Simon Singh and the British Chiropractic Association

Simon Singh is a science writer in London, England and co-author Trick or Treatment? Alternative Medicine on Trial. Singh published an article in The Guardian newspaper that exposed the fraudulent claims of the British Chiropractic Association (BCA) that chiropractic can be used to cure anything, including common childhood illnesses such as colic, ear infections, and asthma. The BCA is now suing Singh for libel.

The libel laws in England are much different than in Canada and the U.S. (and much stupider). There, the burden of proof is on the defendants to prove that their statements are true, rather than on the accuser to prove that they are false (in this case, the BCA does not have to prove that chiropractic can cure anything). The result of this, sadly, is the muzzling of authors, journalists, and speakers, and the restriction of their free speech unless they have the money to defend themselves in costly libel law suits.

The English libel laws are so sad that a phrase has been coined—“libel tourism”—which describes how individuals and corporations take their libel law suits to England to take advantage of their lax libel laws. No matter who you are or where you’ve published, someone can arrange to sue you for libel in England where the laws are much more favourable to them.

The United Nations has said that the English libel law violates human rights.

So, Simon Singh rightly and truthfully condemned spurious or fraudulent claims by the British Chiropractic Association, and they retaliated by trying to intimidate him with a law suit. Note that they did not sue The Guardian, which is a corporation with money, but Singh personally.

Nonetheless, Singh is not backing down.

Singh is committed to fighting this all the way, and he has the support of much of the blogosphere and mainstream press, including scientists, skeptics, critical thinkers, free speech defenders, and even celebrities like Ricky Gervais, Stephen Fry, Penn and Teller, Jo Brand, and Harry Hill. Among the prominent scientists backing Singh are biologist Richard Dawkins, former British government Chief Scientist Sir David King, geneticist Steve Jones, and astronomer Jocelyn Bell.
Sense About Science has started a petition to keep libel laws out of science. See who has signed it and sign it yourself here.

If you’re interested, you can read Singh’s entire account of this story here.

Now that the British Chiropractic Association failed to intimidate Singh with its law suit and the case will go to court, now that the public and mainstream media are talking about this, now that prominent scientists and celebrities are backing Singh, chiropractors are running scared. The British Chiropractic Association, McTimoney Chiropractic Association, and the United Chiropractic Association have all sent letters to their members advising them to remove any spurious claims from their web sites and printed materials. The McTimoney Chiropractic Association blanked its own web site and advised its members to do the same. Sadly, they don’t seem to understand how the internet works nor how much people care about real, honest, evidence-based science and medicine, because folks had already made copies of all of their web sites.

Here is the letter the British Chiropractic Association sent to their members:

4 June 2009

The BCA would remind members of their obligations under the Advertising Standards Authority (ASA) section 50 (relating to Health & Beauty Products and Therapies: see

Members are strongly encouraged to review their current marketing materials (whether they are paper- or web-based) to ensure that they are compliant with both ASA and GCC requirements. Note that the ASA has no jurisdiction over editorial materials placed on members’ own websites.

When reviewing your materials it may be helpful to consider the following:

1. Are there any claims made that cannot be justified by reference to evidence? Remember, the GCC requires chiropractors to practice evidence based care, which is defined as “clinical practice that incorporates the best available evidence from research, the preferences of the patient and the expertise of practitioners (which includes the individual chiropractor himself).

2. Be mindful of making promises that you cannot be sure of delivering on;

3. Be wary of listing conditions that are controversial and away from mainstream chiropractic care e.g. dyslexia/dyspraxia unless you have research to back this up. If you have made references to prolonged crying, sleep and feeding problems, breathing difficulties and frequent infections, as these are symptoms rather than condition specific, we suggest you remove these references.

4. Do not refer to yourself as a specialist in any particular form of chiropractic;

5. Do not use unfamiliar words for common conditions;

6. Do not unjustly criticise other healthcare professionals;

7. If you refer to subluxations, provide information to explain what they are.

8. Take care in the use of the Doctor title. Ensure that there is no way there can be any doubt that you are a chiropractor, and not a registered medical practitioner. Do not use the doctor title in paper advertising without explicitly stating that you are a chiropractor.

It’s pretty amusing.

And now blogs around the world are re-posting Simon Singh’s original article criticizing the BCA. Well, sort of. Bloggers have been advised to protect themselves from frivolous lawsuits by posting the a version if the article edited by lawyers.

But….

Orac has posted the entire article in its original form here, and has even bolded the sentences that the lawyers removed or altered. Huzzah!

And now, without further ado, is the lawyered-up version of Simon Singh’s original article. If you’re a blogger, please post it as well.

Beware the Spinal Trap,  by Simon Singh

Some practitioners claim it is a cure-all, but the research suggests chiropractic therapy has mixed results – and can even be lethal, says Simon Singh.

You might be surprised to know that the founder of chiropractic therapy, Daniel David Palmer, wrote that “99% of all diseases are caused by displaced vertebrae”. In the 1860s, Palmer began to develop his theory that the spine was involved in almost every illness because the spinal cord connects the brain to the rest of the body. Therefore any misalignment could cause a problem in distant parts of the body.

In fact, Palmer’s first chiropractic intervention supposedly cured a man who had been profoundly deaf for 17 years. His second treatment was equally strange, because he claimed that he treated a patient with heart trouble by correcting a displaced vertebra.

You might think that modern chiropractors restrict themselves to treating back problems, but in fact some still possess quite wacky ideas. The fundamentalists argue that they can cure anything, including helping treat children with colic, sleeping and feeding problems, frequent ear infections, asthma and prolonged crying – even though there is not a jot of evidence.

I can confidently label these assertions as utter nonsense because I have co-authored a book about alternative medicine with the world’s first professor of complementary medicine, Edzard Ernst. He learned chiropractic techniques himself and used them as a doctor. This is when he began to see the need for some critical evaluation. Among other projects, he examined the evidence from 70 trials exploring the benefits of chiropractic therapy in conditions unrelated to the back. He found no evidence to suggest that chiropractors could treat any such conditions.

But what about chiropractic in the context of treating back problems? Manipulating the spine can cure some problems, but results are mixed. To be fair, conventional approaches, such as physiotherapy, also struggle to treat back problems with any consistency. Nevertheless, conventional therapy is still preferable because of the serious dangers associated with chiropractic.

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. These are relatively minor effects, but the frequency is very high, and this has to be weighed against the limited benefit offered by chiropractors.

More worryingly, the hallmark technique of the chiropractor, known as high-velocity, low-amplitude thrust, carries much more significant risks. This involves pushing joints beyond their natural range of motion by applying a short, sharp force. Although this is a safe procedure for most patients, others can suffer dislocations and fractures.

Worse still, manipulation of the neck can damage the vertebral arteries, which supply blood to the brain. So-called vertebral dissection can ultimately cut off the blood supply, which in turn can lead to a stroke and even death. Because there is usually a delay between the vertebral dissection and the blockage of blood to the brain, the link between chiropractic and strokes went unnoticed for many years. Recently, however, it has been possible to identify cases where spinal manipulation has certainly been the cause of vertebral dissection.

Laurie Mathiason was a 20-year-old Canadian waitress who visited a chiropractor 21 times between 1997 and 1998 to relieve her low-back pain. On her penultimate visit she complained of stiffness in her neck. That evening she began dropping plates at the restaurant, so she returned to the chiropractor. As the chiropractor manipulated her neck, Mathiason began to cry, her eyes started to roll, she foamed at the mouth and her body began to convulse. She was rushed to hospital, slipped into a coma and died three days later. At the inquest, the coroner declared: “Laurie died of a ruptured vertebral artery, which occurred in association with a chiropractic manipulation of the neck.”

This case is not unique. In Canada alone there have been several other women who have died after receiving chiropractic therapy, and Edzard Ernst has identified about 700 cases of serious complications among the medical literature. This should be a major concern for health officials, particularly as under-reporting will mean that the actual number of cases is much higher.

If spinal manipulation were a drug with such serious adverse effects and so little demonstrable benefit, then it would almost certainly have been taken off the market.

Simon Singh is a science writer in London and the co-author, with Edzard Ernst, of Trick or Treatment? Alternative Medicine on Trial. This is an edited version of an article published in The Guardian for which Singh is being personally sued for libel by the British Chiropractic Association.

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2 CommentsLeave a comment

  1. Excellent! It’s great to see this being posted far and wide and the BCA given such tremendous publicity!

  2. I was very impressed and felt had to get a valuable experience after reading your article. I will learn more and I’ll try to implement. thanks for sharing. Brighton MI Chiropractor Brighton MI Chiropractic


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