is Chiropractic?" contains some interesting quotes that illustrate the sort of thing that the BCA are attracting criticism for:

"Working on all the joints of the body, concentrating particularly on the spine, they use their hands to make often gentle, specific adjustments (the chiropractic word for manipulation) to improve the efficiency of the nervous system and release the body's natural healing ability. Chiropractic does not involve the use of any drugs or surgery."

"Improve the efficiency of the nervous system"? "release the natural healing ability"? These are terms that have pretty much no relation to medicine or biology. It's gobbledegook - marketing fluff like the "science part" in cosmetic ads. They also downplay the risks:

"Chiropractic has far fewer risks than many other treatments for your problem. Serious side effects are extremely uncommon and research shows that chiropractic is one of the safest and most effective forms of treatment available. Your BCA chiropractor will, of course, be happy to discuss all your concerns regarding treatment."

As Simon Singh retorted in the Guardian piece that got him sued:

"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."

Those effects are minor, but there have been far more serious consequences. Thrusting jounts beyond their normal range of motion may be fine for the majority of people, but for others it can result in dislocations or fractures. Manipulating the neck bones can damage the arteries leading to the brain, and cause stroke or death, as happened in the case of 20-year-old waitress Laurie Mathiason among others. Professor Edzard Erst has identifed hundreds of cases of serious complications 700 cases of serious complicationsin the medical literature.

The BCA feel that the comments made about them amount to "defamation". At the preliminary hearing today, the judge will look at the following questions, as reported by Jack of Kent:

- can the BCA actually show that they have been defamed?
- were the passages complained of in the original article "comment" or a statement of "fact"? Or both?
- what did the passages mean?

On the first point, the court will decide if the reputation of the BCA has actually been defamed. The latter points will determine whether Singh has to mount a "fair comment" or "justification" defence, or both. For more analysis of what this means, I'll again direct you to Jack of Kent's expert commentary.

It's also worth pointing out as Jack does that blogs reporting on this case are now liable under the Contempt of Court Act 1981. If you blog about this case and aren't careful, you could in theory face two years in prison.

On that note, I'll finish with one final comment: British laws on libel and contempt of court are absolutely ridiculous. Not only that, but the cost is insane. The Guardian noted recently after paying out £800,000 for Tesco's legal costs that it is 140 - yes, one hundred and forty - times more expensive to fight a libel case in London than the average for the rest of Europe. These figures defy belief, and they explain why it has never been easier to silence your critics.

Just how easy, we're about to find out.

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