The random thoughts of a sceptical activist

What chiroquacktors are allowed to claim

A bit of detail on what Jack of Kent has been talking about on his blog post, BCA v Singh: What The Advertising Standards Authority Said…here’s the information I passed to him:

I made a complaint to the GCC and Trading Standards on Tuesday about a local chiro who was using the title ‘Dr’ on his website. When I looked further into what chiros are allowed to claim and what they are not allowed to claim, I discovered something I don’t think I’ve seen mentioned elsewhere (although I may just have missed it).

The GCC’s Code of Practice and Standards of Proficiency explicitly says at C1.6:

[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. If chiropractors, or others on their behalf, do publicise, the information used must be factual and verifiable. The information must not be misleading or inaccurate in any way. It must not, in any way, abuse the trust of members of the public nor exploit their lack of experience or knowledge about either health or chiropractic matters. It must not put pressure on people to use chiropractic.

The key point here is the reference to the ASA’s guidance. I take this to mean the current Code of Advertising Practice and any and all other guidance issued by them. This paragraph, since the GCC’s CoP is the legally binding contract the chiros have to comply with as a condition of their registration (without which they cannot legally practice), binds them to only making claims the ASA would accept.

I’ll post the reference later, but we know that the ASA will accept nothing less than good scientific evidence when examining the acceptability of any claims made. (Indeed, I’ve made extensive use of this in several successful complaints to the ASA.)

This means that chiros should not be making any claims that they cannot scientifically substantiate. Edzard Ernst, as he has been an expert consulted by the ASA, may be able to give further insight into this.

Currently, some of us are complaining to Trading Standards about the claims made on the websites of chiros because that falls within their remit. However, although I’ve very limited experience of them, I believe their standards are considerably below that required by the ASA.

What this all means is that we should be able to complain to the GCC about what any member claims on their website (and there are many that could be complained about!). This is far easier than trying to find advertising literature issued by the chiro, which falls within the ASA’s direct remit! Such claims, made to the GCC, citing the ASA’s guidance, should succeed, possibly even for claims about about lower back pain, but certainly for the conditions that there really is no scientific evidence in favour of or for conditions where there is no scientific evidence one way or the other.

Now, many chiros will make no claims whatsoever on their websites and someone on Bad Science Forum has already found this, but there are some who do. I compiled a complete list of the chiros on the BCA’s register who have a website and published it on Think Humanism. What we can do is to look at them all (300-odd, IIRC) and make one huge complaint to the GCC. We could certainly broaden this to include all GCC members, but just doing this for BCA members may be more than enough to make the point and throw them into complete apoplexy! I suspect this could gain considerable press attention as well: “Vast numbers of chiros make bogus claims!”, etc (or perhaps something a bit more pithy!).

It does beg the question about whether what the ASA considers bogus can have any bearing on Simon’s predicament. Ideally, the ASA would consider that even claims about lower back pain could not be sufficiently substantiated, and it may well be that any upheld complaint can be described as bogus.

The fact that the ASA would not actually be involved in any way with such a complaint to the GCC is not a problem. The GCC actually seem to be very good at pursuing complaints against their registered chiros and they publish the full details of hearings on their website. These seem to be conducted entirely rigorously and properly. (Of course, they’ve not been good at keeping on top of bogus claims, though!)

One case, after they found against a chiro, was appealed to the High Court – DR. WARREN GAGE v GENERAL CHIROPRACTIC COUNCIL, Neutral Citation Number: [2004] EWHC 2762 (Admin). Although this refers to a paragraph in a previous issue of the BCC’s CoP, it is similar. Mr Justice Jackson said:

As to the first line of attack it should be noted that the CAP Code is a clear and simple code of guidance. It is intended to be readily understood both by the professions and by committees such as the PCC of the General Chiropractic Council. In my judgment, the panel did not need either expert evidence or a ruling from the Advertising Standards Agency in order to understand and apply the CAP Code in the present case. There is however a further point. The panel did in fact hear expert evidence, both from Dr. Brown and from Dr. Stick upon matters relating to the CAP Code.

This says that it does not take an expert to understand what the ASA’s CAP means, but that it can easily be interpreted by ‘the professions and committees such as the PCC’ (the GCC’s Professional Conduct Committee).

This gives us huge potential to create a massive amount of mischief for ths GCC and BCA, but I want some input from David (and perhaps Simon) before proceeding. If it is decided this is a good course of action, I’d like your help in compiling a list of claims made by BCA members. This just needs to be a very simple list for each chiro and I’ll work out the details later.

Now, what JoK realised was that what the BCA were doing by claiming chiropractic could ‘cure’ conditions like colic was putting their own members in an impossible situation (if they had any integrity, that is!): the BCA were saying that these conditions could be helped, but a chiro could not make these very same claims without being in breach of their statutory GCC Code of Conduct! As JoK put it:

Whatever else it may be, for any chiropractor to happily promote chiropractic for colic would now seem to place them in breach of their own professional obligations.

JoK’s argument is that the BCA now have no reputation to defend because they were effectively encouraging their members to breach their legally binding Code of Conduct. (Hopefully, therefore, Simon wins!…but I suspect it may be a bit more complicated than that.)

But there’s something else. As I pointed out to JoK, instead of complaining to Trading Standards about a chiro — and I’m not sure about their rules and how tough they would be — we can simply complain to the GCC! Now, this may have seemed like a poor choice, but, in light of the above, we now know they effectively enforce whatever the ASA have issued as guidance (see my later post on the details of this). They have to enforce this because that what the contract of every registered chiro says!

I think we can very quickly gather up the claims from all BCA members (those who have websites, anyway) — I posted a link to the list a few days ago – and make one massive complaint to the GCC. The actual complaint only needs to be very simple – just like an ASA complaint: “I doubt they can substantiate these claims.” Of the 300-odd who have websites, I’m sure we can find more than a few who are making bogus claims! All we need to do is copy and past quotes wherever they say stuff like “…chiro may/can help with…”.

As I see it (and as JoK agrees), they can only allow claims that the ASA would allow. This would hopefully set the cat amongst the pigeons!

This does obviously depend on the GCC taking any complaint seriously. However, from what I’ve read, they do seem to rigorously enforce their CoP: they even publish the results of their hearings on their website. So, I think we have a very good chance of shaking them up considerably and getting them to rap the knuckles of the BCA members.

(Later, we could follow this up by considering other GCC members who are not BCA members.)

Of course, we have to wonder why the GCC have not been regulating chiro claims properly before now…

Anyone with me? Anyone want to help in compiling the list of chiro claims?

First posted: 25 May 2009

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