
Last year I published an article in The Guardian about chiropractors who claim to treat childhood conditions such as asthma, colic and ear infection. My views on that treatment clashed with those of the British Chiropractic Association (BCA) and it threatened to sue me for libel.BCA was offered space in the Guardian to put forth their evidence and resolve the issue in a proper scientific manner. Instead they sued. Of course we know we the BCA chose that pathway: because they needed too much time to collect their “plethora” of evidence that support chiropractice and until they did, their reputation would suffer significantly.
Although The Guardian offered a right of reply, the dispute was not resolved and the BCA served proceedings. At this point, I could have backed down, apologised and paid a relatively small amount of damages. However, I believe that my article is important and covers a matter of public interest, so I have decided to fight the libel action.
So far, standing by my article and fighting the case has taken up a year of my life and has cost £100,000; the battle could continue for another year, and final costs could exceed £500,000. [emphasis mine]
Of the 29 references, 1 is just the GCC’s code of practice; 6 is an irrelevent paper about medical ethics; 8, 9, 10 and 17 are about osteopathy; 26 is a description of evidence-based medicine; 27, 28 and 29 are about NSAIDs. That’s 10 down straight away, but what’s interesting about these is that 6 of them are just attacks on conventional medicine. In other words, this is not a particularly comprehensive or focused review of the literature.We are down to 19 already.
A further three papers, (12, 13 and 14) cover the safety of chiropractic, which has come under considerable criticism. Curiously, this brief selection ignores the numerous studies showing an increased risk from chiropractic. 14 isn’t a study at all, 12 is considerably less bullish than the BCA suggest it is pointing to a significant number of side-effects “with a possible neurologic involvement”, and 13 provided stronger support (”We found no evidence of excess risk of VBA stroke associated chiropractic care compared to primary care.”), but should be taken in the context of the wider range of studies finding the opposite.Down to 16 possibly relevant.
Of those 16 papers, 9 cover infantile colic, 1 looks at asthma, 2 study ear infections, 3 look at bed-wetting and 1 at a variety of conditions.We are talking serious research; conclusive trials; proven safety and efficacy. Oh poor Simon, the BCA has nailed you… Anyway, down to 7 possibly supportive references…
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Professor David Colquhoun has reviewed the 9 infantile colic papers on his own blog, and the results are, well, poor. 2 had no control group, [...] Ditto 3 and 25. 4 compares chiropractic with the use of dimethicone. Apparently, this is an ingredient in some over-the-counter remedies for colic, which are themselves unproven, so hardly the greatest thing to compare your treatment with - the results simply show that chiropractic is as good as another unproven remedy. Meanwhile, 5 [suggests] that the effect obseved [sic] is largely placebo.18 and 20 are both reports on a couple of individual case studies, and therefore simply anecdote rather than the sort of evidence you’d get from a trial involving hundreds of patients. 19 simply compares one chiropractic treatment against another [and] 24 isn’t actually a study at all.
1 on asthma, 2 on ear infections, 3 on bed-wetting and 1 on ‘various’. 7, the asthma paper, is simply a letter to the editor and contains no actual evidence, so we’re down to six.Good. We are down to… ONE paper that might possibly show some real supportive evidence. And guess what? The very last paper is actually a good one! It’s a Cochrane Collaboration meta-analysis! In their press release, the BCA states that “There was weak evidence to support the use of [chiropractic].”
Of the ear infection papers, 15 is an uncontrolled study that simply shows that children with ear infections tend to eventually get better but can’t say if that’s down to chiropractic. [...] 23 [...] looks rather like the same sort of thing again.
So on to bed-wetting then [...] 22 is a study of one person (an anecdote), and 21 is another uncontrolled “they eventually got better” study
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.F***! Are they completely useless, completely disillusioned, or completely dishonest? Their “plethora” of evidence consists of 10 completely irrelevant papers; a large number of uncontrolled trials; some case studies (!); a lot of inconclusive trials; a lot of cherry picking and “accidental” exclusions of unfavourable trials; and a misquotation from a Cochrane Collaboration review! And these people claim they can treat babies with their (non) bogus treatments!
Gloria Thomas died aged nine months after spending more than half her life with eczema.[Source: Sydney Morning Herald]
The skin condition wore down her natural defences and left her completely vulnerable when she developed an eye infection that killed her within days of developing.
[...] the couple took Gloria to various health professionals, but while they abandoned each conventional medication she was prescribed within a short time of starting it, they solidly pursued homeopathic remedies.
The Crown said these did not work, and all the while Gloria’s tiny body required more nutrition than her mother’s milk could provide, and her immune system became ever more depleted.
By the time she died, she was the weight of an average three-month-old, her body was covered with angry blotches and her once black hair had turned completely white.
But the couple, who were raised and educated in India where homeopathy is accepted as equivalent to conventional medicine, were steadfast to their homeopathic remedies and ignored completely or quickly discarded other treatment.His dissertation on eczema was an exercise in futility. Eczema cannot be treated with magical water unfortunately…
A general practitioner booked them an appointment with a dermatologist they did not attend because they took the child to India instead, a course of action the doctor told them was “cruel”.
They also visited two doctors in India, but discarded the advice of one to return to him every second day, instead consulting a succession of homeopaths including Thomas Sam’s brother, who had recently completed his dissertation on eczema.
Gloria’s miserable life proved all the more poignant by the evidence given at the trial by Dr Orli Wargon, the dermatologist with whom Gloria missed her appointment when the family went to India instead.Her ******* cornea was melting? MELTING? Why?!? Because her parents were criminally misinformed and/or misled. Because in India homeopathy has the same stature as medicine. Because all this flexibility and health law bending to accommodate homeopathy, has resulted in magic water being available everywhere from high street pharmacies to nutrition shops.
Dr Wargon said she would have applied an aggressive treatment program that should have seen the child recover within 24 hours: “Not completely cured, but her skin would look better very, very quickly.”
Nine days after they returned from India, Thomas and Manju Sam finally took Gloria to hospital for an eye infection they thought was conjunctivitis, and she was immediately rushed into emergency to be treated by a team of medical experts. It turned out her cornea was melting.
A large number of (rational) people stand behind Simon at this point, and “Sense About Science“, an organization that helps promote science and evidence, kicks off a campaign to stop the ridiculousness that is the libel law in England, and especially when it steps on our freedom of speech. As I have said before, when a science writer is sued for criticizing a health organization, things are crazy indeed…
It has been a stressful and frustrating twelve months since I published my article on chiropractors and their attempts to treat children with conditions such as asthma. The British Chiropractic Association’s decision to sue me for libel has been an enormous drain on my time and energy. However, the support that I have received from family, friends, readers, bloggers, scientists, journalists and those who care about free speech has been incredible, and it has played a crucial role in my decision to continue defending my article and fighting the libel action.No need to think twice; this is a no-brainer really. Let’s see how it progresses. From our part all we can do is support “Sense About Science” and Simon Singh any way we can.
More importantly, everyone agrees that there is something fundamentally wrong with the English libel laws, which have a chilling effect on journalists, whether they write about science or anything else, whether they live in Britain or anywhere else. Hence, I am delighted that so many individuals and organisations have come together to launch a campaign with Sense About Science to highlight how the English libel laws clash with the right to discuss science in a frank and fair way. The Keep Libel Laws out of Science Campaign will also raise issues related to my particular libel case, and it will encourage a debate on the reform of the English libel system.
The campaign launch revolves around the statement shown below, and I would urge anyone who cares about science or free speech to show support by signing up.
And I would also encourage you to make your friends and colleagues aware of the issues at stake and ask them to sign up. It is possible that the time is right for major libel reform in England, which will then allow scientists and journalists to write with less fear of being intimidated.
I have from time to time expressed sympathy for the accommodationist tendency so ably criticized here by Jerry Coyne. I have occasionally worried that – just maybe – Eugenie Scott and the appeasers might have a point, a purely political point but one, nevertheless, that we should carefully consider. I have lately found myself moving away from that sympathy.And here is Massimo’s commentary (in a post perhaps inappropriately titled “Is Richard Dawkins really that naive?“):
I suspect that most of our regular readers here would agree that ridicule, of a humorous nature, is likely to be more effective than the sort of snuggling-up and head-patting that Jerry is attacking. I lately started to think that we need to go further: go beyond humorous ridicule, sharpen our barbs to a point where they really hurt.
Michael Shermer, Michael Ruse, Eugenie Scott and others are probably right that contemptuous ridicule is not an expedient way to change the minds of those who are deeply religious. But I think we should probably abandon the irremediably religious precisely because that is what they are – irremediable. I am more interested in the fence-sitters who haven’t really considered the question very long or very carefully. And I think that they are likely to be swayed by a display of naked contempt. Nobody likes to be laughed at. Nobody wants to be the butt of contempt.
Scott — who is an atheist — has repeatedly said that one cannot claim that science requires atheism because atheism is a philosophical position, not a scientific one. She leverages the standard distinction between philosophical and methodological naturalism: if you are a scientist you have to be a methodological naturalist (i.e., assume for operative purposes that nature and natural laws are all that there is); but this doesn’t commit you to the stronger position of philosophical naturalism (i.e., to the claim that there really isn’t anything outside of nature and its laws).Now, I never thought that science requires atheism per se, and I do agree that science is a very strong argument for atheism. That said, I am keen to take it one step further and opine that science inevitably leads you to atheism. Well, strictly speaking, and as I have said before, it can lead you to either atheism or madness:
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both Genie and I [Massimo] do recognize that science is one of the strongest arguments for philosophical naturalism, and I suspect that in her case, as in mine, a pretty big reason for why we are atheists is because of our understanding of science.
Personally, I do not see how religion and science can coexist peacefully in one’s mind. Science regularly shreds to pieces religious ideas about our cosmos: from the creation of the world to the emergence of life, and from geocentric systems to flat earth ideas*, biblical (and other religious) accounts of cosmology, creation of life, astronomy, and basic biology come in direct contrast with scientific evidence. If one accepts such evidence (as one should) then faith in the holy scriptures (and therefore the relevant omnipotent, omniscient God-writer) must be shaken -if not abandoned altogether. Otherwise, schizophrenic mechanisms have to be employed in order to accommodate both reason and supernatural irrationality in the same mind! There are of course many people accepting the scientific explanation for the emergence of life and at the same time preserving some hints of faith as a matter of tradition, culture, or something socially relevant. But to accept both Evolution and Creationism at face value sounds a bit too weird…[isn't self-quoting a great thing?]
I emphatically don’t mean we should use foul-mouthed rants. Nor should we raise our voices and shout at them: let’s have no D’Souzereignty here. Instead, what we need is sarcastic, cutting wit.So, is Massimo quote-mining here?
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Maybe I’m wrong. I’m only thinking aloud, among friends. Is it gloves off time? Or should we continue to go along with the appeasers and be all nice and cuddly, like Eugenie and the National Academy?
You might think that modern chiropractors restrict themselves to treating back problems, but in fact they still possess some quite wacky ideas. The fundamentalists argue that they can cure anything. And even the more moderate chiropractors have ideas above their station. The British Chiropractic Association claims that their members can help treat children with colic, sleeping and feeding problems, frequent ear infections, asthma and prolonged crying, even though there is not a jot of evidence. This organisation is the respectable face of the chiropractic profession and yet it happily promotes bogus treatments.The main focus of the lawsuit is the term “bogus” and what Simon really meant by that. And despite the definition of bogus as something counterfeit or fake, the judge ruled that Simon by using the term in this case implied a “deliberate dishonesty” on the part of BCA -which brings him in a difficult position.