The British Chiropractic Association has made a public statement.
However, it has not used this to clarify whether it still endorses the now seemingly withdrawn Happy Families pamphlet, the basis of the current libel litigation.
Nor has it confirmed whether it continues to promote chiropractic for colic, even though the Advertising Standards Authority has banned a chiropractor from making the same claim.
Instead it has published this extraordinary Press Release.
The overall tone is remarkable.
The lumbering BCA seemingly finds it incomprehensible that its tactics have not so far worked; that it has not so far forced Simon Singh to back down.
Tellingly, the BCA seems to think it is to Simon Singh's discredit (rather than its own) that he, unlike almost any other science writer, has the time and money to mount a defence to the horror of an English libel claim.
I would like to draw particular attention to the following passages of the Press Release:-
"Much criticism has been levelled at the BCA for not entering a debate, criticism which is in itself misguided.
"The law exists to protect citizens and organisations from falsehoods and the BCA used the law because of the damage caused by Simon Singh's Guardian article.
"The case brought against Dr Singh was simply a case to establish a libel contained in his article; it never was, and still is not a “freedom of speech” issue.
"Had Dr Singh simply apologised and retracted his remarks, as the BCA originally requested, any action would have been averted – he has chosen not to do so in the face of overwhelming evidence."
Also:-
"In the course of this litigation the BCA has disclosed to the Courts a plethora of medical evidence showing that the treatments work and that the risk associated with the treatments is minimal, if indeed any risk exists at all."
So all this is not, it seems, a free speech issue.
Well, it is.
(Indeed, to adapt Arthur C. Clarke's famous maxim, when a defendant to a libel claim states there is a free speech issue, he is almost certainly right. When the claimant states it is NOT a free speech issue, he is very probably wrong.)
But I would like to emphasise their "medical evidence" point.
Significantly, the BCA now says it actually has the medical evidence to support the promotion of chiropractic for the children's ailments in question, but so far this crucial evidence is only being disclosed to the court, rather than put into the public domain.
It simply should not have taken Simon Singh to defend libel proceedings for the BCA to be forced to disclose its supposed supporting evidence for the claims, and then only (so far) to the court. The BCA should have disclosed it publicly and immediately, in response to Simon Singh's original article.
In my opinion, that is what a responsible and reputable body should have done.
More on this development later.
Wednesday, 27 May 2009
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18 comments:
I just would like to know if they know what a plethora is. I would not like to think that a person would tell someone he has a plethora, and then find out that that person has *no idea* what it means to have a plethora.
http://www.youtube.com/watch?v=-mTUmczVdik
Further evidence of Publispacity's involvement comes in the limited grasp of punctuation evident in the press release.
More pertinently, they try to draw a hopelessly revealing dichotomy between treatments with "no reliable scientific evidence to support [them]" and "fraudulent chiropractic treatments". In the medical context, stop me if I'm wrong, this isn't a terribly meaningful distinction unless you revert to some very legalistic discussions as to mens rea.
If you look at the metadata on the PDF version of the press release it looks like it was authored by Publicasity's Executive Chairman, Carl Courteny.
This is just a poor attempt at reputation management by Publicasity and the BCA. They know they are beginning to look bad and it does expose their dig at Simon Singh for having time and money remarkably hypocritical. I don't imagine Publicasity are offering their services for free.
Also slightly appalling that they've tried to make it look as though it was Simon's decision to use the defence that he didn't 'literally' mean what he said, glossing over the fact that it was the court ruling that's forcing him to do this. It's incredibly misleading.
"promotes fraudulent treatments to children"Has anyone suggested they directed their promotion "to" children?
I also note that the paragraph claiming they presented a "plethora of medical evidence showing that the treatments work" continues their pattern of not sharing that evidence with the rest of us, but more pertinently does not specify which conditions they mean in the specific context of this paragraph. When I read that section my first reaction was to ask, "For what?". The Press Release seems to engage in some rather awkward circumlocutions to avoid repeating the original claims from the Happy Families leaflet. I think it is increasingly important for bloggers and commentators to press them on whether they still support the claims in that leaflet and, if not, when and for what reasons was that support withdrawn.
I predict that the BCA will regurgitate so much 'spin', that a gyroscope might get dizzy.
Never mind "not sharing that evidence with the rest of us", it appears from the recent ASA adjudication Jack cites that they are not even sharing it with their own members, since the chiropractor who was unable to substantiate a claim that chiropractic can treat colic is a BCA member. Or perhaps their evidence isn't as conclusive as they think it is.
lol, this has to be the most childish response the BCA could have come out with. Simon should defintely appeal; they're going to look ridiculous as this gathers momentum. Thanks Jack.
Edzard Ernst has come out at last with post in support of Simon Singh! He wrote his post in "TimesOnline":
http://timesonline.typepad.com/science/2009/05/distrust-me-im-a-chiropractor.html#more
OK! Good work.
If you will forgive me for introducing a note of triviality, and for a shameless self-plug, I have now penned some lyrics for a proposed theme song for the pro-Simon Singh anti-Chiro-nonsense-and-legal-chill campaign. All we need now is a band to perform it...
If a treatment works then there is a duty to make the evidence available, as it's only by appraising such evidence that bodies such as NICE can recommend their use in the NHS. So if it does work, you're denying patients access to it by keeping it secret.
Of course if the evidence is shoddy you might not want professional critical appraisors to look at it.
That they claim the evidence does exist but we can't see it says more than anything Simon has said.
Of course if the evidence is shoddy you might not want professional critical appraisers to look at it.And there, I think, we have it in the proverbial nutshell.
Are the contents of the list "27 different publicly-available research papers" known?
The BCA press release mentions 27 different publicly-available research papers which they believe provide evidence of the proven beneifits of chiropractic treatment.
The BCA isn't able to provide me with details because the case is sub judice. Does anybody know what these references are?
The BCA press release refers to 27 pieces of research being available. The implication that I took from it is that they provided the links to Simon Singh in November 2008.
Are they related specifically to cholic etc or to specific back problems?
Have those links been shared more widely?
Has Simon Singh or others reviewed them and posted their analysis of them?
I, for one, like Anonymous, am most underwhelmed by the "evidence". Especially the invisible and secret kind. As I suppose was Simon at the time.
I hope someone at the BCA is losing lots of sleep over having brought this suit and the damage it, not Simon, is doing the organisation's reputation.
I reckon most of their 27 references can be found here: http://www.chiropractichealthcentres.co.uk/research/
They're not really relevant to the 'bogus' information that Simon was alluding to though...
Here is a summary of the 25 (eerily close to the magic 27) references provided at http://www.chiropractichealthcentres.co.uk/research/
They are mostly about backs or polls of customer satisfaction. Pretty poor stuff, including some that appear to be the same study published in different journals at the same time. Surely they can't be referring to these:
i.1994 Harris Poll.
i.A Benefit of Spinal Manipulation as Adjunctive Therapy for Acute Low-back pain: A Stratified Controlled Trial. Hadler NM et al. Spine - 1987;12:703-706.
i.Acute Low Back Problems in Adults. Clinical Practice Guidelines. Bigos S, et al. Agency for Health Care Policy and Research Publication No. 950642 (1994) - U.S. Department of Health and Human Services.
i.Acute Low-back Pain: Comparison of Two Conservative Treatment Approaches. Farrell JP and Twomey LT. Med J Aust - 1982;1:160-164.
i.Demographic Characteristics of Users of Chiropractic Services. The Gallup Organization, Princeton, New Jersey - 1991.
i.Low-back pain Treated by Manipulation. Coyer AB and Curwin I. British Medical Journal - 1955;1:705-707.
i.Lumbar Spinal Manipulation on Trial: Part 1 - Clinical Assessment. Evans DP et al. Rheumatology and Rehabilitation - 1978;17:46-53.
i.Manipulation in the Treatment of Low-back Pain: A Multicentre Study. Doran D and Newell DJ. British Medical Journal - 1975;2:161-164.
i.Multicentre Trial of Physiotherapy in the Management of Sciatic Symptoms. Coxhead CE et al. Lancet - 1981;1:1065-1068.
i.Patient Evaluations of Care from Family Physicians and Chiropractors. ACA Journal of Chiropractic - 1989.
i.Patient Evaluations of Care from Family Physicians and Chiropractors. Cherkin, D., MacCornack, F. Western Journal of Medicine - 1989;150:351-355.
i.Randomized Clinical Trial of Manipulative Therapy and Physiotherapy for Persistent Back and Neck Complaints: Results of One Year Follow Up. Koes, B.W. et al. British Medical Journal - 1992;304:601-605.
i.Ref 11 Supra.
i.Relative Therapeutic Efficacy of Vertebral Manipulation and Conventional Treatment in Back Pain Management. Nwuga VC. American Journal of Physical Medicine - 1982;61:273-278.
i.Second Report Medicare Benefits Review Committee. Thompson CJ. Commonwealth Government Printer, Canberra, Australia, Chapter 10 (Chiropractic) - June 1986.
i.Spinal Manipulation for Low Back Pain. Shekelle P, et al. Annals of Internal Medicine - 1992;117:590-598.
i.The Appropriateness of Spinal Manipulation for Lower Back Pain. Shekelle PG, et al. RAND Corporation, Santa Monica, California - 1992.
i.The Av-Med Study - 1993.
i.The Effectiveness and Cost Effectiveness of Chiropractic Management of Low-Back Pain. Pran Manga and Associates. University of Ottawa, Canada - 1993.
i.The Efficacy of Manual Treatment in Low-back Pain: A Clinical Trial. Arkuszewski Z. Manual Medicine - 1986;2;68-71.
ii.A Randomized Trial of Manipulation for Low-back Pain in a Medical Setting. Godfrey CM et al. Spine - 1984;9:301-304.
ii.Low Back Pain of Mechanical Origin: Randomized Comparison of Chiropractic and Hospital Outpatient Treatment. Meade, TW et al British Medical Journal - 1990;300:1431-1437.
ii.Manipulation in the Treatment of Low-back Pain - A Randomized Clinical Trial. Rasmussen GG. Manuelle Medizin - 1979;1:8-10.
iii.Back Pain: A Randomized Clinical Trial of Rotational Manipulation of the Trunk. Glover JL et al. British Journal of Industrial Medicine - 1974;31:59-64.
The Midwest Research Institute Study -This study examined clinical trials published in the professional literature between 1930 and 1981.
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