Professor Frizelle’s Instant Classic: Let’s hear your evidence not your legal muscle

It isn’t often that you come across a newly-minted phrase that is destined to become a classic but Professor Frank Frizelle has managed it (pdf). In response to a legal letter on behalf of affronted chiropractors he issued this challenge: “let’s hear your evidence not your legal muscle”.

Read all about it at dcscience.net with Professor David Colquhoun who is (of course) entangled in this legal imbroglio: Chiropractors resort to legal intimidation. Dr Ben Goldacre has a strong commentary on this matter: Silence Dissent!

While chiropractors struggle to manifest to their customers an air of academic rigour, their actions in this letter demonstrate more than anything else how little they understand the simple day to day business of academic journals, journal clubs, work in progress seminars and indeed the entirety of medicine: we take the piss out of each others ideas. We criticise them. We tear them apart, mercilessly. When we criticise survival stats, or the interpretation and analysis of data, make no mistake: we are accusing each other of killing patients unnecessarily. This is the bread and butter of academia and medicine. Only very occasionally does anyone take personal offense. [sic]

Quite. Professor Frizelle’s response is robust, pithy and on-target: HolfordWatch hopes that the Chiropractors’ Association in New Zealand takes note of the response and the wider reaction to their actions.

Dr. Phil Hammond has a provocative programme coming up on Radio 4; he wrote a trailer for it: Why do doctors kill more people than airline pilots?

During the making of the Radio 4 documentary, all the NHS staff I spoke to were passionate about patient safety, but said a culture of blame and exposure was its enemy.

Errors will inevitably occur, but what staff need to prevent these happening again is time and support to understand and learn from them.

He is free to write these pieces and to broadcast about important issues. Presumably the BMA isn’t threatening legal action against him for washing dirty laundry in public and for every lukewarm acknowledgement that tries to claim that reforms are already in hand, there will be someone praising Hammond for drawing attention to these matters. As Goldacre says, this is how progress happens.

Law courts are rarely the appropriate venue for settling such matters. It would be helpful if the wider debate and criticism about various interventions and modalities could take place without intimidation, whether personal or legal.

Relevant Posts and Documents for Background

Professor Colquhoun was asked to write for the Journal of the New Zealand Medical Assocation, as a comment on article in that edition about the misuse of the title ‘doctor’ by chiropractors: Dr Who? Deception by chiropractors. The editorial appeared in the journal as Doctor Who? Inappropriate use of titles by some alternative “medicine” practitioners. The article was a companion piece for others in that issue:
1. Gilbey A. Use of inappropriate titles by New Zealand practitioners of acupuncture, chiropractic, and osteopathy. N Z Med J. 2008;121(1278). [pdf]

2. Evans A, Duncan B, McHugh P, et al. Inpatients’ use, understanding, and attitudes towards traditional, complementary and alternative therapies at a provincial New Zealand hospital. N Z Med J. 2008;121(1278).

Colquhoun reports the subsequent legal letter and Professor Frizelle’s response in his post: Chiropractors resort to legal intimidation. He carries a copy of Frizelle’s editorial that also reproduces the letter sent by Paul Radich, a lawyer who acts for the New Zealand Chiropractors’ Association Inc and its members: Defamatory Articles or Not (pdf).

Updates

Quackometer considers the matter: They Are Bone Doctors, Aren’t They? You will not only read more detail about the business practice of chiropractors but enjoy a, “Where are they now? So that’s what he’s doing” moment about a former drummer with The Clash who is now practising percussion of a different kind on human instruments.
Streisand Effect as shooting oneself in the foot or a self-inflicted lower spinal subluxation: the Streisand subluxation

jdc offers: More Legal Chill – from Spine Cracking Chiropractors and offers A Beginner’s Guide to Chiropractic. We would also add Dr Mark Crislip’s analysis of a paper on chiropractic and stroke and Dr Harriet Hall on the sad case of Sandra Nette who is now living in locked-in syndrome following chiropractic treatment that went badly awry.

20__ joins the news circle: New Zealand Chiropractors Association/Murray from Flight of The Conchords is pretty cool.

Thinking Is Dangerous covers this story and adds in some detail about a UK chiropractor, “Dr” Christian Farthing that explains precisely why this may be an issue that causes consumer confusion: Another Back-Cracking Q’Attack
Update August 9: JREF Forum: New Zealand chiropractors threaten academic journal.
Coracle describes the attempt at intimidation as: Weak-minded, ignorant and superstitious.
August 10: Samuel Homola, a retired chiropractor comments that the majority of chiropractors believe that “spinal adjustment should not be limited to treatment of musculoskeletal problems” although “there appears to be little evidence to support the value of spinal manipulation for nonmusculoskeletal conditions”: Chiropractic: A Profession Seeking Identity.
Bruce Thyer and Gary Whittenberger investigated the willingness of chiropractors’ representatives to agree to consider treating hypertension and arthritis: A Skeptical Consumer’s Look at Chiropractic Claims: Flimflam in Florida?
August 11: Norbury discusses the prime facie plausibility of chiropractors because they are regulated: Chiropractors Get Cross.
Closer to home, it seems that New Zealand blogs are picking up the story. Evidence-based Thinking has a fine account: NZ Chiropractors vs NZ Medical Journal. There is some confirmation that the matter of the use of an appropriate, non-misleading title might be settled in a straightforward fashion by applying existing law.
Silly Beliefs shakes its head in disbelief at the own Chiropractors’ Association’s own goal: Chiropractors attack NZ Medical Journal

So why didn’t the idiots just keep quiet rather than getting lawyers involved and creating a fuss over an article that the public would otherwise have been oblivious to. If they had kept mum then I wouldn’t have heard about it and you wouldn’t be reading this. Remember the Catholic Church giving The Da Vinci Code unimagined and unintended publicity, alerting the world to the very thing they were trying to hide? Rather than learn from this mistake they did it all again trying to get South Park‘s episode Bloody Mary censored. As a result the show got the highest viewer rating ever received. Now following the stupidity of the likes of the Catholic Church, the NZ Chiropractors’ Association Inc believes that by creating a public fuss over their silly pseudoscience they can somehow hide their flawed beliefs from us.

August 12: The ushering in of the Glorious Twelfth sees Open Parachute applauding Professor Frizelle’s stand against the legal letter: Evidence should trump “legal muscle”

Related Reading for Threats

Quackometer and the Society of Homeopaths triggering an I’m Spartacus wave of support
Dr Ann Walker’s affront to Professor Colquhoun’s snort about blood cleansing that prompted the Ann Walker Festival of Appreciation
Quackometer and the wonderful world of ‘Professor Dr’ Joseph Chikelue Obi and Netcetera that prompted another I’m Spartacus movement.
Clifford Shoemaker triggers the Kathleen Seidel I’m Spartacus movement (Spartacus bloggers listed)
Who can forget the fabulous Gillian McKeith and the exquisite proportionality of her response to PhDiva, Professor John Garrow and Ecletech? Or the letter that is currently hosted by Chilling Effects?

In addition to the legal letters, there are the bread and butter threatening letters or comments that bloggers receive on a regular basis.
Professor David Coluqhoun wrote: Response to a threatening letter from Mr Holford
Holford Myths published A Comment from Patrick Holford
jdc has blogged about Legal Chill and Other Threats detailing recent complaints by Dr John Briffa.
Quackometer has, of course, received an admonition from Patrick Holford: No Comment
Losing the UK theme for a moment, Happy Jihad’s House of Pancakes posted about: Another threatened lawsuit!

Spats relating to publications in academic journals are commonplace. Ben Goldacre told the story of the various covert and legal shenanigans surrounding David Horrobin and evening primrose oil – another example of hurt feelings and CAM.
Dr Aubrey Blumsohn maintains the Scientific Misconduct blog that is full of examples involving bad behaviour and intimidation, many of which involve major pharmaceutical companies rather than CAM.

Update Aug 16: British Chiropractors Join the Legal Intimidation Party by issuing a legal writ against Simon Singh for his discussion of chiropractic in a Guardian article about Trick or Treatment? Alternative medicine on trial.

Update Aug 19: It seems that more legal trouble or just hassle is brewing for the forthright Professor David Colquhoun as it seems that despite the popularity of his video short, integrativebaloney@Yale, it proved a saddle burr to others who were able to prevail and have it removed from YouTube. Plain speaking: Wellington, Russell and Wakley on managers, reform, medicine and quacks.

Tim Sands wins a special pun award for his coverage in Nature‘s blog: Kiwi-practors’ legal wrangle.

Dougal at Looking Out To Sea might echo that sentiment. He has a punchy summary of the chiropractors’ tactics (or those of their associations) for both this story and the more recent one involving the British Chiropractic Assocation and Simon Singh: If you don’t have anything nice to say, say it on lawyer’s headed notepaper.

It should be pretty obvious now that these two associations have little interest in medical science or patient wellbeing. If they did then stifling criticism would not be their first reaction.

Update 5 Sept: Chiropractic wars. Part 3: internecine conflict. Professor Colquhoun brings us up to date on the latest exchange of letters on this vexed topic.

BPSDB