Simon Singh has announced, with the support of Sense About Science, that he will fight on in the courts to defend his 2008 article about chiropractic. You can see the details here, along with a petition signed by a host of famous names that you add your name to. I've reproduced the statement and the first 100 signatures below. I'd like to add a few thoughts of my own (and apologies in advance for the Jim Hacker style hand-waving).
It is impossible to say which way the appeal will go. The odds are probably not good, and the process could take years as the incomparable legal blogger Jack of Kent has warned. There is every possibility that Simon will lose the legal case.
But there are many different kinds of victory and defeat. As a result of this court action and appeal, the reputations of the British Chiropractic Association specifically, and chiropractors in general, are being dragged through the mud. Chiropractors are complaining of receiving letters from angry people across the country. Mass complaints have been sent to Trading Standards and the ASA. The General Chiropractic Council have been deluged with complaints about their members. In short, the chiropractic profession in Britain is now under siege from an aggressive grass-roots campaign, and facing a public relations nightmare that the BCA have created for themselves. What must have looked at the time like a clever response to silence a skeptic has turned into a catastrophe, as their increasingly angry and desperate press releases appear to show.
Against this backdrop we have successfully framed this as a freedom-of-speech issue. All of the major newspapers are carrying stories about the appeal, and with the likes of Stephen Fry, Jonathan Ross, a cross-party group of MPs, many journalists and the entire scientific community behind this one hopes that this stream of publicity turns into a river and then a torrent. This is no longer about Simon Singh and the BCA, this is about the defense of fair criticism against censorship, of enlightenment against ignorance. It is about the freedom of you or I to stare a quack in the eye and say "your claim, sir, is bogus."
And that is no trivial matter, in an age when AIDS denialism in South Africa spread by our own crackpot colonialists is estimated to have cost upwards of 300,000 lives. The freedom to criticise claims is vital to a healthy democracy, and freedom itself is a right fiercely protected by the British people. In taking on freedom, the BCA have made a monumental error.
And it is up to us now to compound that error. That means doing more than just tossing a fiver into a pot, but going out and taking action. If you have a computer, and a spare hour this evening, find the website of a chiropractic, see if their claims fall foul of previous ASA rulings, and if so spend ten minutes writing an e-mail to Trading Standards and to the GCC asking them to take action. We should make sure that every bogus claim by every chiropractor is the subject of a complaint, and if we achieve that then we should go back to the beginning of the list and start again, and keep going until every last one has been appropriately sanctioned.
If we can do that, then regardless of the outcome of Singh's adventures in our legal system, he will be the winner.
----------------------------------------------------
The law has no place in scientific disputes
We the undersigned believe that it is inappropriate to use the English libel laws to silence critical discussion of medical practice and scientific evidence.
The British Chiropractic Association has sued Simon Singh for libel. The scientific community would have preferred that it had defended its position about chiropractic for various children's ailments through an open discussion of the peer reviewed medical literature or through debate in the mainstream media.
Singh holds that chiropractic treatments for asthma, ear infections and other infant conditions are not evidence-based. Where medical claims to cure or treat do not appear to be supported by evidence, we should be able to criticise assertions robustly and the public should have access to these views.
English libel law, though, can serve to punish this kind of scrutiny and can severely curtail the right to free speech on a matter of public interest. It is already widely recognised that the law is weighted heavily against writers: among other things, the costs are so high that few defendants can afford to make their case. The ease and success of bringing cases under the English law, including against overseas writers, has led to London being viewed as the "libel capital" of the world.
Freedom to criticise and question in strong terms and without malice is the cornerstone of scientific argument and debate, whether in peer-reviewed journals, on websites or in newspapers, which have a right of reply for complainants. However, the libel laws and cases such as BCA v Singh have a chilling effect, which deters scientists, journalists and science writers from engaging in important disputes about the evidential base supporting products and practices. The libel laws discourage argument and debate and merely encourage the use of the courts to silence critics.
The English law of libel has no place in scientific disputes about evidence; the BCA should discuss the evidence outside of a courtroom. Moreover, the BCA v Singh case shows a wider problem: we urgently need a full review of the way that English libel law affects discussions about scientific and medical evidence.
Signed
Click here to read additional comments from signatories
Everyone below signed as an individual unless otherwise stated
Science
Igor Aleksander FREng
Professor Emeritus in Neural Systems Engineering, Imperial College London
Professor Jim Al-Khalili OBE
Professor of Physics and of Public Engagement in Science, University of Surrey
Dr Sabine Bahn
Cambridge Centre for Neuropsychiatric Research, University of Cambridge
Harriet Ball
Voice of Young Science network
Professor Michael Baum MB FRCS ChM MD FRCR
Emeritus Professor of Surgery and Visiting Professor of Medical Humanities, University College London
Professor Jocelyn Bell Burnell FRS
University of Oxford and President, The Institute of Physics
Willem Betz
Emeritus Professor, Vrije Universiteit Brussel and Chair, SKEPP
Susan Blackmore
Visiting Professor, School of Psychology, University of Plymouth
Professor Colin Blakemore FRS
University of Oxford
Sir Tom Blundell FRS
University of Cambridge and President, The Biochemical Society
Dr Petra Boynton
University College London
Jean Bricmont
Professor of Theoretical Physics, University of Louvain and Honorary President, Association Francaise pour l'Information Scientifique
Tracey Brown
Managing Director, Sense About Science
Sir Iain Chalmers
Editor, The James Lind Library
Professor David Colquhoun FRS
University College London
Professor David Cope
Professor Brian Cox
University of Manchester
Dr Tim Crayford MB BS MSc FFPH FRSA
Former President, Association of Directors of Public Health
Professor Richard Dawkins FRS
University of Oxford
Professor Edzard Ernst MD PhD FRCP FRCP (Edin)
Peninsula Medical School, Exeter University
Dr Oliver Fenwick
Voice of Young Science Network
Professor Elizabeth Fisher FMedSci
Institute of Neurology, University College London
Dr Ron Fraser
Chief Executive, The Society for General Microbiology
Professor Christopher C French
Head, The Anomalistic Psychology Research Unit, Goldsmiths University and Editor, The Skeptic Magazine
Carlos Frenk
Ogden Professor of Fundamental Physics, Durham University
Diana Garnham
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John Garrow MD PhD FRCP FRCP (Edin)
Emeritus Professor of Clinical Nutrition, University of London and Former Chairman, HealthWatch
Professor David Gordon
President, Association of Medical Schools in Europe
Professor Trisha Greenhalgh
University College London
Professor Hugh Griffiths FREng
University College London and Chairman and on behalf of The Campaign for Science and Engineering in the UK
Dr John Haigh
Former Reader in Mathematics, University of Sussex
Kristoffer R Haug
Master of Science, Nanotechnology, University of Oslo
Professor Martin Humphries
University of Manchester and Chair, The Biochemical Society
Sir Tim Hunt FRS
Cancer Research UK
Sir Roland Jackson
Chief Executive, The British Science Association
Professor Steve Jones
University College London
Dr Stephen Keevil
King's College London
Professor Sir David King FRS
Former Chief Scientific Adviser to the UK Government and Director, Smith School of Enterprise and the Environment, University of Oxford
Dr Chris Kirk
Chief Executive, The Biochemical Society
Professor Sir Peter Lachmann FRS FMedSci
University of Cambridge and Founder President, Academy of Medical Sciences
Jennifer Lardge
Voice of Young Science network
Armand Leroi
Professor of Evolutionary Developmental Biology, Imperial College London
Dr Robin Lovell-Badge FRS FMedSci
MRC National Institute for Medical Research
Dr Daniella Muallem
Voice of Young Science network
Professor Dame Bridget Ogilvie FRS FMedSci
Former Director, Wellcome Trust
Professor Clive Orchard
University of Bristol and President, The Physiological Society
Professor Ole H Petersen CBE
University of Liverpool
Lord Rees of Ludlow
Professor of Cosmology and Astrophysics, University of Cambridge
Les Rose
Clinical Science Consultant
Dame Nancy Rothwell FRS
MRC Research Professor and President, Biosciences Federation
Wallace Sampson
Clinical Professor of Medicine, Stanford University
Alan Sokal
Professor of Physics, New York University and Professor of Mathematics, University College London
Professor Beda Stadler
University of Bern, Switzerland
John Stevens CSci FIBMS
President and on behalf of The Institute of Biomedical Science
Professor Ian Stewart FRS
Mathematician and Science Writer
Professor Raymond Tallis FMedSci
Emeritus Professor of Geriatric Medicine, University of Manchester
Lord Taverne
Chair, Sense About Science
Hazel Thornton
Independent Advocate for Quality in Research and Healthcare
Sir Mark Walport
Director, The Wellcome Trust
Professor Robin A Weiss FRS
University College London and President, The Society for General Microbiology
Tom Wells
Voice of Young Science network
Robin Wilson
Professor of Pure Mathematics, Open University
Richard Wiseman
Professor of the Public Understanding of Psychology, University of Hertfordshire and Author
Journalism and Publishing
David Aaronovitch
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Yasmin Alibhai-Brown
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Rosie Boycott
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Duncan Campbell
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Dr Philip Campbell
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Nick Cohen
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Clive Cookson
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Dr Richard Horton FRS FMedSci
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Alok Jha
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Rohit Jaggi
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Barry Karr
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Sam Lister
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Kenan Malik
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Dr Margaret McCartney
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Robin McKie
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George Monbiot
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Andrew Mueller
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Steven Novella
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Vivienne Parry
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John Rennie
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Nick Ross
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Ian Sample
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Andy Lewis
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Padraig Reidy
Index on Censorship
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Amardeo Sarma
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This statement has been sent to the Department for Culture Media and Sport, No 10 and the Department of Justice on Thursday 4th June and with every additional 1000 names we will be sending the statement again to Government until there is a commitment and a timetable from the parties for the necessary legislation. Next 1000 names here (these will be added as quickly as we can).
http://layscience.net/trackback/588
An excellent call to arms. *applause*
Thanks for the nice words.
I think your analysis of the wider situation is very interesting indeed.
But for now, take a deep breath, and slowly turn down the volume of the stirring John Williams theme music :-)
Yeah - I did think of embedding an MP3 into the page, but thought better of it :) I'm allowed to go off on one every few dozen posts!
Martin is the editor of layscience.net.
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Chiropractor, your claim is bogus. Simple. We can all say it, we should all say it.
Obviously I don't agree with the view that Chiropractic is bogus, however I would fight for Simon Singhs or anybody else’s right to say what they think about it. There are many chiropractors who agree with me, but would be afraid to say so publicly for fear of disciplinary retribution. "Bringing the chiropractic profession into disrepute" .
Having been on the receiving end of many threatening letters from the BCA and the GCC I have sympathy for Simon Singh. The GCC spent close to £100,000 trying to have postings removed from my blog and failed. The GCC chairman Peter Dixon was BCA president for four years, so dont expect too much from the GCC, its not fit for purpose, despite what the CHRE says.
We used to say those who cant do, teach. I suspect now they become politicians in associations and regulatory bodies, before moving onto the Houses of Parliament.
Singh wasn't making the claim that "Chiropractic is bogus". This is important - he was making a very specific claim, that use of Chiropratic was bogus to treat certain conditions.
"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."
And great article, Martin, a stirring read!
Thanks Martin, you saved me writing it myself for my site.
I signed the petition as soon as I heard about it, and I had no idea how well supported it would be. If I could meet half the people who are listed as signatories my life would be complete and I would die from pleasure overload.
I just hope it makes a difference, although my experience with the courts is that strict legal literalism can trump common sense and justice.
I agree with @RNB - we should approach a chiropractor every day and say "Your claim is bogus. Are you happy?".
Great article Martin,
...and a grand call to action
- when I first heard of the case I felt that usual pang of helplessness in the face of woo, but you have suggested a solid and practical way to help. I've just filed a claim with the ASA about this ad: http://www.clickchiropractors.co.uk/chiropractor363.asp which mentions whiplash and colic. I've also sent an email to the chiropractors which I include below in case it helps anyone as a template - I doubt it's perfect and so comments welcome on how I might improve future emails.
I also went out and bought Singh's back catalogue - including the excellent Trick or Treatment.
All the best
Tim
------
Dear Sir or Madam,
I write with concern at the descriptions of your services on the following website:
http://www.clickchiropractors.co.uk/chiropractor363.asp
They say that information they list is provided by the chiropractors and concerns should be taken up with them.
My concern is that the listing for your practice contains the following claims about whiplash and colic: (my emphasis)
"Conditions helped by the gentle McTimoney Chiropractic treatment include back, neck and shoulder pain, stiffness in joints and bones, migraine and tension headaches, muscular aches and pains, sciatica, whiplash and sports injuries.
Pregnant mothers, babies and children are especially welcome at our clinic. The McTimoney Chiropractic techniques can offer benefit to pregnant mothers, helping to keep the body aligned and relaxed during pregnancy, alleviating the discomforts and aches that occur during that time. Babies can be helped with conditions such as correcting misalignments created during birth, feeding problems, colic and continuous crying."
GCC guidelines state:
"[Chiropractors] may publicise their practices or permit another person to do so consistent with the law and the guidance issued by the Advertising Standards Authority."
However recent ASA rulings have specifically found that the promotion of chiropractic to treat whiplash and colic should be forbidden. I would ask that you ensure this listing is amended to ensure you are not contravening the GCC guidelines and promoting your services for these treatments.
The specific ASA rulings were:
BritChiro Clinics Ltd - 17th September 2008
"We instructed an independent expert to assess the evidence BritChiro submitted in support of the treatment of whiplash and arthritis. Our expert concluded however that the studies were not sufficient to support efficacy claims for either condition."
Dr. Carl Irwin and Associates - 20th May 2009
"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."
I sincerely hope that this listing is simply out of date and that you can amend it to remain in accord with the GCC guidelines. In the meantime I have submitted a complaint to the Advertising Standards Authority.
I look forward to your response,
Yours sincerely,
Tim Reid.
Headingly Chiropractic Clinic's web page (http://www.headchiro.com/techniques.aspx) suggests, among other things, that head massage can help with learning difficulties. I have made a complaint to the ASA.
Though I'm all for free speech, having been a chiropractic patient since I was 8 years old, and now a chiropractor myself I do find it disturbing that so many people seem to have such a problem with it - even though they've never experienced it.
The simple reason for the 'lack of evidence' is three-fold (in my opinion).
First, the majority of chiropractors just want to get on and help people get better, and just have no interest in doing all the boring number crunching that research needs in the allopathic style.
Second, it just costs too much money, and despite what you may think about the BCA, it has not got hundreds of thousands of pounds to throw around. Most medical trials cost millions - way more money than we have if we want to compete in the way allopathy wants.
Third - everyone is barking up the wrong tree. You have to ask the right questions, and know what you are actually investigating.
To those ends I refer everyone (sceptics, chiropractors, the BCA, Simon Singh) to one book which is 143 pages of scientific review.
The following is the basic outline, you will find hundreds of references to the pertinent literature in the book.
There is no controversy in the concept that spinal joints can have restricted motion and improper static and/or dynamic alignment. The problem has always been over if this type of lesion causes any physiologic disturbance. Now however, science is catching up with chiropractic (and for that matter osteopathic and Chinese medicine) in uncovering the importance of proprioception and proper somatosensory input. To cut a long story short – improper motion of any joint, but particularly the spine and especially the upper cervical spine do affect changes in neural pathways, into the cerebellum and then global physiology necessary to sustain optimal function.
Now I know that a lot of non-neurologists, and even some neurologists, will not be intimately familiar with the pathways, nor will they be aware of the body of peer reviewed scientific literature that supports this. There is also plenty of neurophysiology to get to grips with. Because there is so much to this it really is simpler for me to say – go buy a copy of the book - “The 14 Foundational Premises for the Scientific and Philosophical Validation of the Chiropractic Wellness Paradigm” by Dr Chestnut, read it cover to cover, and then, and only then, will you be in a position to argue for, or against chiropractic.
If you still wish to ‘debunk’ chiropractic without viewing all the valid research you are arguing from ignorance. Likewise, if you try and defend chiropractic with poor science based on allopathic type trials you are also living in ignorance.
The science is already there my friends, all you have to do is read it.
Chris,
Afraid I can't find a cheap copy of the book you mentioned online - don't really want to shell out $108 for it from Amazon.com marketplace, and it isn't in our university library. Do you have any links to the literature about the development of neural pathways? I study neural development so would be very interested in reading it. Lots of factors affect neural development; the problem people have with chiropractic is the claim that these changes in neural development then lead to certain disorders (or even diseases?), for which there is no evidence.
You say you are more concerned with helping people than with performing trials. While the desire to help is admirable, you have a duty to make sure the treatments you are selling do what they say on the tin, which is why clinical trials are absolutely crucial. Why are "allopathic" trials poor science?
@ Chris Pickard
I suspect that the reason that the majority of chiropractors “have no interest in doing all the boring number crunching that research needs in the allopathic style” is because they fear it would add to the unfavourable results that have already been produced by such valid research methods. For example, the most recent systematic review of systematic reviews of spinal manipulation (2006) concluded that there was no convincing evidence to suggest that it was a recommendable treatment option for any medical condition: http://www.jrsm.org/cgi/content/full/99/4/192
Similarly, the most recent systematic review of adverse effects of spinal manipulation, which was published the following year (2007), determined that a risk-benefit evaluation was unlikely to generate positive results: http://www.jrsm.org/cgi/content/full/100/7/330
Indeed, having taken a thorough look at all the available evidence on chiropractic, the following is what impartial scientists, Simon Singh and Edzard Ernst, propose (p.285) in their recent book, ‘Trick or Treatment? Alternative Medicine on Trial’, that all chiropractors be compelled by law to disclose to their patients prior to treatment:
Quote:
“WARNING: This treatment carries the risk of stroke or death if spinal manipulation is applied to the neck. Elsewhere on the spine, chiropractic therapy is relatively safe. It has shown some evidence of benefit in the treatment of back pain, but conventional treatments are usually equally effective and much cheaper. In the treatment of all other conditions, chiropractic therapy is ineffective except that it might act as a placebo.”
In view of the above, for you to say that “the majority of chiropractors just want to get on and help people get better, and just have no interest in doing all the boring number crunching that research needs in the allopathic style” is tantamount to admitting that despite the fact that the risk/benefit profile for spinal manipulation is largely negative, you, and other chiropractors, are quite happy not only to put patients' health at risk, but also to take their money for an intervention for which there are equally effective, cheaper, safer, and more convenient conventional options available. How ethical is that?
As for your claim that research “just costs too much money”, you seem to be forgetting that a massive amount of research has already been conducted by chiropractors. For example, in the September 2009 issue of Dynamic Chiropractic there’s an article on the Foundation for Chiropractic Evidence and Research (FCER) – an organisation that has decided on self-liquidation and filed for bankruptcy. In the article it states that:
Quote:
“Over the foundation’s history [more than 60 years], volunteers contributed more than 33,000 articles and helped fund over 152 randomized, controlled trials concerning chiropractic manipulation…”
http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=54144
Interestingly, as the FCER is closing down, the Foundation for Chiropractic Progress (FCP) has received approximately $650,000 in pledges to help with its mission “To increase the public awareness of the benefits of chiropractic”.
http://www.chiro.org/wordpress/?p=1151
If, as you say, chiropractic research “just costs too much money”, wouldn’t chiropractors be better channelling the FCP’s funds into research rather than marketing?
The bottom line here is that after more than 100 years most of the data are in for chiropractic, and apart from some evidence of short-lived pain relief in a sub-group of low back pain sufferers (i.e. relief which can be provided by other therapists who are more evidence-based), there is very little going for it, and a great deal going against it.
BTW, is this your wesite? http://www.thepainreliefcentres.co.uk/About_Us.asp
As I go through the book again, I'll take notes, and post updates.
Elsewhere on the spine, chiropractic therapy is relatively safe. It has shown some evidence of benefit in the treatment of back pain, but Education school conventional treatments are usually equally effective and much cheaper. Criminal Justice school | Computer Science school