Chiropractic Trade Organisations launch coordinated attack on General Chiropractic Council

A letter expressing no confidence in the General Chiropractic Council’s process, interpretation and proportionality in its regulation of the chiropractic profession has been written to the GCC. Its signatories are the chair of the McTimoney Chiropractic Association and the Presidents of the British Chiropractic Association, Scottish Chiropractic Association and United Chiropractic Association.

You can download the letter here.

It’s a long document, with 89 points of complaint to made against the GCC. The most interesting points from my first read were 35 to 38. The trade organisations are accusing the GCC (rightly in my opinion) of doing exactly what they are now accusing their members of.

They correctly point out that the GCC’s patient information leaflet was making similar claims to those Alan Henness and myself complained about. The GCC withdrew this leaflet after I reported them to the ASA in September last year.

They also point out that the GCC was well aware that these claims were being made for some time, from their 2004 survey of the profession, with over 57% of the profession claiming to treat asthma with a back rub, yet the GCC issued no guidance to the profession.

But these are problems that are only to be expected of the GCC. The GCC was set up by chiropractors in order to protect their profession, rather than by members of the public seeking protection from them.

The GCC only acted when they were cornered: their code of conduct states that claims must follow ASA guidelines, and the ASA clearly informed the GCC that these claims did not. They had no choice.

There’s a lesson here for other quacks seeking to regulate their own quackery. You can use people from your own profession to regulate, and they’ll prove themselves incompetent. Or you can use people to regulate your industry properly - and they’ll destroy it.

The Mass Libel Reform Blog – Fight for Free Speech!

This week is the first anniversary of the report Free Speech is Not for Sale, which highlighted the oppressive nature of English libel law. In short, the law is extremely hostile to writers, while being unreasonably friendly towards powerful corporations and individuals who want to silence critics.

The English libel law is particularly dangerous for bloggers, who are generally not backed by publishers, and who can end up being sued in London regardless of where the blog was posted. The internet allows bloggers to reach a global audience, but it also allows the High Court in London to have a global reach.

You can read more about the peculiar and grossly unfair nature of English libel law at the website of the Libel Reform Campaign. You will see that the campaign is not calling for the removal of libel law, but for a libel law that is fair and which would allow writers a reasonable opportunity to express their opinion and then defend it.

The good news is that the British Government has made a commitment to draft a bill that will reform libel, but it is essential that bloggers and their readers send a strong signal to politicians so that they follow through on this promise. You can do this by joining me and over 50,000 others who have signed the libel reform petition at

http://www.libelreform.org/sign

Remember, you can sign the petition whatever your nationality and wherever you live. Indeed, signatories from overseas remind British politicians that the English libel law is out of step with the rest of the free world.

If you have already signed the petition, then please encourage friends, family and colleagues to sign up. Moreover, if you have your own blog, you can join hundreds of other bloggers by posting this blog on your own site. There is a real chance that bloggers could help change the most censorious libel law in the democratic world.

We must speak out to defend free speech. Please sign the petition for libel reform at

http://www.libelreform.org/sign

The Morality of Employment Law

Completely off the normal topic of this blog, but following probably my fifth argument on Twitter over employment law, I figured I’d explain myself in more than 140 characters.

I’ve experienced employment law on both sides of the fence: as employer and as employee. And while I acknowledge that for some people these laws are a benefit, I personally see them as an attack on my freedom. In my experience, the situation seems far worse for the employee than it is for the employer.

So much so, that as an employee in 2000 I spent around £1200 with an accountant to help me waive my employment “rights”. Why, might you ask, would anyone actually pay money to waive their “rights”?

I wanted to waive, amongst other rights:

• My “right” to 20 days paid leave (it’s 28 now).
• My “right” to sick pay, and protection of my job while I’m sick.
• My “right” to a long drawn out disciplinary procedure if my employer no longer wants to employ me.
• My “right” to paternity leave and pay.

So why did I want to waive these “rights”?

Let’s use an analogy: TV rentals.

A TV rentals salesman is pitching to you. It’s the perfect TV and you love it. But there are some strange terms and conditions.

Firstly, you don’t get your TV all year round. For 28 days, you can’t have it. You can rent another TV for that time, but you have to keep paying for the first one.

Secondly, the TV may break. If it breaks, you get a slight discount on the rental price while it’s being repaired but you do need to keep paying for it. If the TV is broken for a long time, you are able to get out of the contract but only after a long drawn out process.

Thirdly, the contract lasts until the TV is 65 years old. If you think the TV is no longer up to the task and wish to change it – or you just no longer need it, you’ve got to follow a long drawn out process. You need to fully document this process in advance, and stick to it to the letter or the TV company may sue you. If the TV company no longer wishes to continue renting the TV, they can take it away easily.

Fourthly, the TV company might need the TV back for a while to help make another TV. They can decide to do this at any time, but you need to keep renting the TV at full price for the first 6 weeks of this process, and then at a reduced price for up to a year. At a time decided by the TV company, they can bring the TV back and you need to put it back in your home and continue paying full price. You can rent another TV to cover this period, but of course it will be under the same contract terms.

Now it should be fairly obvious that if you are trying to rent a TV under this contract, then you’re not going to get a great deal of money for it. This is a very silly way to rent TVs.

But, I hear you say. This isn’t about TVs, it’s way more important than that: these are people’s lives.

And you’re right. My life is way more important than a TV and if I’m going to sell a significant portion of it, it is critical that I am able to negotiate the best possible terms.

I can save up for my holidays; I don’t need my employer to do this for me. I can put money aside for when I’m sick. I can imagine nothing more demoralising than turning up to work and demanding pay from someone who no longer wishes to employ me. I will only make the decision to have children if I can pay for them myself.

Waiving these “rights” gives me the negotiating power to demand more of what I do want. For me personally that means more holiday time, flexible hours, better pay, great people to work with and interesting & challenging work.

I’m not negotiating a simple contract to rent a TV; I’m selling a significant portion of my life. When the government forces me to sell under these ludicrous terms that personally offer me little benefit, they’re not controlling and devaluing my TV.

They’re controlling and devaluing my life.

Controlling another person’s life when they are causing no harm is immoral. Controlling another person’s life in a way that significantly devalues it is exceptionally immoral. This is the morality of employment law.

It's a real shame nobody will help stop Boots making false claims

Sadly, the 240 ASA complaints about quack medicine products being sold at Boots got nowhere. Boots took the rather cowardly decision of withdrawing the 3 for the price of 2 offer to take their products outside of the ASA's remit, rather than defend the claims they make about their products.

I didn't think they'd be able to get away with this, though I'm continuing to learn about how the ASA operates. When I complained about the GCC's patient information leaflet last year, the GCC agreed to remove the claims, but initially continued making the claims on a PDF on their website. When I queried the ASA about this, they asked them to remove it even though being online, the PDF was presumably outside their remit.

When I asked about this apparent double standard, the ASA replied as below (I'd skip reading it, it's quite dull):

Dear Simon,

Thank you for your e-mail, I’m sorry for the delay responding to you. As I explained, our remit does not cover material on advertisers own websites where it does not refer to a sales promotion. While I appreciate your concern about these claims and the manner in which Boots have brought their promotion into line with the CAP Code, the ASA (at this time) is not entitled to comment on claims on companies’ own websites (outside of promotions), such as the Ladycare menopause relief magnet you mention.

Leaflets available to download on advertisers websites, when they are also distributed to the public as hard-copy (the contents of which therefore fall within the ASA’s remit) are generally also subject to any ASA Council adjudication on the hard-copy. However, this only applies where the leaflet itself is available to download in identical form to that which is distributed as hard-copy material.

Our main aim in cases such as the original investigation into the objections you raised about numerous claims on Boots’ websites is to ensure claims which fall within our remit are amended or removed. In this instance, Boots agreed to ensure that any claims subject to the CAP Code would in future conform, without a formal adjudication from the ASA Council being necessary and there do not appear to be grounds to challenge this decision, nor material within space governed by our remit which appear to give us grounds to investigate further.

However, claims made on companies own websites is sometimes subject to specific legislation which Consumer Direct (0845 4040506) or the MHRA (020 7084 2000, www.mhra.org.uk) might be able to advise further.

Again, I realise this will disappoint, but thank you for taking the time and trouble to contact us with your concerns.

Kind regards

Sam

So I think I've hit a dead end with the ASA. Next stop Trading Standards. The thing is, Trading Standards doesn't really do anything unless a lot of people complain.

And I can't imagine there will be many people who will have come back inspired by the excellent TAM London speakers, ready and willing to do the following:

• Choose one product to complain about. You might like to complain about the Fanny Magnet that apparently "helps to reduce or completely eliminate the symptoms of menopause". Or maybe about the BioFirm Danish Detox Plan, which they claim "naturally supports the body’s own internal processes of elimination and detoxification." Or maybe you're really angry that they sell "Boots Teething Pain Relief" which claims, in the title, that it is for teething pain relief yet can't possibly work as it's homeopathic.
• Go the Consumer Direct Complaints Form.
• Fill it out. I've helped with that below by making it easy to copy & paste some basic info that will be relevant to all complaints.
• Submit the form.
• Put a comment below so I can see who did what.

Sadly, I doubt anyone will do this. What a shame.

Helpful advice and information to copy & paste:

Section 1:

Clearly quote any text you believe to be unsupported by robust evidence. Point out that Consumer Protection Regulations 2008 require the company to be able to back up any claims with evidence.

Section 2:

Name of Trader: Boots UK Limited

Address: 1 Thane Road West

Town or City: Nottingham

County: Nottinghamshire

Postcode: NG2 3AA

Telephone Number: 0115 918 2000

Trader's website address: http://www.boots-uk.com

Trader's email address: [Leave blank]

Section 3:

Have you paid for goods or services from this trader?: NO

Leave rest of Section 3 blank.

Section 4:

Please let us know how you heard of Consumer Direct: Website/Internet search.

But as I said, I can't imagine anyone will actually do this and comment to let me know they have done so. Real shame.

Off skiing in Tignes.

1023

I wasn’t able to make Frank Swain’s talk at Westminster Skeptics in the Pub on Monday night, but I did catch up with the uncensored parts on The Pod Delusion Podcast later.

Frank is right when he says that there are a whole host of reasons why people believe, and to convince them we need to meet them on their own turf. If anecdotes convince people to believe, anecdotes will be more effective in convincing them not to believe. (I should clarify that I’m summarising what Frank says, these are my words.)

As an example of a campaign that was not effective, Frank cited 1023.

On the point of 1023 being ineffective, I disagree.

What Frank was saying is that the main message of the 1023 campaign is that “there’s nothing in it”. Homeopaths know there's nothing in it. People who have been shunning real medicine in favour of homeopathy for years know there's nothing in it.

And people who already know there’s nothing in it are not going to be convinced by being told that there’s nothing in it. Frank’s right here - but he’s very wrong when he says that this makes it an ineffective campaign.

A tiny percentage of the population shares our skeptical viewpoint. A larger, yet still small percentage; practice homeopathy.

In the middle sits the vast majority, ready to be plucked by either camp. They go to dinner parties and people tell them they’ve visited a homeopath. They walk past homeopathic practices on their way to work. They’re mostly rational, but don’t know what homeopathy is. They may know there isn’t much evidence to show that it works, but they don’t realise that it’s been tested time after time and shown to be ineffective. They don’t realise that it lacks an active ingredient altogether. They don’t realise that it’s a thoroughly discredited absurdity. They don't realise that there's nothing in it.

It is these people who will be convinced by 1023.

If you’re trying to convince as many people as possible, and are within an environment where the vast majority of people are ignorant yet open minded, only a complete fool would target those who already know about the subject, but are so close minded that they ignore the knowledge they already possess.

I have had a couple of opportunities to speak to open-minded, intelligent audiences on this subject. Most people don’t know what it is. Simply explaining it is all that is required to convince them, completely, that it’s nonsense. It takes minutes.

1023 did this on a mass scale. It was a beautiful, engaging demonstration. Hundreds of people took 42 times the recommended dosage of so called "drugs". This impersonation of a crazed religious sect grasped the attention of newspaper reporters. How can a paper not report a mass drug overdose?

The message was clear: we’re able to do something that seems implausible because we’re using implausible medicine. Or - we’ll be fine: there’s nothing in it.

Of course you won’t convince a homeopath. But that homeopath needs customers. And because of 1023, homeopaths are now operating in an environment where many more people know they’re peddling pills that contain nothing. Their customers are socialising with more people who know the pills contain nothing.

Grow this simple understanding throughout the population and you create an environment where homeopathy will struggle to survive. 1023 did that beautifully.

Frank said people aren’t convinced by facts. Telling a story is in many cases more convincing. So I’ll end with a story. Here it is:

Before I was convinced by facts, I once suggested to someone that they might try visiting a homeopath.

A Step-by-Step ASA complaint

Recently I’ve had lots of requests for advice on the best way to complain to the Advertising Standards Authority about various devices falsely claiming health benefits. The good news is that it’s easy. But of course, if you hadn’t done it before you wouldn’t know that.

I’m going to walk you through the process with a quick example, an advertisement for a Reflexology Circulation Enhancer in July 25th’s Sunday Telegraph.

The first step is to look through the ad, sentence by sentence, to see if you can find any specific misleading claims. You’re not just looking for outright lies, but also what Harry Frankfurt defines as bullshit. Claims that have been made up without concern for whether they’re true or not.

Sometimes the advertiser won’t make their claims clearly, they will imply them. The ASA can still adjudicate against misleading implications.

You can click the picture to the right to see a clearer view of the ad. If I work through from the top, we find something pretty quick.

1. The title “circulation enhancer” clearly implies that this product is able to increase circulation. I do not believe that the manufacturer JML have any evidence to substantiate this claim.

Easy.

The subtitle is the next obvious bit. “The ingenious electronic device uses ancient Chinese reflexology techniques to relieve the stresses and strains of the day and boost your energy levels through the power of your feet!”. So I’d simply quote this, then question it:

2. The advertisement claims “The ingenious electronic device uses ancient Chinese reflexology techniques to relieve the stresses and strains of the day and boost your energy levels through the power of your feet!”.

I doubt that JBL have any evidence to back up their claims that:
a. This system is capable of relieving stresses and strains.
b. This system is capable of “boosting energy levels”.
c. It is in any way possible to “boost your energy levels through the power of your feet!”.

Again; easy. The ad continues:

“For centuries, the Chinese have believed that every part, gland and organ of the body is connected to specific areas of your feet which when manipulated using fingertips help soothe and re-energise, restoring a natural feeling of well being again.”

“Bringing that philosophy into the 21st century, the JML Circulation Enhancer uses proven T.E.N.S technology to create the same effect – but this time at the touch of a button and in the comfort of your home.”

I’ll quote this text to the ASA, and then make the following observations:

3. While it may be true that some people believe that manipulating parts of the feet can “soothe and re-energise, restoring a natural feeling of well being again”, that advert is implying that these beliefs are true. I do not believe that the advertiser possesses evidence to back these claims up.

4. When JML state “proven T.E.N.S technology” they are implying that T.E.N.S has been proved to be effective for the specific claims they make, for example to “re-energise”.

5. When JML state that their technology creates “the same effect” as reflexology, I do not doubt them, as reflexology is unlikely to have any effect. However, the implication is clearly that both their product and reflexology have a beneficial effect on health.

6. JML state “Chinese have believed…”. While there may be Chinese people who do believe this, I have found no evidence to suggest that it is believed by a significant portion of the Chinese population. I find this statement offensive because it implies that the Chinese are a particularly gullible race.

I should clarify that I don’t think JML are a racist organisation, I don’t think they’ve thought through the implications of what they are saying. That last point was for my own personal amusement.

There is also a testimonial:

“The effect is amazing. I could feel it working from the moment I switched it on!”

7. Statements made in testimonials need to also be backed by evidence. This clearly implies that the device is efficacious for the health benefits outlined at the top of the advert.

Under benefits, they state “Low frequency micro-currents safely stimulate the reflex points in your feet”.

8. I do not believe that there is any evidence to suggest that “reflex points” actually exist, let alone that they are capable of being “stimulated” by this device.

And “Reinvigorates tired parts of the body”.

9. I do not believe JWL have evidence to show that this device is capable of doing this.

There is also the picture with the magic blue bullshit field around the legs of the lady on the chair.

10. The picture showing the rings around the lady’s feet are clearly designed to imply that there is some sort of magic field emanating from the device. I doubt that JWL have any evidence to show that this field exists.

Once you’ve made the points, simply wrap it up in an email. I generally prefer to email the ASA rather than use their online form because of attachment size limits on their form, but either way is fine if it works.

Here’s the final product.

To: new.complaint@asa.org.uk
Subject: Complaint about Circulation Enhancer advert in The Sunday Telegraph.

To whom it may concern:

I am writing to complain about an advertisement I found on page 20 of the Lifestyle section of the Sunday Telegraph on the 25th July. The advert makes a number of what I believe to be unsubstantiated health claims.

I have attached a copy of the advert.

1. The title “circulation enhancer” clearly implies that this product is able to increase circulation. I do not believe that the manufacturer JML have any evidence to substantiate this claim.

2. The advertisement claims “The ingenious electronic device uses ancient Chinese reflexology techniques to relieve the stresses and strains of the day and boost your energy levels through the power of your feet!”

I doubt that JBL have any evidence to back up their claims that:
a. This system is capable of relieving stresses and strains.
b. This system is capable of “boosting energy levels”.
c. It is in any way possible to “boost your energy levels through the power of your feet!”.

The advert also states:
“For centuries, the Chinese have believed that every part, gland and organ of the body is connected to specific areas of your feet which when manipulated using fingertips help soothe and re-energise, restoring a natural feeling of well being again.”

“Bringing that philosophy into the 21st century, the JML Circulation Enhancer uses proven T.E.N.S technology to create the same effect – but this time at the touch of a button and in the comfort of your home.”

3. While it may be true that some people believe that manipulating parts of the feet can “soothe and re-energise, restoring a natural feeling of well being again”, that advert is implying that these beliefs are true. I do not believe that the advertiser possesses evidence to back these claims up.

4. When JML state “proven T.E.N.S technology” they are implying that T.E.N.S has been proved to be effective for the specific claims they make, for example to “re-energise”.

5. When JML state that their technology creates “the same effect” as reflexology, I do not doubt them, as reflexology is unlikely to have any effect. However, the implication is clearly that both their product and reflexology have a beneficial effect on health.

6. JML state “Chinese have believed…”. While there may be Chinese people who do believe this, I have found no evidence to suggest that it is believed by a significant portion of the Chinese population. I find this statement offensive because it implies that the Chinese are a particularly gullible race.

There is also a testimonial:

“The effect is amazing. I could feel it working from the moment I switched it on!”
7. Statements made in testimonials need to also be backed by evidence. This clearly implies that the device is efficacious for the health benefits outlined at the top of the advert.

Under benefits, they state “Low frequency micro-currents safely stimulate the reflex points in your feet”.

8. I do not believe that there is any evidence to suggest that “reflex points” actually exist, let alone that they are capable of being “stimulated” by this device.

And “Reinvigorates tired parts of the body”.

9. I do not believe JWL have evidence to show that this device is capable of doing this.

10. The picture showing the rings around the lady’s feet are clearly designed to imply that there is some sort of magic field emanating from the device. I doubt that JWL have any evidence to show that this field exists.

I am complaining as a concerned member of the public and wish to confirm I have no commercial interest.

[full name, address and phone number]

Many thanks,

Simon Perry

There is little evidence that it doesn’t work

When Maggie Dunn and Maggy Wallace of the Complementary and Natural Healthcare Council spoke at Leicester Skeptics in the Pub earlier this week, I certainly got the impression that they were, at least to a certain extent, able to be swayed by rational argument.

I think they genuinely took something away from the Q&A session, yet there was one thing that they repeatedly said both in the Q&A and during our dinner beforehand that was (a) important and (b) not responded to. I wish to address this point here.

When faced with points made about the fact that there was no evidence for the claims made by a lot of the practices they regulate, their response was words to the effect of “but there is little evidence that it doesn’t work”.

The argument offered in opposition to this was simply that the onus of evidence is on the person making the claim. While I agree with this, it is more of a custom in argument rather than a valid point. However, there are reasons why this custom is observed that I believe are more influential than simply stating it.

There are two points that are implicitly made when someone points out that there is “no evidence that it doesn’t work either”:

1. That in the absence of knowledge, the probability of being right or wrong is 50/50.
2. That in the absence of knowledge, it is ethical to take a position and communicate it authoritatively.

Both of these points are incorrect.

The human body is an incredibly complex organism, and there are potentially billions of possible medical interventions, only a small handful of which are likely to work for any given ailment.

Even if we find that a given intervention is indeed useful, the probability of it being useful for any particular disease is still small. I can think of no intervention that works for most diseases.

If you were to make one reasonable and thought-through assumption about a drug’s possible effects from extensive knowledge of chemistry and biology, there is a good chance you’re going to be wrong when you apply it to the complexities of the human body.

But if you were to make an assumption based on no knowledge whatsoever, it would be highly likely that you are wrong. What’s more, the principle of Occam’s razor dictates that the chances of you being right will diminish with the number of assumptions made.

For instance, take reflexology. The first assumption is that various parts of the body are somehow connected with pathways to various parts of the foot. The second assumption is that massaging near one end of a pathway will produce an effect at the other. The third assumption is that this effect will be clinically beneficial. The forth assumption is that reflexologists have correctly mapped which positions on the foot are connected to which organs.

The likelihood of any of these single assumptions being correct in the absence of any evidence is miniscule. But for reflexology to be effective, all of these assumptions would have to be correct.

Even if we assume that the chance of each being correct is 10%, a ludicrous overestimate, then the chances of the therapy working would be a tiny 1 in 10,000.

But, for the purposes of argument, let’s imagine we live in a strange universe where the probability of any intervention being efficacious for any disease was the same as a coin toss landing heads.

Would it then be ethical to make claims of efficacy for an untested intervention?

I think not.

By making an authoritative claim that the intervention works, you are implying that you have a greater knowledge of the intervention’s efficacy than someone who is ignorant on the subject. In the mind of a person hearing your claim, the probability of efficacy will now be significantly higher than 50/50. After all, they heard it from someone presenting themselves as an expert.

If you were to ask a person who has never studied the efficacy of reflexology if it works for arthritis, the only honest answer they would be able to give would be “I’ve never studied it but in the absence of evidence it is unlikely to be effective”. For reflexologists, having never tested their treatment’s efficacy, any other reply is dishonest.