H A R A T A N

Chiropractic is a freak offshoot from osteopathy. Disease, say the chiropractors, is due to pressure on the spinal nerves; ergo it can be cured by “adjusting” the spinal column. It is the sheerest quackery, and those who profess to teach it make their appeal to the cupidity of the ignorant. Its practice is in no sense a profession but a trade – and a trade that is potent for great harm. It is carried on almost exclusively by those of no education, ignorant of anatomy, ignorant even of the fundamental sciences on which the treatment of disease depends.

The view that chiropractic was a trade, rather than a profession, was stated clearly by B.J. Palmer, who asserted that chiropractic was founded on “…a business, not a professional basis. We manufacture chiropractors. We teach them the idea and then we show them how to sell it”.

Health misinformation can be found in just about any issue of any chiropractic trade publication (and some of the research journals) and much of the promotional materials chiropractors disseminate to patients. The recent unsubstantiated claims of the ACA are exemplary [examples provided]…It escapes me entirely how Dr. Downing, the ACA, MPI, and Dynamic Chiropractic can suggest that there is no quackery in chiropractic. Either these groups and individuals do not read the chiropractic literature or have no crap-detectors. I urge a reconsideration of advertising and promotion policies in chiropractic.”

In an article on quackery, W.T. Jarvis has stated that “Non-scientific health care (e.g., acupuncture, ayurvedic medicine, chiropractic, homeopathy, naturopathy) is licensed by individual states. Practitioners use unscientific practices and deception on a public who, lacking complex health-care knowledge, must rely upon the trustworthiness of providers. Quackery not only harms people, it undermines the scientific enterprise and should be actively opposed by every scientist.”

The fact that chiropractors are licensed and most chiropractic schools have achieved accreditation has been discussed and criticized. In an August 1983 interview of Stephen Barrett by the ACA Journal of Chiropractic, Barrett responded to questions by stating that the licensing “law has nothing to do with science. If enough people are interested in getting a law passed, and do it cleverly, they can get a lot accomplished. Other forms of health quackery have been legalized in a number of states. The state legislatures simply say if you can make it and sell it in the state, then it’s legal.” As to accreditation, he responded that accreditation “has nothing to do with what’s taught. You can get accreditation if you develop the correct form and structure in your school. And that has nothing to do with what you teach. Actually, chiropractic is proof that the accreditation system has a hole in it. The accreditation system worked until chiropractic got accredited.”
J.C. Smith, a chiropractor in private practice, wrote in a 1999 article that ethical issues are “in dire need of debate” because of “years of intense medical misinformation/slander” and because of well publicised examples of tacky advertising, outlandish claims, sensationalism and insurance fraud: “Why do we tolerate the charlatans, hucksters, profiteers, and wild-eyed ‘philosophers’ who taint our profession’s image, who obstruct political unity and espouse untrue science that cannot withstand the test of research; who recruit patients with gimmicks, and who mislead naive students and young practitioners with dogma and promises of great wealth? Is it because profession ethics is mostly lacking in chiropractic? Is it due to a laissez faire attitude within chiropractic where anyone can say anything under the guise of “philosophy”? Or is mainstream chiropractic simply scared to confront these fringe elements, fearful of litigation or argument?”
In a 2008 commentary, the chiropractic authors proposed that “the chiropractic profession has an obligation to actively divorce itself from metaphysical explanations of health and disease as well as to actively regulate itself in refusing to tolerate fraud, abuse and quackery, which are more rampant in our profession than in other healthcare professions,” a situation which violates the social contract between patients and physicians. Such self-regulation “will dramatically increase the level of trust in and respect for the profession from society at large.” Another chiropractic study documented that the largest chiropractic associations in the U.S. and Canada distributed patient brochures which contained unsubstantiated claims. Chiropractors, especially in America, have a reputation for unnecessarily treating patients. Sustained chiropractic care is promoted as a preventative tool but unnecessary manipulation could possibly present a risk to patients. Some chiropractors are concerned by the routine unjustified claims chiropractors have made. In English speaking countries the majority of chiropractors and their associations appear to make efficacy claims that are unsupported by scientific evidence. Claims not supported by solid evidence were made about asthma, ear infection, earache, otitis media, and neck pain.
A 2009 chiropractic spinal manipulation review for infant colic stated “Some chiropractors claim that spinal manipulation is an effective treatment for infant colic but the “evidence fails to demonstrate the effectiveness of this treatment. It is concluded that the above claim is not based on convincing data from rigorous clinical trials.”
Some New Zealand chiropractors appeared to have used the title ‘Doctor’ in a New Zealand Yellow pages telephone directory in a way that implied they are registered medical practitioners, when no evidence was presented it was true. In New Zealand, chiropractors are allowed to use the title ‘doctor’ when it is qualified to show that the title refers to their chiropractic role. A representative from the NZ Chiropractic Board states that entries in the Yellow Pages under the heading of ‘Chiropractors’ fulfills this obligation when suitably qualified. If a chiropractor is not a registered medical practitioner, then the misuse of the title ‘Doctor’ while working in healthcare will not comply with the Health Practitioners Competence Assurance Act 2003.
UK chiropractic organizations and their members make numerous claims which are not supported by scientific evidence. Many chiropractors adhere to ideas which are against science and most seemingly violate important principles of ethical behaviour on a regular basis. The advice chiropractors gave to their patients is often misleading and dangerous.This situation, coupled with a backlash to the libel suit filed against Simon Singh, has inspired the filing of formal complaints of false advertising against more than 500 individual chiropractors within one 24 hour period,prompting the McTimoney Chiropractic Association to write to its members advising them to remove leaflets that make claims about whiplash and colic from their practice, to be wary of new patients and telephone inquiries, and telling their members: “If you have a website, take it down NOW.” and “Finally, we strongly suggest you do NOT discuss this with others, especially patients.”