The British chiropractic profession is now under intense regulatory scrutiny, and I think the strain is beginning to show.
This significant phenomenon really deserves its own name, and in view of its reactive origin, I will dub it the Quacklash.
This Blogpost is an exploration of the causes and effects of this Quacklash.
The Causes Of The Quacklash
The primary cause of this anxious scrutiny is clear.
It is a reaction of a number of activists and Bloggers (though not me) to the misconceived libel case brought by the British Chiropractic Association against Simon Singh.
Amongst the Bloggers involved in this frenzy of activity are Zeno and JDC325, though there are many others.
And earlier today the Blogger Adventures In Nonsense revealed how he went about reporting 500 chiropractors to Trading Standards and the General Chiropractic Council.
However, it really should not be a surprise to the chiropractic profession that they are under regulatory obligations.
In particular, they should be aware of three main sources of regulatory oversight:
1. chiropractors are a regulated profession, and so the prospect of complaints to the appropriate regulatory body are an necessary aspect of being in such a regulated profession;
2. chiropractors are also, in my view, traders under the Unfair Commercial Practices Regulations, and so they also face the prospect of interventions by Trading Standards; and
3. chiropractors advertise, and so - as is catalogued on the Lay Scientist site - they can be held to strict standards in their advertising.
Chiropractors surely should not be afraid of these regulatory regimes. No chiropractor wants to be in breach of their professional standards, to be adopting unfair commercial practices, and to be using misleading advertising.
However, many Bloggers and activists contend that chiropractors are indeed in breach of their regulatory duties and have made complaints to all the appropriate bodies.
Why this attention? Why is so much time and effort being devoted to the chiropractic profession rather than other complementary and alternative health practitioners?
Adventures In Nonsense eloquently provides his answer on his Blog:
"For some time, chiropractic has managed to get away with being the acceptable face of alternative medicine. With some evidence to show that it helps with lower back pain, and many chiropractors only using the therapy for this purpose, it was seen by many as a legitimate therapy and largely escaped criticism from sceptics.
"That all changed when the BCA decided to sue Simon Singh for libel. In a fine example of the Streisand effect, all the energy usually reserved for criticising homeopaths and reiki healers was redirected straight at those chiropractors making wild and outlandish claims to treat colic, asthma and a host of other problems unrelated to the spine.
"With the BCA attempting to stifle debate over the bogus* claims made by Simon Singh, I was determined to do something."
I suspect all those making the complaints and reports have similar views to those of Adventures In Nonsense .
The Short Term Effect Of The Quacklash
The immediate response by the chiropractic profession to this regulatory scrutiny seems to be panic: websites have been pulled; material have been withdrawn; and worried chiropractors have been contacting their regulator and professional bodies.
Amongst all this, there has of course been the McTimoney Letter.
I blogged quickly on this bizarre letter earlier this week. One or two followers of this Blog then suggested the letter perhaps had a wider impact for the Simon Singh case than I had set out.
I have thought about this, but I am afraid the McTimoney Letter really does not have a great deal of evidential value. It is actually a silly and badly-worded document, which misunderstands the applicable law, and is startlingly alarmist.
There is - sadly - no reason to believe that the McTimoney Chiropractic Association actually have the slightest clue what they are talking about when they mention "claims for treatment that cannot be substantiated with chiropractic research."
Unless they set out the evidential basis for this assertion, then their apparent implicit admission that the treatments cannot be substantiated is actually of no more probative or forensic value than the British Chiropractic Association's (so far) empty claim to the contrary.
All because the McTimoney Letter contains something convenient for the skeptic position, it does not somehow make the MCA gallant skeptics-in-exile.
For me, the main value of the McTimoney Letter is that it shows that there is no common position for the chiropractic profession in respect of promoting chiropractic for various children's ailments. This itself badly hinders the BCA case, as the opinions of other chiropractors cannot be as easily brushed off as those outside the profession.
So perhaps a more significant example of panic is the letter of the British Chiropractic Association itself revealed on Gimpy's Blog.
This important BCA letter undoubtedly would not exist but for the Quacklash.
And, in my view, the notorious Happy Families Leaflet fails completely to comply with the guidance in this letter.
The BCA letter is also interesting in what it omits. The recent adverse ASA ruling was not just that there had been a breach of the Health and Beauty Products and Therapies provision, but also of the requirements for Substantiation and Truthfulness.
However, the BCA letter makes no mention of these other ASA requirements and, unless there are separate letters in respect of Substantiation and Truthfulness, I wonder whether this is a telling omission.
Overall, it appears websites have been taken down and materials withdrawn by chiropractors across the country; Trading Standards and the ASA are already looking into complaints; the General Chiropractic Council is being prompted into action; and the MCA issues its own zany letter whilst the BCA finally reminds its members of their regulatory obligations (albeit seemingly incompletely).
This is the immediate effect of Quacklash.
The Long Term Effect Of The Quacklash?
But I think there may be a longer term effect of the Quacklash.
Here I am not sure that Adventures In Nonsense is totally correct that this invocation of regulation is a Streisand effect, which I take to mean widespread repeating of suppressed material; nor is it perhaps the Sparticus effect, where there is a collective assertion of solidarity.
As a Geek born and brought up in the 1970s, I prefer to call it the Obi-Wan effect:
"If you strike me down, I shall become more powerful than you could possibly imagine."
(Yep, I can even remember going to Star Wars on its original release.)
Whenever a CAM practitioner - or professional body or regulator or indeed entire profession - now resorts to using legal devices (especially libel) to seemingly suppress criticism or deter scrutiny, they can expect in turn to be subjected to the same intense Quacklash that is being endured by chiropractors.
Every effort will be made to hold the perceived culprits to full regulatory account and their claims will be scrutinised to a severe degree.
My personal view is that laws and regulations should not be used as light-sabres.
Both sides should instead join in a non-legalistic enterprise of providing and assessing the relevant evidence.
That is why I have not made a single complaint, and I do not intend to do so.
However, I suspect that any future sabre-rattling of a threatened libel writ in the context of CAM and public health will be answered by another Quacklash.
I would prefer neither a threat of libel nor a Quacklash to occur; but I do wonder if the real prospect of the latter will deter anyone again resorting to the former.
After all, libel really has no place in scientific disputes.