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Thursday, 18 June 2009

BCA v Singh: The BCA's "Third Update"

Late yesterday evening, the British Chiropractic Association at last released a list of research papers.

Other Bloggers will surely examine that list in more detail; I want quickly to draw attention to some statements in the covering statement (the "Update").

First, their reference to their lack of financial resources is, for me, sickening.

This is a knowing claimant in an English libel action, a form of litigation which almost uniquely throws a terrifying costs burden on a defendant, in this case a private individual and journalist. They did not need to do this; and for them to now implicitly plead poverty is markedly to their discredit.

But the most striking assertion in the Update is the statement that the BCA had no wish for its dispute with Simon Singh to "end up in the courtroom".

But to end up in a courtroom is a natural consequence of bringing a legal claim.


Unless the claim is settled or abandoned, the courtroom experience is actually what happens to legal claims.

I suspect they indeed did not wish for this case to end up in a courtroom. They undoubtedly expected for Simon Singh to just capitulate.

They must have been startled when it became clear that Simon Singh was not going to settle, despite the horror of the costs risks involved.

One should only ever threaten litigation if one can go through with it; it seems that the BCA is now suffering from not thinking through the consequences of their actions.

As readers of this Blog will know, I did try and tell them this last August:

"A misconceived libel action can be an incredible financial and reputational disaster of the very first order...

"Litigation is rarely the only course of action. However, bad decisions to litigate can arise when the other options are either not properly set out or considered."


Another striking feature of the Update regards timing.

The original article was published in April 2008; it has therefore taken the BCA some fifteen months to publish this list of references, and then only in response to an incredible internet campaign.

There is no good reason, and - in my view - certainly no legal reason, why there was any delay in doing this.

Indeed, one wonders whether these references were even known to the BCA until late in the litigation.

They are certainly not listed in the original Happy Families leaflet, and the BCA iself states that the list was sent to Dr Singh on 3 November 2008.

There is no explanation for this delay, and the circumstances suggest that many of these references only became known to the BCA once Simon Singh had put them to task when he decided to defend his case.

In passing, I also note that there is no mention of The Guardian's offer of a right to reply. This omission would have a misleading effect on someone reading this Update who was otherwise unaware of this significant opportunity.

Overall, the content of this latest Update is disappointing. As with the previous updates it shows a sad lack of self-awareness by the BCA that bringing a libel case was never an appropriate way to deal with Simon Singh's criticisms.

It was, and continues to be, both a tactical and strategic mistake by the BCA.

And they seem to want to have credit for now publishing supporting material which (had they had it) would have simply been the right thing to have done in the very first place.

Other Bloggers will now undoubtedly assess this "plethora" of evidence.

But the covering Update is the strong evidence that the BCA's libel case was misconceived and ill-thought through right from the beginning.

I fear they still don't get this.

21 comments:

paulathomas said...

You are right about the BCA's plea of poverty being sickening, but is there a way the Simon could use this to get the action dropped because he is unlikely to get his costs should he win?

Jeff Pickthall said...

It sounds like they're rapidly back-pedalling from their sabre-rattling ('scuse the mixed metaphor)

Unity said...

Other Bloggers will surely examine that list in more detail;

Already made a start, thanks...

http://www.ministryoftruth.me.uk/2009/06/18/examining-the-bcas-plethora-of-evidence/

I should point at the BCA have secured the PDF version of their statement, which prevents copying/pasting from it for comment. However, I have put up a unsecured version, over at the Ministry, for use when publishing criticism/analysis of their response on that basis that this is covered by fair dealing.

Jeff Pickthall said...

I've copied the statement here just in case it should disappear once the scrutiny gets going:

http://tinyurl.com/nq6m2r

Niklas said...

@paulathomas: I very much doubt it. David Irving was bankrupted by the legal bill he had to pay after losing his case and Penguin had to cover most of their own costs themselves. The legal costs of libel litigation are totally excessive, as we all know. Why can the rest of Europe do the same job one hundred and forty (!) times cheaper on average?

Stephen Bain said...

Of this list, a cursory examination suggests the following:

3 papers are about adverse effects of drugs rather than efficacy of chiropractic.

3 are about the safety of chiropractic rather than its effectiveness.

At least 3 are not about chiropractic but about osteopathy and related therapies.

Several are letters to the editors or articles rather than peer-reviewed papers.

The Cochrane review (16) listed as showing "weak evidence" also said this was from "single small trials, some of dubious methodological rigour."

If I were to be generous, I'd say perhaps 5 of those references are even worth reading in relation to their claims.

Andy said...

Damn, the PDF is password protected in Acrobat Pro 6.0 (Mac), so I can't copy and paste from it.

Does anyone know of a text version of the statement because a locked media release is pretty much useless as a media release?

Ta.

Andy said...

Oops, I see Ministry of Truth (Unity) made an unlocked file available - unfortunately that hasn't worked for me either :(

The whole point of a media release is to get it published as widely as possible. Locking it seems somewhat counter-productive since many journos will just move onto someone else's story before they try hacking a locked file.

I assume this was locked in error.

Anonymous said...

So the BCA have actually gone and showed that there IS evidence for the efficacy of chiropractic in childhood conditions. Hang on, wasn't this case all about Singh sayin there wasn't "a jot of evidence". Instead of sidetracking about irrelevant things like BCA funds I think the skeptics need to wake up and realise that there is an evergrowing evidence base for chiropractic.

TK said...

@Anonymous

If you're going to enter the debate to defend chiropractors, at least have the courage of your convictions and use a name rather than sniping from the bushes.

Andy said...

Anonymous wrote:
Instead of sidetracking about irrelevant things like BCA funds...

I agree. I don't think the BCA should have mentioned their financial circumstances - it's irrelevant. I wonder why they did mention it? Any ideas?

神経オタク said...

Layscience.net points out a particular example of quote mining from a study. An analysis from a legit source was quote-mined as reading:

"There was weak evidence to support the use of [chiropractic]."

The quote in full read:

"There was weak evidence to support the use of hypnosis, psychotherapy, acupuncture and chiropractic but it was provided in each case by single small trials, some of dubious methodological rigour." ... up to ""each of these findings came from small single trials, and need to be verified in further trials,..."

Seeing as how anyone with a grasp on normal English can read this as anything but inconclusive, I wonder:

Could this example of quote mining actually help Singh's case? Could it prove an example of deliberate dishonesty under Eady's definition of bogus?

Olle K said...

Yet another indication that the BCA may indeed be dishonest or inexcusibly ignorant or both is the fact they un-cherry-picked the following paper, perhaps the only well-made study available on chiropractic treatment for infant colic, which concluded that "Chiropractic spinal manipulation is no more effective than placebo in the treatment of infantile colic."

Olafsdottir E, Forshei S, Fluge G, Markestad T. Randomised controlled trial of infantile colic treated with chiropractic spinal manipulation. Arch Dis Child. 2001 Feb;84(2):138-41.
http://tinyurl.com/nbszy3

jdc325 said...

"I think the skeptics need to wake up and realise that there is an evergrowing evidence base for chiropractic."
If that is true, then why did the BCA choose to rely on so many papers completely irrelevant to the point. How do three papers on NSAIDs; a description of evidence-based medicine; a paper about medical ethics; the GCC’s code of practice; and another four papers on osteopathy show that chiropractic is effective? It's almost as if the BCA don't understand the concept of evidence of efficacy...

Think Logic said...

Also, from the BCA's PDF:
"It has never been the BCA's case that the evidence is overwhelmingly conclusive. It is the BCA's case that there is good evidence."

Really?

Do we know when they will provide it?

Is this public statement about "good evidence" submittable in a court of law?

davidp said...

"Dr Sing should not have published statements which he either knew to be untrue or which he could not be bothered to check as true, and which he must have known would be highly damaging to the BCA's integrity and reputation."

This sounds libellous to me. Is it usual for libel plaintiff's to make libellous claims about their respondents ?

Frankly I thought Singh's statement would improve their reputation amoung their customer base - Chriopractors who pay fees to an association - because Singh implied that they actively support chriopractic salesmanship, even in the face of the evidence.

Andy said...

On a separate issue, has anyone seen the BCA terms and conditions which seem to suggest (8:2) that you should not link to anything on their site except the front page.

What is the legal standing of such a condition?

BSM said...

""The way it works is that your dorsal horn has been sensitised so that, now, when you get back pain, its usually in the same place, this is caused centralisation. Im glad you dont get much back pain anymore, thats great, but you still sound like a chronic pain sufferer. Again, as ive already explained to you, acute pain lasts up to approx 3 months (debatable) and after that is chronic and centralised. The accepted way of avoiding pain becoming chronic is to treat during the acute phase.
This is the latest, accepted view on acute and chronic pain. "

and for all therapies, whether conventional or quacky, giving good narrative is part of the treatment.

The trick is to show whether your own particular modality gives anything more than good narrative. Especially for something like back pain where it may be an effectively permanent, though fluctuating condition, the really tricky thing is that people's perception of their own problem can be manipulated more easily than their spines can be. That is not necessarily a bad thing but no one should fool themselves into thinking their therapeutic modality has specific benefit if it only and solely gives the patient a new perspective that lets them live better with their problem.

This is where those of us who demand evidence can meet the quacks, if not half-way, at least someway into the intervening gulf- we accept you can give patients a narrative that in turn gives them a sense of power over what may actually be an intractable problem, particularly if the patient has inflated that problem to be a major focus of their life. The trouble is that the quacks have so much of their own lives vested in their personal form of magic that as we approach them making simple and reasonable points it is to be greeted by the sight of them fleeing in the opposite direction clutching their toys to their chests and crying about nasty people were being horrid to them."

As has been said above, that is a fairly clear accusation that Simon Singh was either deliberately dishonest or reckless as to the truth of his statements.

Perhaps the BCA offices have no mirrors so that they could recognise themselves in them.

Think Logic said...

I keep noticing more stuff that doesn't seem add up in the BCA's statement.

For example, they say:
"The BCA never claimed to cure [various childhood conditions]" by which I presume they mean cholic and so forth.

Yet the evidence they present in the same document is making the claim that Chiropractic cures cholic, asthma etc.

If they are listing these conditions as curable, along with what they say is "overwhelming" evidence, then does this not suggest that they are indeed claiming to cure cholic and so forth? Rather than not?

Or should we disgregard all evidence which relates to cholic and asthma, and just stick with what's left?

I am confused.

MK said...

Like others, I saw that the BCA had password protected its response.

I have waged a campaign against this sort of thing in other places. (Believe it or not, I have received press releases that prevent text copying.) Sometimes it is a genuine error on the part of the creator, occasionally perpetuated by an overzealous designer. Sometimes, as in the case of the CBI, so they tell me, it is to prevent plagiarism.

In this case, I got round it very easily. Print to an image file. Run optical character recognition. Read PDF file with text.

I am happy to put this somewhere accessible if the other version does not work.

On the saga itself, surely the BCA must now realise that this is the biggest own goal of the 21st century. They have thrown a huge spotlight on their "b***s" remedies.

Andy said...

@Think Logic
You need to remember that this is a pedantic word game. We have "happily" and "bogus" and now we have "cure". If I recall correctly, the original Happy Families brochure only claims that chiropractic "helps" with various conditions. The other word we often see is "treat".

I can "treat" colic with a paper clip and week-old cola that's been aged in a waxed paper cup. It won't do anything useful, but it is still a "treatment" according to my definition of the word. Just remember, I never claimed to "cure".

Do any of the "plethora" of papers claim to "cure"?

(word verification: "sapien")