Singh recently published a book with Edzard Ernst, the first Professor of complimentary medicine in the UK, called "Trick or Treatment?" It is an evidence-based examination of the claims of alternative medicine practitioners, the money wasted on ineffective treatments, and the necessity of subjecting all treatments and therapies to the scientific method. Ernst himself is published in hundreds of scientific papers and is a leading reformer in the complimentary medicine community.
In April of last year, Singh took this a step further and published an editorial in The Guardian that has since been taken down. A Russian skeptic has graciously hosted the cache of Singh's editorial for everyone to read. In the editorial, Singh takes on the claims of chiropractic and notes the lack of peer-reviewed evidence for their efficacy.
The following was what got him in trouble, though:
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.
I can confidently label these treatments as bogus 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.
The BCA has sued Singh for libel because of the bolded phrase. While US libel laws put the burden of proof on the plaintiff and set the bar relatively high, UK libel laws require the defendant to disprove the plaintiff's claims. In Singh's case, the judge presiding over the preliminary hearing bizarrely ruled that Singh was stating, as a matter of fact, that the BCA was being deliberately dishonest.
This ruling would make an effective defense impossible for Singh because he would essentially have to prove that every member of the BCA was deliberately lying to their patients. Despite the fact that Singh never actually questions the motivations of the BCA itself and the following paragraph clearly shows he was questioning the efficacy of the treatments, the judge somehow decided for Singh what he 'really' meant.
Fortunately, Singh was granted leave to appeal this ruling earlier this month. His appeal is pending. The BCA may also have undermined its own case through its own statements in response to Singh's appeal. Curiously, they asserted the BCA was "maliciously attacked by Dr. Singh" in their first press release. The BCA then released a new statement simply saying they were "libelled." By ascribing malice to Dr. Singh, the BCA may have opened themselves up to a countersuit.
Sense About Science has organized a petition on Simon Singh's behalf to change the laws in the UK to be more consistent with the scientific method and freedom of expression. Singh's case has garnered worldwide support from scientists, academia, media, and skeptics groups. I just signed it myself.
Libel laws should not be used to silence dissent and scientific inquiry. Don't think it can't happen here in the United States, either. In the 80s, the American Medical Association was sued by chiropractors for "restraint of trade" because it told their members not to refer to chiropractors. The AMA lost its "quality of care" defense because the boycott was ruled unnecessarily anti-competitive, though the ruling said the AMA is still free to criticize chiropractic.
Some skeptic writers are now even told by defenders of chiropractic that they aren't allowed to criticize the field as a result of the permanent injunction against the AMA. It's not at all true, but it illustrates how far some of the true believers are willing to go.
It is my sincere hope that Simon Singh is exonerated of the claims against him and that reason and critical analysis are not sacrificed on the altar of political correctness.
"If the chiropractors are claiming they can treat illnesses, then the burden of proof should be on them to prove they can. Singh has done nothing wrong by pointing out that he and his colleague can't find any such evidence, except for limited efficacy for lower back problems."
I know anecdotal evidence is not what is needed here, but I will say that many people I know who have back problems HAVE been helped by chiropractors, but I want to SEE the results of studies with babies, and personally, for treatment of fibromyalgia. Not EVERYTHING is about alignment, and I know a woman put in the hospital because of harmful treatment. After 3 sessions I had to quit because of intense pain between sessions, yet insurance covered it. Go figure.
Reminds me of Consumer Reports Magazine getting sued every time they turn around.
I have the same recollection as SSTMelon.
And Singh never said they were being deliberately dishonest. Such a statement is nowhere in the actual article. It was inferred by the judge, which I think is problematic. All Singh said was that they were promoting ineffective treatments. They obviously very much believe they are doing the right thing.
I do. And maybe I was just deluded, but my recollection is that there was plenty of public (or at least media) outrage and astonishment that she was being sued for saying what she did. These suits are classic SLAPP suits, or "strategic lawsuits against public participation." They're deeply problematic.
And does anyone remember the lawsuit against Oprah Winfrey by the cattlemen who said she had disparaged beef products? As I recall, she won, but what I don't recall is a great hue and cry in this country about stifling criticism.
"In Singh's case, the judge presiding over the preliminary hearing bizarrely ruled that Singh was stating, as a matter of fact, that the BCA was being deliberately dishonest."
Reading the bolded words, I think the judge got it right. What else can those words mean?
If the chiropractors are claiming they can treat illnesses, then the burden of proof should be on them to prove they can. Singh has done nothing wrong by pointing out that he and his colleague can't find any such evidence, except for limited efficacy for lower back problems.
My wife (a biomedical engineer PhD) was not impressed with the doctor's technical writing. From my end, when someone states something as fact it becomes problematic unless they can prove that. Assuming he does in the book, it is still problematic because more will read the column and not the book. If I were to say that any of bill james' theories were bogus without proof I would be in some hot water (I am also a sabermetrician). If I state it as an opinion I am on much more solid ground.
I see the article: Nov. 6, 2008. It's a book review. It doesn't even mention the section on chiropractic medicine. It also observes that the book contains few references.
I'm not saying they should be prosecuted for making the claims for which they're being sued - certainly not. But they may very well not have sufficient evidence, under Britain's standards, to successfully defend themselves. It's hard to back up a claim that a group of practitioners promotes bogus treatments if there's only limited evidence one way or the other to support the assertion.
SSTMelon,
His and Ernst's claims were supported by the New England Journal of Medicine as an effective summary of the evidence on the topic. I'll see if my wife has already recycled her copy of that issue or not.
tragicmagic,
I'm of the opinion that the "war on drugs" is a miserable failure anyways and that most of it should be regulated like beer, cigarettes, and pharmaceuticals, depending on potency and effect. I tend to agree with Singh and Ernst that we need to figure out what works and use it, rather than being concerned about what is "traditional" and what "isn't."
That Homer........wise behind his ears.
Reminds me of a simpsons episode where homer discovered a cure for back pain by throwing the patient over a bent trash can. When people began to pay him, the chiropractors came by and destroyed his trash can. They told him it wasn't an accepted form of medicine. You could slice the irony with a knife.
very informative but troubling post. i'll next be visiting the "sense about science" link you provided and i'm curious about any significance of england's socialized medicine system in relation to the rule of law. you are correct, i never assume things like this can't and don't happen here. speaking of complementary medicine, would you care to tackle the issue of medical cannabis some time? i've been working part time for a research project on the subject to supplement my income, and have uncovered a few eye openers off the beaten path.
Freedom of speech in the UK is a rather different animal than it is here. As for the "they aren't allowed to criticize the field as a result of the permanent injunction against the AMA," I'd wager you'd go about as far on that theory in a U.S. court of law as you would with a shovelful of horse pucky.
As for the claim Singh made, have you seen the evidence supporting it? I've not read the book. As you may know, there aren't a heck of a lot of double-blinded randomized control studies on the efficacy of many if not most of the treatments that most allopathic physicians offer, let alone chiropractors. Are they therefore "bogus"? Or are they merely therefore "untested" or "insufficiently tested" or something else of the sort?