We have  a lot of science communication programmes and activities in Canada but a huge percentage of them are aimed at children. Once you leave high school you don’t learn much about science any more. Yes, you can read an article in a newspaper or catch a science programme on tv but as I noted in my Friday (Sept. 18, 2009) posting, the media don’t cover  the sciences very often. (I’ll see if I can dig up some data on science coverage in the media.)

There is another issue with science coverage which has an impact on  the media’s willingness to run science stories, legal suits for defamation.  There’s an article on Techdirt, UK Libel Laws, Scientific Criticism, Chilling Effects, Bloggers and The Streisand Effect, which presents the interesting case of Simon Singh (physicist and author of books such as Fermat’s Last Theorem, aka Fermat’s Enigma: The Epic Quest to Solve the Word’s Greatest Mathematical Problem, Big Bang and others) who’s being sued for criticising the evidence for claims by the British Chiropractic Association (BCA) about diseases that chiropractors can cure. The BCA filed a defamation suit against Singh, which is having a chilling effect on science journalism not only in the UK but also in the US (I haven’t found any Canadian commentary). You can find links to other articles on the topic including one from the New York Times in the Techdirt article. Meanwhile, I think this comment from the British Humanist Association (BHA) summarises the issues best,

BHA Chief Executive Hanne Stinson said today, “We’re proud to re-publish Simon’s article here on our website. This is not just an issue about freedom of speech, although that is important in itself. But if legitimate scientific criticism ever leads to a successful libel action, that will not only prevent people speaking out about false claims, it actually threatens scientific progress. Scientific advances almost always involve disagreement and criticism, and scientists have to able to express their views robustly without fear of prosecution. If our courts interpret one ambiguous phrase in a piece labelled ‘Comment’ as defamation, with the result that the writer loses a huge sum of money, then there is something very wrong in the balance between libel and freedom of speech.”

I found Singh’s edited (of allegedly libellous comments, apparently Singh used the word ‘bogus’ to describe some of the claims) article on the BHA site and even though I’m late to the party (there was a July 29, 2009 worldwide posting of the article, organized by Sense about Science, I’m going to post it now.

Beware the spinal trap

Some practitioners claim it is a cure-all, but the research suggests chiropractic therapy has mixed results – and can even be lethal, says Simon Singh.

You might be surprised to know that the founder of chiropractic therapy, Daniel David Palmer, wrote that “99% of all diseases are caused by displaced vertebrae”. In the 1860s, Palmer began to develop his theory that the spine was involved in almost every illness because the spinal cord connects the brain to the rest of the body. Therefore any misalignment could cause a problem in distant parts of the body.

In fact, Palmer’s first chiropractic intervention supposedly cured a man who had been profoundly deaf for 17 years. His second treatment was equally strange, because he claimed that he treated a patient with heart trouble by correcting a displaced vertebra.

You might think that modern chiropractors restrict themselves to treating back problems, but in fact some still possess quite wacky ideas. The fundamentalists argue that they can cure anything, including helping treat children with colic, sleeping and feeding problems, frequent ear infections, asthma and prolonged crying – even though there is not a jot of evidence.

I can confidently label these assertions as utter nonsense 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.

But what about chiropractic in the context of treating back problems? Manipulating the spine can cure some problems, but results are mixed. To be fair, conventional approaches, such as physiotherapy, also struggle to treat back problems with any consistency. Nevertheless, conventional therapy is still preferable because of the serious dangers associated with chiropractic.

In 2001, a systematic review of five studies revealed that roughly half of all chiropractic patients experience temporary adverse effects, such as pain, numbness, stiffness, dizziness and headaches. These are relatively minor effects, but the frequency is very high, and this has to be weighed against the limited benefit offered by chiropractors.

More worryingly, the hallmark technique of the chiropractor, known as high-velocity, low-amplitude thrust, carries much more significant risks. This involves pushing joints beyond their natural range of motion by applying a short, sharp force. Although this is a safe procedure for most patients, others can suffer dislocations and fractures.

Worse still, manipulation of the neck can damage the vertebral arteries, which supply blood to the brain. So-called vertebral dissection can ultimately cut off the blood supply, which in turn can lead to a stroke and even death. Because there is usually a delay between the vertebral dissection and the blockage of blood to the brain, the link between chiropractic and strokes went unnoticed for many years. Recently, however, it has been possible to identify cases where spinal manipulation has certainly been the cause of vertebral dissection.

Laurie Mathiason was a 20-year-old Canadian waitress who visited a chiropractor 21 times between 1997 and 1998 to relieve her low-back pain. On her penultimate visit she complained of stiffness in her neck. That evening she began dropping plates at the restaurant, so she returned to the chiropractor. As the chiropractor manipulated her neck, Mathiason began to cry, her eyes started to roll, she foamed at the mouth and her body began to convulse. She was rushed to hospital, slipped into a coma and died three days later. At the inquest, the coroner declared: “Laurie died of a ruptured vertebral artery, which occurred in association with a chiropractic manipulation of the neck.”

This case is not unique. In Canada alone there have been several other women who have died after receiving chiropractic therapy, and Edzard Ernst has identified about 700 cases of serious complications among the medical literature. This should be a major concern for health officials, particularly as under-reporting will mean that the actual number of cases is much higher.
If spinal manipulation were a drug with such serious adverse effects and so little demonstrable benefit, then it would almost certainly have been taken off the market.

Simon Singh is a science writer in London and the co-author, with Edzard Ernst, of Trick or Treatment? Alternative Medicine on Trial. This is an edited version of an article published in The Guardian for which Singh is being personally sued for libel by the British Chiropractic Association.

Personally, I have gone to chiropractors for spinal manipulations and like any other profession (including writing), there’s the good, the bad, the competent, and the mediocre. I also know people who get good results and others for whom chiropractic adjustments do nothing. I think, in common with many others, that the BHA (correction: this should be BCA for British Chiropractic Association) should have responded with evidence and not with a legal suit complaining that they were being criticised.

As for whether or not this legal suit has had any impact on science journalism in Canada, I have no evidence, other than the absence of any discussion in the Canadian media, to back the assertion that follows. Taking into account the federal government’s relatively recent dictum (gag order) that scientists in Environment Canada are not allowed to speak to journalists unless they had received permission from the ministry’s communication department (National Post, Jan. 31, 2008, article by Margaret Munro, other articles can be found via search engines) and our close ties to UK jurisprudence, there is a big chill taking place here that affects both scientists and journalists.

Tomorrow I expect to be looking at public relations/marketing and science.