Silencing Our Science: SOS

It is the stuff of nightmares - a society so wound up in the legal system that no-one is allowed to tell you the truth, or that those with money control state censorship. However, this isn't some John Grisham novel, this is the unfortunate state of the UK libel system today...

Put simply, the current UK libel laws have no place in science. Scientists should be free to tell the truth, to publish the results of their experiments and should be free to criticise bad science. Criticism is the cornerstone of science and without it UK science will crumble. Think about it - without criticism how will you be able to spot falsification? Without criticism, what is even the point of proving your ideas anyway? Who needs experiments and proof? Ownership of the truth would fall to the highest bidder - and the UK (and many other countries) would turn into very dangerous places.

But why does the UK have this problem? In a country that has practically unparalleled human rights it seems odd that people would be silenced. Unfortunately, our libel laws are historical artefacts, set up originally to reduce the number of duels being fought. The laws are also constructed in such a way that the defendant has to prove his allegation to be true, which puts the person being accused of libel at a significant disadvantage.

Luckily for them, other countries don't have this problem. Others, like America, have even gone so far as to create new laws to protect their citizens against the exigences of our libel system. This is because the UK legal process is so biased against the defendant that, in recent years, foreigners have been deliberately bringing cases here, even when they have little or no connection with the UK at all, because the odds stack up so well in their favour. This so-called 'libel tourism' is becoming a significant problem.

But why are the UK laws courts so appealing to people that want to gag someone? At stake is money and time. Libel cases takes months if not years to defend. During that time freelance writers can struggle to continue working and therefore end up losing money. Getting sued for libel may also scare off others from employing you.

Big corporations think nothing of spending thousands on lawyers, but imagine if someone such as you or me was asked to personally come up with £100,000 to defend a libel claim? And as there is no legal aid for such instances, you're on your own, unless your publishers decide to help you out.

All this leads to one thing: silence. Scientists can no longer afford to disagree with big corporations; it is too much of a risk. So watch the literature and newspapers: stories will be pulled, wording will be changed, subjects will be ignored. This problem is insidious - but we don't know the half of it!

But maybe that's about to change because the issue has been in the spotlight in a big way recently since the writer Simon Singh was sued over an article he wrote for the Guardian about alternative therapy. I've read it, and, like many others, cannot conclude that it's libellous at all. In fact, why not read the article itself and form your own decision. Here's a version of Simon Singh's Guardian piece, kindly provided by Sense about Science (see also Ref. 1).

"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."

But, before you assume that this is the exception rather than the rule, be assured - it's not an isolated example. In another high-profile case in 2008, action was initiated against Guardian 'Bad Science' columnist Ben Goldacre when he covered a story about a businessman who, as he puts it, 'bought full page adverts denouncing AIDS drugs while promoting his vitamin pills in South Africa, a country where hundreds of thousands die every year from Aids under an HIV denialist president and the population is ripe for miracle cures.'

Goldacre's case was finally dropped but was a gruelling experience and led Goldacre to lament on his website 'This libel case has drawn on for over a year, with the writ hanging both in my toilet, and over my head. Although fighting it has been fascinating, and in many respects a great pleasure, it has also taken a phenomenal amount of my time, entirely unpaid, to deal with it. For the duration of the case I have also been silenced on the serious issues that [Matthias] Rath's activities raise, the chapter on his work was pulled from my book, and I have been unable to comment on his further movements around the world.'

I'm not for one minute advocating the abolition of libel laws. Nasty stories of people wrongfully calling other people paedophiles (tactics used by some animal rights groups (see ref 3)) are a good reason why we should keep some semblance of these laws. But surely laws that threaten the very essence of the scientific method and the right to have an informed public debate on issues that affect us all need re-examining?

Thankfully, scientists and science-writers are now beginning to fight back. The 'Keep libel laws out of science' (ref 4) campaign run by Sense About Science has already gained 17,834 signatures since it began, and already has the support of some political parties. Famous figures have been weighing in too: Stephen Fry supports the campaign saying "The simplicity and purity of evidence is all that stands between us and the wildest kinds of tyranny, superstition and fraudulent nonsense. When a powerful organisation tries to silence a man of Simon Singh's reputation, then anyone who believes in science, fairness and the truth should rise in indignation".

The UK has a proud history of scientists and writers that have defied the world to tell us the truth. Darwin's right to free speech allowed him to teach us about evolution and revolutionise modern thinking. However, without immediate libel reform, what hope is there that the truth will triumph over mis-information?