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← Simon Singh and Free Speech - Against the BCA Libel Claim

Simon Singh and Free Speech - Against the BCA Libel Claim - Comments

Telic's Avatar Comment 1 by Telic

I have read both "Fermat's Last Theorem" & "The Codebook", and I have a huge amount of respect for Simon Singh's ability to make potentially dry subjects, both easy to understand, and hugely entertaining.

Good luck Simon.

Sun, 17 May 2009 11:25:00 UTC | #361016

andygaffey's Avatar Comment 2 by andygaffey

The BCA should be quaking in their boots. I suppose their best form of defense is attack.

I've seen dozens of kids treated for musculo-skeletal conditions by chiropractors. None of them had any benefit from this treatment, but all had proper treatment delayed. It is only be a matter of time before one of these quacks kills a kid by missing a tumour/other significant illness.

I usually advise parents that chiropractors have no right to treat children (adults can choose whatever quackery they like and suffer the consequences). In future I'll be recommending legal action for mis/delayed diagnosis.

I fully support Simon in his endeavor and hope that the legal action falls flat on it's gluteus maximus!

OK, Just got off pubmed.... no RCT comparing Asthma or ear infection with children comparing chiropractor vs anything else/placebo. The "golden nugget" came from....

http://www.ncbi.nlm.nih.gov/pubmed/11890430?ordinalpos=49&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

A typical pseudoscientific paper suggesting that as Chiropractering works, but no one knows how it is impossible to generate a placebo. Isn't this the same argument for crystals/homoepathy etc...?

Sun, 17 May 2009 11:34:00 UTC | #361025

Zarlan's Avatar Comment 3 by Zarlan

"The BCA want damages"

What about the damages that the BCA can cause?
Chiropractic treatment of asthma and frequent ear infections, I find highly suspect. Now add to that, that it's for children...

This whole thing is ridiculous.
Libel? For criticizing them, for using suspect, and unscientific, treatments?

Speaking of Simon Singh, I've got to get around to reading "Trick or Treatment", which he co-authored with Edzard Ernst.

Sun, 17 May 2009 11:37:00 UTC | #361028

PaulJ's Avatar Comment 4 by PaulJ

From what I've read (though I admit I'm not up to date), the BCA objected to Singh's use of the word bogus, which the BCA took to mean fraudulent, which was not his intention. Unfortunately the judge in this case agreed with the BCA.

I'm not sure which dictionary they keep handy in court, but the Concise Oxford defines bogus as "not genuine or true", which would seem to fit the bill.

Sun, 17 May 2009 11:55:00 UTC | #361039

andygaffey's Avatar Comment 5 by andygaffey

Sorry, I'm on a roll here, but this is one of my bug bears. Forgive the medical jargon.

Going to Pubmed and searching a MeSH heading for "Manipulation/Chiropractic" gives me 378 papers. Limiting this to randomised control trials reduces the number to 49. The majority of these are for treatment of lower back pain (a well recognized self limiting condition). Combining this with the MeSH heading for Asthma (using the Boolean "AND" term) resulted in NO matches. When I took out the RCT limit I found three papers. 1 had no abstract, but the other two did. I include them below (if space permitting).

Abstract 1

BACKGROUND: A variety of manual therapies with similar postulated biologic mechanisms of action are commonly used to treat patients with asthma. Manual therapy practitioners are also varied, including physiotherapists, respiratory therapists, chiropractic and osteopathic physicians. A systematic review across disciplines is warranted. OBJECTIVES: To evaluate the evidence for the effects of manual therapies for treatment of patients with bronchial asthma. SEARCH STRATEGY: We searched for trials in computerized general (EMBASE, CINAHL and MEDLINE) and specialized databases (Cochrane Complementary Medicine Field, Cochrane Rehabilitation Field, Index to Chiropractic Literature (ICL), and Manual, Alternative and Natural Therapy (MANTIS)). In addition, we assessed bibliographies from included studies, and contacted authors of known studies for additional information about published and unpublished trials. Date of most recent search: August 2004. SELECTION CRITERIA: Trials were included if they: (1) were randomised; (2) included asthmatic children or adults; (3) examined one or more types of manual therapy; and (4) included clinical outcomes with observation periods of at least two weeks. DATA COLLECTION AND ANALYSIS: All three reviewers independently extracted data and assessed trial quality using a standard form. MAIN RESULTS: From 473 unique citations, 68 full text articles were retrieved and evaluated, which resulted in nine citations to three RCTs (156 patients) suitable for inclusion. Trials could not be pooled statistically because studies that addressed similar interventions used disparate patient groups or outcomes. The methodological quality of one of two trials examining chiropractic manipulation was good and neither trial found significant differences between chiropractic spinal manipulation and a sham manoeuvre on any of the outcomes measured. One small trial compared massage therapy with a relaxation control group and found significant differences in many of the lung function measures obtained. However, this trial had poor reporting characteristics and the data have yet to be confirmed. AUTHORS' CONCLUSIONS: There is insufficient evidence to support the use of manual therapies for patients with asthma. There is a need to conduct adequately-sized RCTs that examine the effects of manual therapies on clinically relevant outcomes. Future trials should maintain observer blinding for outcome assessments, and report on the costs of care and adverse events. Currently, there is insufficient evidence to support or refute the use of manual therapy for patients with asthma.

Abstract 2

OBJECTIVE: To provide a brief overview of the current state of evidence for chiropractic care, specifically in the management of asthma and to a lesser extent allergy. DATA SOURCES: A search of MEDLINE for English-language articles published between January 1966 and July 2002 was conducted using the keywords asthma, allergy, manual therapy, physical therapy techniques, chiropractic, physical therapy (specialty), physiotherapy, massage, and massage therapy. A hand search of the primary chiropractic and osteopathic literature on the treatment of asthma was performed, and proceedings from a recent research symposium on spinal manipulation were included. STUDY SELECTION: Clinical controlled studies and systematic reviews on spinal manipulative therapy (SMT) and asthma were selected. There were no primary clinical trials on SMT and allergy found. RESULTS: Many of the claims of chiropractic success in asthma have been primarily based on anecdotal evidence or uncontrolled case studies. Three recently reported randomized controlled studies showed benefit in subjective measures, such as quality of life, symptoms, and bronchodilator use; however, the differences were not statistically significant between controls and treated groups. There were no significant changes in any objective lung function measures. The clinical issues emanating from these trials are discussed. CONCLUSIONS: There is currently no evidence to support the use of chiropractic SMT as a primary treatment for asthma or allergy. Based on reported subjective improvement in patients receiving chiropractic care, certain clinical circumstances may warrant a therapeutic trial in patients with asthma. Further properly designed, collaborative research is needed to determine if there is a role for chiropractic SMT in the care of asthma or allergy.

Looks like the BCA have their hands full on this one. Go F@£%$K 'em Simon!!!!

Sun, 17 May 2009 11:57:00 UTC | #361040

squinky's Avatar Comment 6 by squinky

Sorry British friends but this libel shit has to go. It hampers free speech and I'm amazed you haven't jettisoned it by now.

Sun, 17 May 2009 12:50:00 UTC | #361069

AshtonBlack's Avatar Comment 7 by AshtonBlack

@ 8. Comment #377992 by squinky on May 17, 2009 at 1:50 pm

Erm...no. There has to be a way to protect people's characters from false accusations made by a media outlet. Otherwise, they would print ANYTHING if it "sold papers" no matter the individual damage this might cause.

Say what you like, just make sure you have evidence to present, if you are making accusations.

In this case the BCA, I suggest, has just put it's self on trial.

I wish Simon luck and hope that reason prevails.

Sun, 17 May 2009 13:20:00 UTC | #361080

Mark Jones's Avatar Comment 8 by Mark Jones

Comment #377969 by Raiko

Good comment, but, yeah, should be over there...

Sun, 17 May 2009 13:35:00 UTC | #361085

PrimeNumbers's Avatar Comment 9 by PrimeNumbers

I used to work in an office next door to a Chiropractor. I remember the screams, and there alway seemed to be an ambulance visiting too.

Not to mention, that a Chiropractor could cripple me...

Sun, 17 May 2009 13:51:00 UTC | #361089

vampfan30's Avatar Comment 10 by vampfan30

this is my first comment here ever, please be nice ^_^

I visited a chiropractor when I was about 20 years old. I had some problems with my neck due to over using my left side. After the first round, things were a lot better for me. I also have had several family members that went to the same doctor with good results. There are several choriprctors that practice here in my town & I have never heard any patients complain.

From the looks of things, maybe we were the exceptions to prove the apparent rule that most chiropractors are dangerous nutjobs...

just my two cents, guys.

V

Sun, 17 May 2009 15:13:00 UTC | #361110

polestar's Avatar Comment 11 by polestar

As 4. Comment #377961 by PaulJ pointed out, Singh has already been convicted: pay attention folks, especially those hoping that reason will prevail. I'll say it again: he has already been convicted.

See the details in the latest Private Eye (for Americans, it is an investigative and satirical magazine) and on the Facebook site above.

The only hope now is an extremely expensive appeal so the only relevant question now is does anyone know of a defence fund we can contribute to? There's no clue on the Facebook site cited above.

Sun, 17 May 2009 15:25:00 UTC | #361115

Carl Sai Baba's Avatar Comment 12 by Carl Sai Baba

The BCA can shove their spines up their asses.

As much as any other failed theory of disease, "chiropractic" fails to account for virtually every known disease-causing agent and immunity mechanism discovered in the past 100 years.

Sun, 17 May 2009 16:46:00 UTC | #361134

j.mills's Avatar Comment 13 by j.mills

vampfan30: Chiropractors manipulate the spine. It's not out of the question that that could assist with your neck problem. But here the claim is that it can help with asthma and ear infections.

squinky:

Sorry British friends but this libel shit has to go. It hampers free speech and I'm amazed you haven't jettisoned it by now.
It certainly needs improvement. Unlike other 'offences', it places the burden of proof on the accused. Also it is penalised by substantial claims for damages. I'd like to see the default penalty be simply a retraction in the same publication, presented with equal prominence and with wording agreed by the court. If The Sun fills its Saturday front page with a story that David Beckham smells of elderberries, and he proves he doesn't, then The Sun should have to waste another Saturday front page in saying so.

Sun, 17 May 2009 17:19:00 UTC | #361145

heathen2's Avatar Comment 14 by heathen2

Anyone have a link to the original comment piece that Singh wrote? I tried finding it on the Guardian site, but it does not seem to be there.

Sun, 17 May 2009 17:52:00 UTC | #361154

j.mills's Avatar Comment 15 by j.mills

Here's the original, mirrored by a Rusky, since the Graudian seems to have removed it.

http://svetlana14s.narod.ru/Simon_Singhs_silenced_paper.html

EDIT: It seems that the judge ruled that "bogus" meant fraudulent rather than simply false or unsupported, and this surprising ruling is a serious obstacle to the legal resolution. I'm No Lawyer, but it looks to me like 'fraudulent' is a perfectly reasonable description: there appears to be no evidence that the treatment can do what the BCA says and they have no business making the claim. [Shrug.]

Sun, 17 May 2009 18:09:00 UTC | #361159

Greybeard's Avatar Comment 16 by Greybeard

I have had immediate results from chiropractic spinal manipulations, many times over the last twenty-five years.

It works. Fast relief from serious back pain, when a doctor would have sent me to bed for two weeks with pain killers.

However, it did not cure my asthma or hay fever and I am very sceptical about claims that chiropractic cures various diseases and other ailments, other than a misaligned spine.

Sun, 17 May 2009 18:27:00 UTC | #361166

heathen2's Avatar Comment 17 by heathen2

Thanks j.mills.

Sun, 17 May 2009 18:38:00 UTC | #361167

Goldy's Avatar Comment 18 by Goldy

I've had my back cracked. Damn, felt good afterwards! Could finally go to the toilet unaided!
Maybe the one I go to is realistic - when having slipped a disc and damaged a nerve (and by all that is holy the pain was something else) he decided that the doctor was the better person for me to visit.
As it was, the conventional medical side really helped with Tramadol, diclofenac and ibuprofen. Sorted that pain right out. In return, I had to offer my bare bum for finger insertion (twice - don't they read notes?) to ascertain where the damaged nerve was (L5, I believe).
Chiro I went to never claimed anything for his treatments. As he put it, he can help, but the onus is on me, the patient, to try and get my body in order - lose weight, stretch, lose weight, exercise adn lose weight. I think he was trying to tell me something...

For what it's worth, I don't think they can do more than get the body comfortable when there's back issues. And then these issues have to be fairly chiropractically specific...

Sun, 17 May 2009 18:41:00 UTC | #361168

Alternative Carpark's Avatar Comment 19 by Alternative Carpark

Simon Singh is great. Best of luck to him.

Aside from its dubious efficacy against non-musculo-skeletal complaints, given that their bones are still developing and pliable, isn't chiropractics for kids pointless at best and dangerous at worst?

Sun, 17 May 2009 18:56:00 UTC | #361171

Rob Schneider's Avatar Comment 20 by Rob Schneider

Re: Comments 7 and 8.

In the US, truth is always a defense in both slander and libel cases. That's the way it "should be"... and I gather that truth is NOT a defense in Britain.

So,
1. It is NOT the case that people will be able to "publish anything" and ruin other peoples' character.

2. British libel law (if I understand it correctly at this point) is antithetical to free speech. True statements (especially in this case, about a group or a medical field of practice) can't be libelous, unless you also hold that the Organization of Muslim Nations push in the UN is also a good thing?

They're getting the UN rules re-written to make religious offense punishable. Isn't a true statement about the inefficacy of chiropractic (for asthma, parkinsons, etc.) as offensive as a true statement about the inefficacy of believing in the invisible friend of your choosing?

Blasphemy law must go, and British libel law (as I've been led to understand it from comments on this site) is effectively a blasphemy law of sorts. Sad.

Sun, 17 May 2009 19:03:00 UTC | #361174

j.mills's Avatar Comment 21 by j.mills

Alternative Carpark:

isn't chiropractics for kids pointless at best and dangerous at worst?
Actually it was babies in the original leaflet!

Sun, 17 May 2009 19:51:00 UTC | #361181

zecat's Avatar Comment 22 by zecat

I thought chiropractics was "real" medicine. In fact, I do visit my chiropractor once in a while when my low back or my neck hurts. It does help a lot, I have to say. All chiropractors I know are also "real" doctors, too. But I wouldn't consult a chiropractor for asthma problem!

Sun, 17 May 2009 23:28:00 UTC | #361206

mrjonno's Avatar Comment 23 by mrjonno

Chiropractors comes from the late 19th century religious nuts who wanted to squeeze demons out of your bones (it technically known as bollocks).

However some chiropractors have left this behind and some even have qualifications in real parts of medicine. A massage could well give some relief to some symptoms but its not going to cure anything

Mon, 18 May 2009 00:15:00 UTC | #361214

bendigeidfran's Avatar Comment 24 by bendigeidfran

Comment #378095 by Goldy

No, it was L6. We've been through this twice already.

Mon, 18 May 2009 00:44:00 UTC | #361216

clodhopper's Avatar Comment 25 by clodhopper

The BCA will do itself more damage if it persues this case. They fall into the trap of over egging the efficacy of their treatments thereby taking whatever is proven, sound and effective about their treatments into the wackier realms of CMA. Bad mistake and they will pay for it.

Mon, 18 May 2009 01:07:00 UTC | #361219

carlitoernesto's Avatar Comment 26 by carlitoernesto

Why go to a Chiropractor when you can go instead to a board-certified physical therapist? We don't have chiropractors here though.


From Gale Encyclopedia of Alternative Medicine:

It has become well-accepted treatment for acute pain and problems of the spine, including lower back pain and whiplash. Applications beyond that scope are not supported by current evidence.

There is some anecdotal evidence recommending chiropractic treatment for ailments unrelated to musculoskeletal problems, but there is not enough research-based data to support this.

...others claim to treat disorders that are not closely related to the back or musculoskeletal system. These include asthma, bed-wetting, bronchitis, coughs, dizziness, dysmenorrhea, earache, fainting, headache, hyperactivity, indigestion, infertility, migraine, pneumonia, and issues related to pregnancy.

There are at least three explanations for possible efficacy for these conditions ... a) relieve nerve impingement ... b) relief from complicating pain & spasms ... c) manipulation/soft-tissue techniques may directly promote improvement of some conditions.

[what??! yep. those are the three possible explanations in short.]

One particular procedure, known as the endonasal technique, is thought to help the eustachian tube to open and thus improve drainage of the middle ear. The tube is sometimes blocked off due to exudates or inflammatory processes. This can offer significant relief from earaches. Some headaches also fall in this category, as skilled use of soft tissue techniques and adjustment may relieve the muscle tension that may initiate some headaches. Dysmenorrhea, hyperactivity, indigestion, and infertility are said to be relieved as a result of improved flow of blood and nerve energy following treatment. Evidence for this is anecdotal at best

[nerve energy??! soft tissue techniques & adjustment??! endonasal technique??! acute otitis media is quite common in children... the doctor usually prescribes small amounts of corticosteroids to help open the Eustachian tube, or do a guided valsalva maneuver. Myringotomy may be done if needed. For chronic otitis media, suctioning is done under otoscopic guidance. Serous otitis media most often resolves on its own. I can't understand why anyone who has a headache, asthma, ear problems, dysmenorrhea etc. needs to go to a chiropractor... The scope of their practice should be limited -- as far as I'm concerned. If you're kid has an ear problem, I suggest visiting a nurse practitioner instead (cheaper) -- if the kid needs a myringotomy or delicate otoscope-guided suctioning, she should know when to consult a specialist.]

Chiropractic practice requires at least two years of science-based undergraduate work, and most applicants have completed a bachelor’s degree. Chiropractic college is an additional four-year program, and graduates receive a D.C. (doctor of chiropractic) degree. Chiropractic education emphasizes knowledge of anatomy, physiology, diagnostic skills, neurology, and radiology.

[I don't think it's appropriate to give the title 'Doctor' to these professionals... unless if they've undergone additional specialized training for several more years. Fact is: very few chiropractors get additional specialized training beyond their four-year degree.]

Mon, 18 May 2009 01:15:00 UTC | #361223

stephenray's Avatar Comment 27 by stephenray

From Jack of Kent:

"This "reverse burden" of proof means that English libel law is regarded as unfair to defendants and too advantageous to the claimant."

Er... not by me, it isn't.

Beyondbelief says that British libel law is 'antithetical to free speech'; squinky is similarly condescending.

If a citizen alleges that I have caused him bodily injury in a car accident, I do not expect to have to disprove his allegation; I expect that he will be required to prove the truth of his claim.

If he alleges that I have sex with animals, I do not expect to have to disprove his allegation. Once I have proved that he made the allegation, I expect him to have the burden of proving that it is true.

If Mr Singh had not used the word 'bogus' but 'unproven' or something similar, he would be unimpeachable; even 'risky' or 'dangerous' might have been OK. But he's a writer; we can assume that he knows the tools of his trade. He made the mistake of allowing the BCA to pick its ground, and thus tilt the battle in its favour. If he'd been more careful, it could not have launched such a claim.

More generally, if your position is true and you do not carelessly overstate it, you'll get just as much protection for free speech in England as in the US.

Of course, if you are Ann Coulter or Fred Phelps, our free speech protections don't extend to you. Hey, imagine my dismay.

Mon, 18 May 2009 01:52:00 UTC | #361233

stephenray's Avatar Comment 28 by stephenray

As for the definition of 'bogus', my dictionary - nothing special - says: "spurious or counterfeit; not genuine", and its thesaurus section lists: "artificial, counterfeit, fake, false, forged, fraudulent, imitation, phoney, sham, spurious".

The judge starts from this point.

His claimant says: "By using 'bogus', the journalist means we are providing treatments we know to be ineffective, that we are charlatans"

His defendant says: "No, by the use of the word 'bogus' I merely mean that there is no scientific basis for the treatment (nor the practice) of chiropracters."

The judge looks at his dictionary, and (for example) thinks to himself: "it seems to me that in his article the Defendant is either stating: 'the treatment has no merit, but the BCA are offering it anyway' OR 'the treatment is quackery'. In either case, he's allowing his readers to conclude that the BCA is at fault. The selection of the word 'bogus' - by a professional writer - in such circumstances is not neutral, and so I find I agree with the Claimant."

I don't like Eady J's conclusion, but I find it difficult to escape. As a lawyer I often have to deal with unpalatable decisions by judges which hamstring the case I need to argue. One thing I cannot do is assume that which the court will require me to prove.

I'm afraid that this is what nearly everyone here (and in Pharyngula's comments) is doing. 'Everyone knows this is bollocks', they say; 'why is this pesky judge making those who think like us work so hard?'

Um - it isn't a question of faith, so it must be a question of proof, right?

Mon, 18 May 2009 02:20:00 UTC | #361239

Ian's Avatar Comment 29 by Ian

I haven't had time yet to read in detail, but I've not seen a link to a fighting fund. Is there one?

Mon, 18 May 2009 03:13:00 UTC | #361251

Steve Zara's Avatar Comment 30 by Steve Zara

Comment #378168 by stephenray

I am afraid I have tended to think of the word "bogus" as "wrong" or "bad". But if the common definition does include the concept of "forgery", or "lying" in other words, a deliberate attempt to deceive, then Singh was very unwise to use the word. Saying that a treatment is useless or even dangerous is one thing. Implying an intent to deceive people is quite another.

And checking the definition, I have to agree with your dictionary.

Mon, 18 May 2009 03:32:00 UTC | #361258