British Chiropractic Association v Simon Singh

I think if can be shown they knew about the "plethora" and how pathetic it was, and I think it can also be shown they knew about the good, negative studies they left out of their list.

It's obviously not easy, but if pushed, I suspect a case could be made.

If Simon's up for it, even a judgement saying chiropractic is actually completely useless for these conditions, but the BCAwere ignorant of the available evidence showing that, could hole them close to the waterline.

Rolfe.
 
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Quite.

Knowing what the law is like, I wouldn't care to bet actual money on that working, but if Simon has enough to give it a go, I'll guarantee to cheer from the touchline.

Rolfe.
 
Rolfe said:
I think if can be shown they knew about the "plethora" and how pathetic it was, and I think it can also be shown they knew about the good, negative studies they left out of their list.

It's obviously not easy, but if pushed, I suspect a case could be made.

If Simon's up for it, even a judgement saying chiropractic is actually completely useless for these conditions, but the BCAwere ignorant of the available evidence showing that, could hole them close to the waterline.

Rolfe.
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Actually, that last article does have a good point: the websites of directors of the BCA have claims that the BCA has asked their membership not to make, due to having lost legal rulings about their legitemacy in the past. ie: the BCA directors have been informed in black and white that these claims are bogus by the very definition they believe Singh is using.
 
zeno2712 said:
Blogging: Zeno's Blog » What's Polish for 'chiropractor'?

More about the GCC's leaflets, some comments on Bronfort et al. and who actually regulates what chiros can claim.
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Great post, Zeno. I've left a comment about the Bronfort et al. review. In brief, lead author, Bronfort, serves on NCCAM's National Advisory Council for Complementary and Alternative Medicine (NACCAM), and both he, and one of the review's co-authors, Roni Evans, were keynote speakers at the British Chiropractic Association Conference held in Wales, England, in October 2009.

ETA. Also see from post #23 onwards of this thread:
http://www.internationalskeptics.com/forums/showthread.php?p=5673480#post5673480
 
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BenBurch said:
Well, I think that showing their ignorance is not enough. Showing that they KNEW that they did not know is what he would have to demonstrate. especially if he can find some prior admission on their part, but difficult
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I think you are saying something you didn't mean but, if you are saying what I think you mean :D, the problem for SS is that he actually believed that they were ignorant about what the evidence says or, more accurately, ignorant about what the word "evidence" actually means.

edit: same response to Rolfe
 
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BillyJoe said:
I think you are saying something you didn't mean but, if you are saying what I think you mean :D, the problem for SS is that he actually believed that they were ignorant about what the evidence says or, more accurately, ignorant about what the word "evidence" actually means.

edit: same response to Rolfe
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Right, but the ruling on meaning has him saying that they KNEW they were wrong. He would have to prove that.
 
They appear to have known about the high-quality negative studies they left out of their literature review. And

Blutoski said:
Actually, that last article does have a good point: the websites of directors of the BCA have claims that the BCA has asked their membership not to make, due to having lost legal rulings about their legitemacy in the past. ie: the BCA directors have been informed in black and white that these claims are bogus by the very definition they believe Singh is using.
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These are people putting themselves forward as health professionals. They made these claims, apparently on the basis of the "plethora" they took so long to produce, but that turned out to be pathetically weak, with many of the papers not even referring to chiropractic. And the strongest evidence, the high quality studies that showed there was no effect, they knew about, but omitted.

I'd say a case could be made.

BJ, I know you think it necessary that Simon should have intended that meaning from the start. I don't agree. If the court rules his words had that meaning, that is the meaning he has to prove, and if he can prove it, good luck to him.

Rolfe.
 
My opinion is that Simon was calling them liars pure and simple, but if he can manage without needing to defend that, I can't blame the man.
 
Rolfe said:
They appear to have known about the high-quality negative studies they left out of their literature review. And

Actually, that last article does have a good point: the websites of directors of the BCA have claims that the BCA has asked their membership not to make, due to having lost legal rulings about their legitemacy in the past. ie: the BCA directors have been informed in black and white that these claims are bogus by the very definition they believe Singh is using.
Click to expand...


These are people putting themselves forward as health professionals. They made these claims, apparently on the basis of the "plethora" they took so long to produce, but that turned out to be pathetically weak, with many of the papers not even referring to chiropractic. And the strongest evidence, the high quality studies that showed there was no effect, they knew about, but omitted.

I'd say a case could be made.
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It might be difficult. From Adrienne Page QC's submissions on behalf of Singh, from the transcript of the CA proceedings on Jack of Kent's blog:
In libel no less than in any other context in these courts, in order to allege dishonesty, you must particularise it as if it was an indictment. That is the expression that is commonly used in the context of defamation. You would have to identify in your pleadings the individuals within the BCA who were those responsible for the claims being placed on the website, and whose state of mind can properly be attributed to the company so their knowledge can be attributed to the company.
Ironically, in a Part 18 request Mr McCormick actually asked for the identity of the individual or individuals on behalf of the BCA who performed the task of reviewing the state of the published literature, and that was refused in the response as disproportionate and unnecessary. The fact is where would Dr Singh start? He does not know anything about who within the BCA would have been responsible for this or their state of knowledge.
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Soapy Sam said:
My opinion is that Simon was calling them liars pure and simple, but if he can manage without needing to defend that, I can't blame the man.
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From interviews I've seen of him, I think this is just not his style.
He's generally a very cautious, nuanced, circumspect sort of guy.
 
Rolfe said:
BJ, I know you think it necessary that Simon should have intended that meaning from the start. I don't agree. If the court rules his words had that meaning, that is the meaning he has to prove, and if he can prove it, good luck to him.
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Well, perhaps he could say that he didn't intend that meaning when he wrote that article, but that he has discovered subsequently that, in fact, they are a deliberately dishonest and disreputable bunch of cretinous idiots and here is the proof.
.....except in his usual cautious, nuanced, circumspect sort of style.
 
[SIZE=-2][/SIZE]Jennifer Bolton:
(Director of Chiropractic research!)
[SIZE=-1]The answer, on balance, is that the research evidence for chiropractic treatment of certain conditions is weak, and yes, of course, we need much, much more. In the meantime, however, we have to rely on evidence from other sources, which means the clinician’s expertise and experience and also the views and wishes of the patient.[/SIZE]
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Did SS say happily ignorant?
Here is a knock-out response:

[SIZE=-1]Jennifer Bolton's comment makes no sense. [/SIZE][SIZE=-1] With the possible exception of low back pain, there is no compelling evidence that chiropractic is safe and effective for anything...[/SIZE][SIZE=-1]In the absence of evidence, Ms. Bolton would have us rely on "clinician’s expertise and experience and also the views and wishes of the patient"...It was not until we learned that we can be fooled by "expertise and experience," and adopted scientific methods, that we began to make progress in health care. [/SIZE]
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Will Jennifer continue to "happily" promote "bogus" treatments "without a jot" of evidence?
Two years down the track from the SS article, who could doubt it?
 
Hmmm...that sounds suspiciously like something I've said:

"You seem to be making the claim that a careful, considered, subjective evaluation by someone with expertise, as a tool, is a reasonable way to discover real patterns...This is how medicine was practiced for thousands of years and no progress was made during that time. It wasn't until we began to seriously consider the possibility that we were wrong, that we began to make progress."

http://www.internationalskeptics.com/forums/showthread.php?postid=3144061#post3144061

Or:

"What finally pulled us out of the mud was the realization that we were fooling ourselves. We were falsely assuming that just because one thing followed the other (we felt better after taking a medicine), that the medicine was responsible. It wasn't until we asked, "what would have happened if we didn't do anything?" and "does it mean that somebody is better just because they say they feel a little better?", that we began to make progress toward discovering medicines and therapies that actually made a real difference."

http://www.internationalskeptics.com/forums/showthread.php?postid=4117168#post4117168

Linda
 
BillyJoe said:
[SIZE=-2][/SIZE]Jennifer Bolton:
(Director of Chiropractic research!)

-snip-

Will Jennifer continue to "happily" promote "bogus" treatments "without a jot" of evidence?
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It's interesting to note what Edzard Ernst had to say in 2008 about a study into the safety of chiropractic cervical manipulation that Professor Jennifer Bolton co-authored in 2007:
Thiel HW, Bolton JE, Docherty S, Portlock JC. Safety of chiropractic manipulation of the cervical spine: a prospective national survey. Spine 2007; 32: 2375–8.

The sample of this survey was sizeable but not large enough to exclude rare events…

The picture gets more complicated when considering the 698 treatment consultations of patients who failed to return for their next treatment. Theoretically some or most or all of these patients could have died of a stroke. Overlooking even one single serious adverse event would change the estimated incidence rates from this study quite dramatically.

In my view, the most confusing aspect about the results of this survey is the fact that the incidence of minor adverse events is so low. Previous studies have repeatedly shown it to be around 50%. The discrepancy requires an explanation. There could be several but mine goes as follows: the participating chiropractors were highly self-selected. Thus they were sufficiently experienced to select low-risk patients (in violation of the protocol).

This explains the low rate of minor adverse events and begs the question whether the incidence of serious adverse events is reliable.

http://www.medicinescomplete.com/journals/fact/current/fact1301a07g04r01.htm
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It’s also interesting that in response to Ernst's remarks (also published in the above link) JE Bolton and another co-author, HW Thiel, claimed that in the UK alone there were an estimated *four* million manipulations of the neck carried out by chiropractors each year. Yet, six months earlier, in October 2007, in a letter to the Journal of the Royal Society of Medicine, they claimed that the figure was “estimated to be well over *two* million cervical spine manipulations”:
http://www.jrsm.org/cgi/content/full/100/7/330

How that estimate could double in under 6 months is anyone’s guess, but it leaves them open to accusations that they may be trying to play down the risks.

But, to be fair, at least Jennifer Bolton did concede in 2002 that chiropractic for the treatment of infantile colic probably had no benefit over placebo:
Is chiropractic an effective treatment in infantile colic?

Report by Stephen Hughes (1) and Jennifer Bolton (2)
1. Paediatric SpR, Northwick Park Hospital, Harrow
2. Director of Research Anglo-European College of Chiropractic, Bournemouth B5 2DF

Mrs A presents with her 6 week old baby, complaining of his excessive and uncontrollable crying behaviour, particularly in the evening and at night. The child is otherwise healthy, thriving, and has normal weight gain. Following questions regarding the pattern of crying, and associated signs, it is apparent that the child is exhibiting typical colic behaviour. There are clear signs that the continual and excessive crying behaviour is impairing the mother-child relationship, and you consider the child might be at an increased of risk of harm (or neglect). In discussing the treatment options, Mrs A tells you that her chiropractor has offered to treat her baby for the excessive crying behaviour. She herself has been treated by this chiropractor in the past for back pain, and it is obvious she has considerable confidence in him. She asks your advice.

Structured clinical question

In an otherwise health 6 week old infant with typical colicky pain [patient], is chiropractic [intervention] effective in reducing the severity of the colic, or the length of time spent crying [outcome]?

Search strategy and outcome

o The evidence suggests that chiropractic has no benefit over placebo in the treatment of infantile colic. However, there is good evidence that taking a colicky infant to a chiropractor will result in fewer reported hours of colic by the parents.

o In this clinical scenario where the family is under significant strain, where the infant may be at risk of harm and possible long term repercussions, where there are limited alternative effective interventions, and where the mother has confidence in a chiropractor from other experiences, the advice is to seek chiropractic treatment.

Hughes and Bolton Arch Dis Child.2002; 86: 382-384
http://adc.bmj.com/cgi/content/full/archdischild;86/5/382
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NB. At the time the above advice "to seek chiropractic treatment" was given, safety data on paediatric spinal manipulation were virtually non-existent, so a valid risk/benefit assessment would have been impossible:
http://pediatrics.aappublications.org/cgi/content/full/119/1/e275

How ethical is that?
 
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