Zeno's Blog

After the General Chiropractic Council ‘withdrew’ their What is Chiropractic? leaflet two weeks ago — as a result of a complaint by Simon Perry about its claims for childhood ailments — it took them a week to publish a new version on their website.

Simon sought advice from the ASA about this delay. They replied:

We’d normally expect an advertiser to implement the changes as soon as is ‘reasonably practicable’ (bearing in mind the time involved in printing new leaflets).

However, if it’s a leaflet on a website then it should be taken down as soon as possible.

Of course it takes a short while to get new leaflets printed, but there was no excuse for the delay in removing it from their website — they did not need to wait until a revised leaflet was available. Indeed, since the GCC had been discussing their leaflet with the ASA, they would have known that the ASA considered the wording to be misleading several weeks before the decision was made public. They should have withdrawn the leaflet then and not left it to continue to  mislead the public.

We now find out from disgruntled ex-chiropractor, Richard Lanigan, that the GCC have produced an amendment to the misleading leaflet that will be inserted into any leaflets sent out by the GCC. In an email/letter sent to GCC members, Paul Robinson, their Admin Assistant (Communications), stated:

…printed versions of the leaflet despatched by the GCC will contain an insert until our current stocks are used and we need to reprint. This approach is to ensure compatibility between the electronic and print versions.

Very sensible. There’s no point in wasting leaflets as long as they include the insert that corrects the misleading information.

However, they also say:

There should be no problem if you display or distribute any remaining stocks that you have of the current version, but if you do have any concerns we would be happy to send you a supply of the inserts.

So the GCC think it is OK for chiropractors to continue to display and distribute the leaflet — without the correcting inserts — that they have agreed with the ASA was misleading? I wonder what the ASA will have to say about that…

Yet another misleading chiropractic leaflet

Meanwhile, fellow sceptic and connoisseur of the espresso, Skeptic Barista, has today won an ASA adjudication against another leaflet used by chiropractors. Although the leaflet originates in the US, the publisher, chiropractor Tedd Koren of Koren Publications, distributes chiropractic publications all around the world including the UK. Read the post about it on his Skeptic Barista blog.

The misleading leaflet, Infants & Babies (cached pdf), made claims about chiropractic and childhood ailments:

For over a hundred years doctors of chiropractic have observed the often dramatic responses of infants to chiropractic care.

There seems to be no limit to the conditions that can respond to chiropractic care: colic, difficulty breastfeeding, Erb’s palsy (an arm is limp and undeveloped), torticollis (twisted neck), unbalanced face conditions that can respond to and skull development, foot inversion, “nervousness,” ear, nose and throat infections, allergies and -, sleep disorders, and projectile vomiting are just a sampling. All infants however, sick or well, need to have a healthy spine.

These claims are well referenced — fourteen in total and four for colic alone. But three of these four are in the BCA’s utterly demolished plethora. However, the one the BCA either didn’t know about or didn’t include because they didn’t think it would help their case was:

Vertebral subluxation and colic: a case study. Pluhar GR, Schobert PD. J of Chiropractic Research and Clinical Investigation, 1991;7:75-76.

From the abstract: A case study of a three-month-old female suffering from colic with resultant sleep interruption and appetite decrease is presented. Child received three adjustments with two weeks between adjustments (T-7 and upper cervical area were areas worked on.) Symptoms of colic were relieved within the above brief period.

Ah! A single case study. Colic that was relieved within just four weeks. That’s all. Not even a half-decent jot.

Defending the indefensible…and failing

Anyway, back to the ASA adjudication.

In their defence, Koren said that their:

…leaflets did not claim that chiropractic could treat any specific condition.

We’ve already seen how using woolly weasel words and making claims without looking as if they are making claims, just doesn’t wash with the ASA, who:

…considered that the claim “There seems to be no limit to the conditions which can respond to chiropractic care”, followed by a list of conditions, implied that chiropractic was efficacious as a treatment for those conditions.

That should come as no surprise to anyone who has even glanced at the ASA’s guidance and especially past adjudications. They added:

Furthermore, we noted the ad featured a testimonial about a baby, suffering from a variety of conditions, which claimed that “his health returned to normal” after chiropractic adjustments and considered that furthered the ads impression that chiropractic care would cure or alleviate those conditions.

So the ASA were concerned about the overall impression given by the leaflet as well as the actual words of the testimonial.

We considered that abstracts, case studies and references alone were not sufficient to demonstrate the efficacy of chiropractic in the treatment of the advertised conditions and therefore concluded the ad was likely to mislead.

This is getting a bit repetitive now: how long will chiropractors continue to make claims that fall foul of the very simple and straightforward guidance the ASA has, which — in case it isn’t yet clear — are there to protect the public?

Of course the ASA adjudicated against the leaflet:

On this point, the ad breached CAP Code clauses 3.1 (Substantiation), 7.1 (Truthfulness), and 50.1 (Health & beauty products and therapies).

Apply pressure here…

There are several other worrying things in this leaflet, including the subtle and not so subtle pressure put on new parents to get their baby started on a regime of life-long ‘chiropractic care’:

…there are six times in a baby’s first year when spinal examinations are especially important:

• After the birth process.
• When the baby starts to hold his/her head up.
• When the baby sits up.
• When the baby starts to crawl.
• When the baby starts to stand.
• When the baby starts to walk.

One wonders, what would have happened to this child if he never had spinal care? A life of antibiotics and other medicines? A life of continued sickness?

Surely too many children are born with subluxations that left uncorrected could hinder their health the rest of their lives.

Give your baby the best possible chance to have a healthy life. A simple checkup now might make a BIG difference  for your child(ren) for the rest of their lives.

But have you had your baby’s spine checked? How do you know if your child’s spine is healthy? An unhealthy spine can affect your child’s health for his/her entire life.

How well does this repeated badgering of parents, newly-born babe in arms, fit in with the GCC’s Code of Practice? It mandates:

C1.3 …Chiropractors must not encourage patients to become dependent on particular forms of care.

C1.6 …[Advertising] 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.

Shaken Baby Syndrome

Interestingly — but very worryingly — the advertiser made another claim that Skeptic Barista complained about: Shaken Baby Syndrome. The leaflet advises:

Any child who has been subjected to this rough behavior desperately needs a chiropractic checkup to prevent possible nerve damage.

No. The child desperately needs to be taken to a proper medical professional. Unbelievable.

Funnily enough, the ASA thought the same as most sensible people:

We considered that SBS was a serious condition, commonly associated with maltreatment, for which immediate medical advice should be sought. Because the ad targeted parents of very young children, and invited them to seek the advice of a chiropractor for SBS and other potentially serious conditions for children, we concluded the ad could discourage parents from seeking appropriate medical advice from a general medical practitioner.

Chiropractic is not a suitable treatment for SBS. Full stop.

Passing Muster

Why are chiropractors still making claims — whether for minor conditions or for more serious ones — that just do not pass muster with the ASA? They are doing this in leaflets, other advertising media (watch this space), which fall foul of the ASA and on their own websites. As many have said before, the ASA has no direct jurisdiction over claims made on advertisers’ own websites, but they still fall foul of the ASA’s CAP and adjudications because it is written into the GCC’s Code of Practice they all have to sign up to as a legal requirement for being given the privilege of calling themselves ‘chiropractors’.

In the case of the Koren leaflet, the ASA ruled:

The ad must not appear again in its current form. We advised Koren to consult the CAP Copy Advice team before making references to medical conditions in future.

The ASA’s Copy Advice Team are there to help advertisers keep within the guidance. Their service is free. It costs not a jot. Their website heralds:

Why gamble with the ASA?
All ads in the UK, wherever they appear, must be legal, decent, honest and truthful in line with the The British Code of Advertising, Sales Promotion and Direct Marketing (The CAP Code). The Copy Advice service is here to help you avoid breaking the rules and potential action by the Advertising Standards Authority by giving you free advice on your non-broadcast marketing communications before they are launched.

Why gamble with the ASA? Why indeed.

The GCC’s email/letter I mentioned at the start closes with:

Finally, you may find it helpful to sign-up to the Committee of Advertising Practice’s Copy Advice Team’s e-newsletter; the most recent version is attached below. Here’s a link to its webpage: http://copyadvice.co.uk

Do chiropractors not know by now what is and isn’t acceptable and what standard of evidence they need to hold before making claims? It’s good of the GCC to point them in the right direction. But aren’t they trying to shut the stable door long, long after the horse has bolted?

Instead of spending time printing new sales leaflets, do they not think that they could be weeding out those misleading claims their members are making and telling them what is — and what isn’t — misleading?

56 Responses to “The trouble with leaflets”