Last year the British science journalist Dr Simon Singh was accused of libel by the British Chiropractic Association because he had written an article in the Guardian newspaper saying that chiropractors had been “happily promoting” “bogus” treatments. Singh pointed to the inadequacy of evidence supporting claims that chiropractic could treat childhood colic and asthma.
Earlier this year, Justice Eady ruled on the meaning of the word “bogus” and argued that Dr Singh was accusing the BCA of being deliberately dishonest, which was explicitly not what Singh’s article was saying.
It was clear to those reading the article that Singh was deploring the poor quality of the evidence offered, arguing that the claims were unjustified. He was criticising the BCA for defending those members who were making what he saw as unjustified claims.
The response of the BCA in launching a lawsuit was, at best, using a hammer to crack a nut. The obvious recourse would have been to openly evaluate the available evidence, invite those members who were offering treatment of colic and asthma to submit their best evidence, and then organise a panel to evaluate it. At the end of such an evaluation, it would have been reasonably clear whether there was any convincing evidence to support the claim. An open look at the evidence would have resolved, or at least clarified, the issue.
Once it became clear that Simon Singh was going to be dragged into court, very many scientists and eminent people from around the world gathered in support of his right to subject medical claims to criticism and evaluation. A petition was sent to the UK parliament, and open letters were published in the press.
The previous year, Dr Singh and Professor Edzard Ernst (a UK professor of Complementary Medicine) had written a book called Trick Or Treatment, in which they extensively evaluated the evidence for alternative medicine. In their chapter on chiropractic they concluded that there was no evidence for it being effective anywhere except for relief of lower back pain, and even there the evidence was poor, with conventional physiotherapy both more effective and less risky. They also found no evidence for the so-called subluxations, misalignments of the spine which are supposed to provide a diagnostic method for identifying illnesses in the organs of the body.
Once the BCA had launched the libel case, and Justice Eady had ruled on the meaning of “bogus”, the onus was on Dr Singh to prove his innocence. In contrast to the usual principles of justice, instead of being innocent until found guilty, UK libel laws are amongst the most draconian in the world, assuming guilt until the accused can prove his innocence.
It is vastly more expensive to defend a libel action in the UK than anywhere else in the world, which means that without extensive financial backing, anyone accused is almost always forced to settle out of court, paying damages even if innocent. This has prompted moves in the US to limit the applicability of UK libel law in the States because it hampers free speech. Simon Singh was at risk of potential bankruptcy.
But the supporters of Singh were not simply passive. In the UK, there is legislation to ensure that chiropractors have to register with a professional association, and members are bound by a code of practice, part of which says they shouldn’t make unjustified claims. There is also consumer protection legislation which provides recourse for those contesting false advertising claims.
Within a couple of days, more than 500 chiropractors who had advertised that they could treat childhood colic, asthma, and a variety of other illnesses were subject to complaints about unsubstantiated claims. The General Chiropractic Council was legally obliged to investigate each claim. In addition, the Advertising Standards Authority started dealing with the complaints as well, and told many chiropractors to remove the unsubstantiated claims from their websites.
The response was a mixture of panic and farce amongst the chiropractors. The McTimony Association sent out a letter to its members advising them to take down their websites pending further advice, and it was clear that for the first time, many chiropractors were having to think about the evidence behind their marketing claims.
As is the way with the British justice system, Simon Singh had to ask for permission to appeal the earlier ruling by Justice Eady on the meaning of the word “bogus”, and yesterday he had his chance. In court again, the aptly named Lord Justice Laws ruled that not only had Justice Eady’s ruling been “legally erroneous” but that there was no question of Simon Singh acting in good faith. He was now free to appeal the case.
What happens now is anyone’s guess. The BCA has issued a defiant press release (PDF) with potentially questionable content. Simon Singh will be back in court some time next year. If the BCA had any sense in this matter, it would let it drop rather than further embarrass its members.
But in all this legal hullabaloo, we shouldn’t lose sight of the importance of the issue. If someone makes questionable claims, which are abundant in the land of Woo, science journalists and others should have the right to challenge them, to question the evidence, and where those claims are seen to be unfounded, to say so openly. It is in the public interest. It is an unacceptable encroachment on free speech to use the libel laws to gag journalists and others seeking to expose questionable therapies.
There is now a coordinated campaign in the UK to get the libel laws amended so that science journalists and others are not attacked the moment they question therapies that are inadequately supported by evidence. This particular case only came up because the chiropractors are regulated by law and have to be answerable to the General Chiropractic Council. The British Chiropractic Association decided to go to court to attack the journalist who was questioning the practices of its members.
There are vast areas of alternative medicine where the most fanciful therapies are marketed on the basis of bizarre theories without even a passing glance at the notion of evidence. This is a massive business sector and few governments have the courage to put it under the spotlight. Journalists such as Simon Singh deserve our thanks for having the courage to investigate, and where appropriate, expose them.