What You Say Can and May be Used Against You
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I recently came across a posting on the internet which illustrates clearly the need for our professional associations to watchdog our regulatory agencies and those who would presume to be "authorities" for our profession.  This will not be a long recitation of facts to prove a point, this is an editorial to highlight a concept.

First the background.  The case of Singh's "song".  In Great Britain a "famous author" wrote in one of his works a basic assertion that chiropractic treatment had no evidence in fact and was a sham.  His original statement was very negative, very broad, and very much a statement of opinion rather than fact.  It was, however, presented as fact.   The British Chiropractic Association sued Simon Singh over what they perceived a libelous statement.  This case has become a hot spot of British legal interest. If you've an interest, do more research more on the case of Simon Singh v. British Chiropractic Association.

So here is a chiropractic trade association, the BCA, trying to serve and protect the interest of the profession by taking legal action against a perceived wrong.  They are also pitting themselves against many in the British legal professions, the British medical profession, and the British scientific community.  The BCA regularly "takes a beating" on behalf of the profession.  A search of the internet will turn up numerous articles of those ridiculing the BCA.

Today there is a new posting found HERE in a story titled Chiropractic Libel Suit Snagged by its Own Ruling Body?  SciBlogs, Code for Life, from New Zealand, reports that the "UK’s ruling body for chiropractors, the General Chiropractic Council (GCC), has declared" that what the  BCA is accusing Simon Singh of calling libelous and false actually "are contrary to evidence."

"According to the GCC’s What is the GCC page 'it is a criminal offence for anyone to describe themselves as any sort of chiropractor [in the UK] without being registered with the GCC' and that one of their aims is to 'set the standards of chiropractic education, conduct and practice'."

"...an article from the Guardian by Martin Robbins...Robbins claims that an up-shot of the law suit against Simon Singh is that: A staggering one in four chiropractors in Britain are now under investigation for allegedly making misleading claims in advertisements, according to figures from the General Chiropractic Council....I’d like to draw readers attention to these two paragraphs near the end of Robbins’ article:...In a new report, it has attempted to clarify the assertions that chiropractors can and cannot make, backed up by a systematic review of the evidence. Notably, the report concludes that the evidence does not support claims that chiropractic treatment is effective for childhood colic, bed-wetting, ear infections or asthma, the very claims that Singh was sued for describing as 'bogus'."  Notes the author of  this article "At most readers would realize, the ruling body has undermined the British association’s case. As far as I can see, they’ve obliterated it."

It appears that the regulatory agency is using "scientific literature" and that "from their tables, symptoms that they list as having inconclusive or negative evidence for treatment by any of the treatments examined are:

"Asthma, Colic, Otitis media, Nocturnal Enuresis, Premenstrual syndrome, Hypertension, Pneumonia in Older Adults, Fibromyalgia, Myofascial Pain Syndrome, Miscellaneous Headache, Morton’s Neuroma, Hallux Limitus, Hallux Abducto Valgus, Ankle Sprains or fractures, Knee Arthroplasty Rehabilitation, Hip Arthroplasty Rehabilitation, Carpal Tunnel Syndrome, Rotator Cuff Pain, Shoulder Pain, Sciatica / Radiating Leg Pain, Coccydynia, Mid Back Pain

"The GCC rejects many of the claims many of it’s practitioners make, including the very claims that the BCA have objected to Simon Singh objecting to. The only treatment they report as showing positive support at a high level of evidence was treatment for chronic low back pain using spinal manipulation /mobilization."

The author of this article concludes: "A key concept here is that treatments offered should be based on claims that can be substantiated, as also lies at the heart of the issue with other remedies such as homeopathy and 'treatments' for autism based on unsound ideas.  It will be interesting to watch the impact has on the BCA’s libel case against Simon Singh and if the public exposure of these unsupported remedies encourages people to move on to sounder practice. Let’s hope so."

So what's my point?  Without attempting to address the "right or wrong" of the parties involved in this argument, here is an example of where several things have occurred.  A trade association, based upon a long history of clinical experience, is  is attempting to defend its profession from an assertion that chiropractic is an unsubstantiated profession; a claim that was also unsubstantiated.  The regulatory agency, in an effort to be "purely scientific" (meaning evidential science rather than observational science), has now placed its profession in a position to be limited to merely chronic low back pain treated by manipulation only.

Now, lets bring this observation home and apply the terminology of our state and nation to create an analogous set of circumstances. 

  • A profession which has existed in vital and successful practice for more than 100 years has "observational science" to support statements which, to the unobservant, seem irrational and fantastic.
  • In an effort to be "accepted" within the "scientific community" the profession  begins to rely more upon "evidential science" to "prove" that which a profession is suitable.
  • In an effort to rely upon "the best science", a regulatory body asserts that the profession is ONLY suitable for the limited conditions which have been "proved" by "evidential science" to work. 
  • This focus upon "evidential science" over "observational" science by a regulatory agency has the effect of limiting an entire profession to ONLY what is "provable" by "evidence", and yet it rejects the "evidence" of observation.
  • This has the effect of hindering the defense of a profession.
Here are the final points I wish to make: 

  • Science is BOTH observational and evidential.  The reliance upon one to the EXCLUSION of the other is neither wise, nor science.
  • The historical clinical observations of an entire profession should not be discounted, neither should they be used to make absolute claims.
  • The decision of a regulatory board may have a PROFOUND effect upon an entire profession.

I point this out because in Texas our regulatory board is composed of six chiropractic doctors and three lay people.  This small number of individuals have been given the legal right to determine the definition and function of our profession.  With such a small number of people affecting such a large number of people, it only makes sense that the regulatory board and the professional trade associations work together to insure that the needs of the many are not outweighed by the desires of a few.

This is one reason why the Texas Chiropractic Association regularly observes, works with, and on occasion fights against our regulatory agency.  It is what insures that a few appointed governmental individuals do not run roughshod over an entire profession. 

Thankfully the relationship with our regulatory board seems to be more favorable than what is occurring in the United Kingdom.  The main point, however, is that the conclusion of the "Miranda rights" still holds true...remember "what you say can and may be used against you in a court of law." 

 
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Added: March 06, 2010. 01:59 AM CDT
Yes to Scientific Method, NO to Absolutism
Anonymous,

I FULLY support the scientific method. I just wish to call attention to the fact the "absolutism" is not a part of the scientific method.

ABSOLUTISM: "the contention that in a particular domain of thought, all statements in that domain are either absolutely true or absolutely false" --Wikipedia

SCIENTIFIC METHOD: "refers to a body of techniques for investigating phenomena, acquiring new knowledge, or correcting and integrating previous knowledge. To be termed scientific, a method of inquiry must be based on gathering observable, empirical and measurable evidence subject to specific principles of reasoning. A scientific method consists of the collection of data through observation and experimentation, and the formulation and testing of hypotheses." --Wikipedia

STEPS OF THE SCIENTIFIC METHOD:
The scientific method is a way to ask and answer scientific questions by making observations and doing experiments.

The steps of the scientific method are to:
o Ask a Question
o Do Background Research
o Construct a Hypothesis
o Test Your Hypothesis by Doing an Experiment
o Analyze Your Data and Draw a Conclusion
o Communicate Your Results

It is important for your experiment to be a fair test. A "fair test" occurs when you change only one factor (variable) and keep all other conditions the same.

The scientific method should be observed when conducting research to test a hypothesis, BUT it should also be remembered that there are an INFINITE number of variables within a human being for which to control. Thus, an absolute "fair test" is not likely.

THIS is why the healing arts are described as "art"--"... Latin meaning, which roughly translates to "skill" or "craft." A few examples where this meaning proves very broad include artifact, artificial, artifice, medical arts, and military arts. However, there are many other colloquial uses of the word, all with some relation to its etymology ["skill as a result of learning or practice" -Etymology online]." --Wikipedia

Through observation the "artist" learns what "works or doesn't work", and learns to reproduce "the desired effect." Through science one learns why or how the desired effect is produced. The art and science of archaeology has a saying: "the absence of evidence is NOT the presence of proof."

Despite the beliefs of many, humans do NOT yet know all there is to know about the universe, nor have they detected all that may be detected. Hence one should be cautious about claiming "there is NO proof".

And remember the last step of the scientific method: "communicate your results". Communication is the exchange of ideas one to another. Ideas are subject to the infinite variables associated with the human mind.

So hold to the scientific method, YES. Believe that the scientific method may produce an "absolute truth", I don't think so. But that's just MY variable.

Chris Dalrymple D.C.
Added: March 05, 2010. 02:26 PM CDT
Observational evidence must eventually be testable
Dr. Dalrymple,

You make some good points, especially about the profession needing to monitor what the board does.

A couple of "observations" on my part: 2. The Singh libel case hinged primarily on Great Britain's unique and some say "wierd" approach to libel laws, not on the actual truth or error of what Singh said; and (2) at some point even "observational evidence" has to be testable, with repeated, verified results from scientifically valid procedures. Observation tells us that the sun revsolves around the earth and not the way around. Observation tell hoemopaths that their incredibly diluted potents make their patients better, when scientific analysis of their claims show that results cannot be proven, are logically impossible and are no better than a placebo.

I would be careful in arguing that chiropractic should ignore the scientific method.
Anonymous
 
 
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