This is another sceptic blog; The Lay Scientist who has put all the ASA decisions against chiropractic together. The bloggers can’t figure out why the GCC do not pursue these cases themselves. Margaret Coats began using the ASA to define scope of practice after Dafid Byfield got a hammering for trying to define the chiropractors scope of practice.
GCC chiropractic council members do not want to get their hands dirty and they started using ASA a few years ago. No doubt the same time they began using Private Investigators to spy on practitioners they don’t like.
It would appear Osteopaths deal with these advertising problems in house, which would be the sensible thing to do. Ther is a problem here for the chiropractic profession. On Wednesday NICE will recommend spinal manipulation for the management of back pain, however I would ask, Is back pain a disease, is chiropractic a treatment for back pain? or does an adjustment help the spine to adapt better to everyday stressors like sitting? Is chiropractic a treatment for colic or does the adjustment help the infants spine and nervous system adapt better to their stressors?
The “Lay Scientist” posting is titled
What Chiropractors Can’t Say: Previous Advertising Standards Rulings on Chiropractic:
By Martin – Posted on 22 May 2009, 11:30 (GMT)
[bpsdb] Recently, the Advertising Standards Agency adjudicated against Dr. Carl Irwin and associates, noting that their claims that chiropractic was an effective treatment for colic could not be substantiated. Thanks to some excellent work by Alan Henness of Think Humanism, we now know that the General Chiropractic Council (GCC) guidelines, which every UK practitioner must apply by, state that:
[Chiropractors] may publicise their practices or permit another person to do so consistent with the law and the guidance issued by the Advertising Standards Authority.
In this post, I’m going to look in the ASA archives to see to what extent this could apply to the BCA statements criticised by Singh, and to other chiropractors that we might wish to target.
Jack of Kent has an excellent blog entry covering the legal implications of the latest ruling with regard to the Singh vs. BCA libel case. I’m going to leave the legal aspects to him, although I would note that it seems absurd that the BCA can be regarded as being defamed when they were criticised for promoting something which their own professional guidelines state they are not allowed to promoted.
Instead, I’m going to look at previous ASA rulings on Chiropractic, to see what they can and can’t promote, in the hopes of prompting some of you to start a Blitzkrieg of complaints against some of the quacks out there.
In the last five years that archives are available, the ASA have filed 13 adjudications on chiropractic which chiropractors must abide by under GCC rules, and informally resolved a further 11 complaints. All of these cases are listed here.
Since we have no further information on the complaints, and as they probably don’t apply to the GCC rules, we’ll look at the 13 adjudications. I’m going to list them, and state what they prohibit chiropractors from saying. At the end, I’ll list all of the conditions that GCC guidelines prohibit them from promoting treatments for.
David Stevens t/a Vital Body Clinic – 15th September 2004
"ASA told the advertiser to remove references to those serious conditions that the complainants had challenged ["ANAPHYLAXIA", "ANOREXIA", "DEPRESSION", "FERTILITY", "M.E [sic]" and "PALPITATIONS"] and also the references to the serious conditions of arthritis, migraine, obesity and thyroid imbalance."
Optimum Health Centres – 19th December 2007
"We considered that the four articles and the text of other abstracts supplied were insufficient to support the claim or to show that spinal therapy had a stimulating effect on the immune system."
Spinal Health Centre – 9th January 2008
No relevant ruling.
Ideal Spine Centre – 20th February 2008
"We had, however, recently seen evidence from another chiropractor that satisfied us that chiropractors could treat migraine."
Atlas Wellness Centre – 20th February 2008
"…the evidence provided did not support the claim that spinal manipulation affected the immune system, and that, even if effects were proven, the matter would be open to further debate and research to determine whether that translated into beneficial clinical effects on the health of patients or healthy people."
Gonstead Clinic of Chiropractic – 6th August 2008
No relevant ruling.
BritChiro Clinics Ltd – 17th September 2008
"We considered that the evidence submitted about migraine supported the efficacy of chiropractic in treating that condition. We therefore considered that BritChiro could continue to refer to the treatment of ‘migraine’ in future ads."
"We instructed an independent expert to assess the evidence BritChiro submitted in support of the treatment of whiplash and arthritis. Our expert concluded however that the studies were not sufficient to support efficacy claims for either condition."
Optimum Health Centres – 17th September 2008
No relevant ruling (case involves "osteomylogy", which is a whole other blog post).
BritChiro Clinics Ltd – 15th October 2008
No relevant ruling.
Ideal Spine Centre – 15th October 2008
"We considered that the review of the purpose, principles and practice of chiropractic provided in support of the ad did not justify the implication in the ad that having the spine checked throughout life would have an impact on resistance to disease."
"The ASA considered that an abstract of a research study was not sufficient evidence to substantiate the claim that chiropractic was the best way to treat most spinal problems causing neck and back pain. We also noted that the conclusion of the abstract stated that "chiropractic … may be effective for reducing levels of disability and perceived pain …", not that chiropractic was better than all other treatment methods."
Homeo Home – 25th March 2009
No relevant ruling.
Dr. Carl Irwin and Associates – 20th May 2009
"We considered that, whilst some of the studies indicated that further research was worth pursuing, in particular in relation to the chiropractic relief of colic, we had not seen robust clinical evidence to support the claim that chiropractic could treat IBS, colic and learning difficulties."
There are a couple of points that need to be made regarding these cases. Firstly, those adjudications where there was no relevant ruling nearly all involve cases of misrepresenting qualifications. Secondly, most of the chiropractors involved were practising things like spinal manipulation that of course aren’t chiropractic treatments, rather treatments that chiropractics often use.
Nonetheless, while the ASA allowed migraine claims to continue, their rulings and therefore the policy of the GCC must apply to the following claims:
– that spinal therapy boosts the immune system;
– that chiropractic can treat colic, IBS, learning difficulties, whiplash, arthritis;
– that chiropractic is the best way to treat back and neck pain;
– that chiropractic improves resistance to disease;
– that "chirokinetic therapy" (which as far as I can see is the same thing as chiropractic) can treat obesity, thyroid imbalance, anaphylaxia, anorexia, depression, fertility problems, ME or palpitations.
At this point it’s worth going back to Simon Singh’s now infamous "defamatory" paragraph:
"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 ASA rulings described here specifically prevent the promotion of chiropractic for both colic and the frequent ear infections. I would argue that between the ruling on CKT and on learning difficulties, claims for the treatment of problems with sleeping, feeding and crying are either very near, at, or beyond the limits imposed by the ASA.
The rationalist in me believes that this should completely undermine the BCA’s case. After all, how can they claim their reputation has suffered when they are barred by their own professional code from making some of these claims? The cynic however suspects that it will change nothing in Eady’s eyes, as he will still regard Singh as accusing them of lying, and the ASA rulings say nothing about that.
Still, for the BCA to promote the use of chiropractic to treat colic they must have been either deluded, ignorant, or liars. The travesty is that justice doesn’t seem to care about the first two scenarios.
Still, the ASA and GCC between them have given us a handy rod to apply to the backs of chiropractors around the UK. If you see one making the claims listed above, you know what to do.