The British Chiropractic Association is suing Dr Simon Singh for libel over an article in which he criticised the lack of evidence supporting chiropractic treatment of child asthma and other child ailments.
It is a central tenet of science that claims can be made freely but are taken seriously only when based on reproducible, testable, recorded evidence. In the case of medicine it is critically important that treatments are tested and studied for their efficacy. We do this so that we can prevent any dangerous therapies persisting, so we can focus on those treatments that are most effective, and that in turn, we protect resources from being exploited by those simply following unfounded ideas.
Dr Simon Singh, with Professor Edvard Ernst wrote a book called Trick or Treatment in which they considered the evidence for Acupuncture, Homeopathy, Chiropractic, and Herbal Medicine. It was a carefully researched book with impeccable methodology, openness and clarity. No-one produced any contrary evidence to the claim of the book that these alternative medicines were either ineffective or the same as placebo treatments. In the case of Chiropractic, Singh & Ernst said that the only situation in which it may be effective is in the alleviation of back pain but in that case, other forms of physiotherapy were likely to be more effective.
They also issued a detailed warning of the severe damage that can be caused by cervical manipulation, a twisting of the vertebrae in the neck, which is a popular chiropractic technique. They presented the clinical case study of a patient who suffered a rupture of a cervical artery leading to a stroke. It's a documented case.
A year ago, Simon Singh wrote an article for the Guardian newspaper criticising chiropractor claims of being able to treat child asthma and other ailments. Although the article has been removed by the Guardian because of the libel claim, you can read it here.
You will notice that every statement made has been backed up by evidence from a peer-reviewed source. He has even identified explicitly where he offers a personal opinion. That's the way of good science - if you are claiming something, you have to show either peer-reviewed evidence, or your own evidence.
Why does all this matter so much? Because the libel laws effectively reverse the burden of proof. In science, your claim doesn't get past the starting block until you show the evidence, explain how you obtained it, invite others to reproduce it, and subject it to open criticism. In libel, the accusation is an immediate gagging order, and in court you have to be able to show that you didn't imply what has been perceived as the meaning. In Singh's case, the word "bogus" was interpreted by a judge to mean "deliberately fraudulent", which incidentally was not what Singh said. Clearly the judge was none too literate.
So in science, the evidence is paramount. In libel, the interpretation of words by a judge is paramount and the accusers have all the force of law once a judge is found that agrees there "might" be a case.
These days, it would be hard to find any rational human being willing to go along with the claim that 95% of ailments are caused by a misalignment of the vertebrae but there are some chiropractors who believe this. That alone ought to bar them from medical practice of any kind.
If the chiropractors get their way, no-one will be able to write articles criticising their lack of evidence for their claims - because it will imply the accusation of fraud and they'll be slapped with a libel writ. But surely, it you are selling a treatment for which there is no evidence, as if there is you are at the very least behaving dishonestly. Even if you believe in your treatment, that's not enough. That's why we train doctors and examine them to make sure they understand evidence-based medicine. It's to protect us against fake cures, unreasonable claims, dangerous practices. Chiropractic has no peer-reviewed supporting evidence and therefore surely any claim that it works must be dishonest at the least, and possibly fraudulent. The best anyone can say is that "it might work" - and so might whistling... We can't leave scientific criticism subject to libel judgements!
You can do your bit to support Simon Singh by adding your name to the illustrious list of people who put rationality over nonsense therapies:
