I do not pretend to have any legal expertise and you can read the opinions of someone who has over at @jackofkent's excellent blog.
The "facts" of the case (as reported)suggest that Mr Clarke found a shotgun and ammunition in his garden, took these items to his nearest police station, and handed them in. He was then arrested, charged with possession of a gun, convicted in court, and now faces five years in prison.
Now there are many reasons to suspect that the story I summarize above may not be the whole story, and, at the very least, may be incorrect in some of the details. Certainly, anyone who knows anything about almost anything that is reported in the newspapers will attest that the newspapers have got vital details wrong. If shy ten year old Priscilla breaks the record for winning coconuts on the tombola for the third year in a row at the local fête; the local rag will report that "Three year old Priscilla broke the tombola during her ten goes on the coconut shy". I have always presumed that this sort of thing happens because journalist take notes in shorthand, forget all about the original events, and then try to construct a story (using their own imaginations) from what is essentially a list of phonemes. Sometimes, of course, there are more sinister forces at work.
But let us suppose the Paul Clarke story is entirely true and as reported, and let us suppose that the authorities, in spite of all the mitigating circumstances, decided to press ahead with a case like this and apply the full rigour of the law. Within such a thought experiment, many of the concerns that have been raised in the comments on @jackofkent's blog (which we may be able to dismiss once we know the full facts of the actual case) raise their ugly heads and do, I submit, require a reasoned response.
These comments raise a general problem with the law that is rarely discussed: the problem that most people (myself included) simply do not know what the law is (in all sorts of areas).
Recently I found a purse full of money and credit cards on the ground in a car-park in a part of town where I could reasonably expect that the purse might quickly be discovered by someone with less integrity than I pretend to. I had my mobile phone on me so I rang one of the relevant banks (there were no phone/address details for the owner inside the purse). The bank recommended that I take the purse to the local police station - which I did. But suppose I have not had my mobile phone on me and I had been stopped by the police on my way to the station. Is there a risk that I could have been charged with possession of stolen property? I have no idea. Even though I had been following the advice of a bank, banks are not reliable sources of legal advice - or even financial advice (but let's leave that to one side). Even if I had rung the police first, we all know that the police themselves are not necessarily a reliable source of correct legal advice - as in this case where (again, if the press story is to be believed) a man was instructed by the police to walk the streets with a loaded gun.
If I found what appeared to be a quantity of drugs (say) in a children's playground and did not have a phone on me and could not see any passers by, should I take the drugs and hand them in at the nearest police station or leave them in situ while attempting to report my find. I think I am right in believing that (in a case like this) I should have a defence if found in possession of drugs. But I don't know for sure.
On the subject of drugs, I recently attended a drugs awareness talk at the school my kids attend. During the course of the evening, it became apparent that the vast majority of the attendees had absolutely no idea what the laws were concerning the purchase and consumption of alcohol and tobacco by minors in different environments let alone what the laws were concerning illicit (though not necessarily illegal) drugs. And these were educated (often highly educated) grown-ups.
Given that we expect laws to serve as a deterrent and given that politicians are forever making new laws (often to "send a message") I think we, as a society, need to be aware that the messages are often not getting though. I realize that ignorance of the law could never be allowed to stand as a defence argument (for obvious reasons) but this does not absolve the people who make our laws from responsibility to use the historically unparalleled opportunities for the dissemination of information to educate people as to what the laws are and are intended to achieve.
Suppose I found a loaded gun in a park frequented by children (though deserted at the time of my discovery) and did not have my mobile phone on me. What should I do? Leave it there? Hide it? Take it to the police and rely on the good will of the CPS?
I did not know the answers to these questions before the Clarke case and I don't know them now.
######################################
Postscript:
Allen Green ("@jackofkent") has carried out some sterling investigation and research on this story and written up his conclusions in a cracking blog entry at: Anatomy of an Injustice.
As I have also mentioned below (in a comment), pace my light-hearted digs at the quality of a great deal of journalism, I have every reason to believe that Holly Thompson's piece (which broke this story) is an accurate and balanced report of the facts available to that journalist and that that Holly Thompson (@h_thompson) is a journalist of integrity.
2009-11-01
Drug Classification: Why David Nutt and the Government are Both Wrong
The government is clearly in the wrong because it appoints scientists to look at evidence and then ignores the evidence when it doesn't suit; in this case then shooting the messenger for good measure.
But David Nutt is wrong too. He apparently endorses the notion that there is or should be (the distinction is no always made clear) a sliding scale of criminal penalties according to the harmfulness of drugs. His only gripe with the government seems to be on the question of where certain drugs should be on this scale and the government's insistence on relying on prejudice rather than science in assessing this.
This question is discussed regularly in the media. The question of whether the sliding scale makes any sense seems never to be discussed at all.
First of all, is there currently a sliding scale of penalties corresponding to the harmfulness of drugs? No! Not in any meaningful sense.
Heroin is a class A drug (most severe penalties). Which health problems does heroin cause? Constipation! That's about it. Heroin is, of course, addictive but that does not mean that it damages the health of people who keep taking it. Street heroin does cause all sorts of health of problems, from infections to death by overdose, but these problems occur, by and large, precisely because heroin incurs criminal penalties and arrives in unknown strengths mixed with unknown substances in dirty syringes.
At the other end of the scale, solvents, which can cause all sorts of health problems (eg liver damage) are perfectly legal.
Just up into the scale at "C" are various tranquillisers and sleeping pills which, like heroin are addictive and like heroin have a high overdose potential.
The drugs that cause the most health problems of all - alcohol and tobacco - are, like solvents, not on the scale at all.
So should there be a sliding scale of penalties corresponding to the harmfulness of drugs? Could the scale be adjusted and made coherent?
I submit not.
Part of the problem is that the harms caused by drugs are simply too complex to represent meaningfully on an ABC scale. Some drugs, eg tobacco and cannabis (when smoked), have long term cumulative health effects on the respiratory system. Others, eg alcohol and heroin can easily cause the very short term health effect of sudden death by overdose. Despite this, and the fact that alcohol also causes lots of other long term health problems, moderate social drinking can be a life long pursuit for most people without them coming to very much grief. Cannabis (assuming some of the more worrying research turns out to be indicative of real effects) may be a particular danger for young people whose brains are still developing and less of a problem for older people. The question of how drugs are taken is also highly relevant. If you obtain your nicotine high from smoking cigarettes you stand a significant chance of contracting lung cancer. If you obtain your nicotine high from chewing gum. you don't.
But a more fundamental objection here concerns the very principle that criminal law should be used to inflict criminal penalties on people who do things that may cause them harm. We all know that drinking bleach and standing too near the edges of cliffs are extremely hazardous, but we don't feel that it is necessary or appropriate to make such activities illegal. It would be very foolish of me to begin smoking cigarettes or injecting myself with heroin every day, and I accept that it is quite appropriate for the state to discourage me from such pursuing such activities. In the end, however, it should be up to me - providing I don't inflict my smoke on others or sell my spare heroin to minors or whatever.
The only argument for making drugs illegal that seems to hold any (a priori) merit whatsoever, is the argument that illegality is likely to discourage use. The evidence for this contention is, however, thinner than a Rizla paper. Cannabis use is higher in the UK than it is in the Netherlands where users and retailers of the drug incur no criminal penalties and when the classification of cannabis was lowered from B to C here in the UK, use actually declined. The 30 odd year long war on drugs in the USA has seen an unremitting growth in the availability and use of all types of drugs whereas experiments with decriminalization in many countries have not led to explosions in use. Even if legalization led to a slight growth in consumption (which I doubt would be the case) there is still a strong argument in favour of legalization if this massively reduces the harm cased be drugs overall.
So, what should be done?
Nobody is suggesting that we put crack on the supermarket shelves. A well thought through programme of legalization would see clean drugs with regulated potency supplied in a controlled fashion to adults and an end to the black market and the huge international criminal enterprise it supports.
Meanwhile, we should increase the supply of accurate and believable information about the health (and other drawbacks) of all drugs - including the ones which are currently legal.
We have been remarkably successful at reducing the incidence and social acceptability of tobacco smoking in this country and we have achieved this without imprisoning a single smoker or tobacconist.
There has to be a lesson in that experience somewhere.
But David Nutt is wrong too. He apparently endorses the notion that there is or should be (the distinction is no always made clear) a sliding scale of criminal penalties according to the harmfulness of drugs. His only gripe with the government seems to be on the question of where certain drugs should be on this scale and the government's insistence on relying on prejudice rather than science in assessing this.
This question is discussed regularly in the media. The question of whether the sliding scale makes any sense seems never to be discussed at all.
First of all, is there currently a sliding scale of penalties corresponding to the harmfulness of drugs? No! Not in any meaningful sense.
Heroin is a class A drug (most severe penalties). Which health problems does heroin cause? Constipation! That's about it. Heroin is, of course, addictive but that does not mean that it damages the health of people who keep taking it. Street heroin does cause all sorts of health of problems, from infections to death by overdose, but these problems occur, by and large, precisely because heroin incurs criminal penalties and arrives in unknown strengths mixed with unknown substances in dirty syringes.
At the other end of the scale, solvents, which can cause all sorts of health problems (eg liver damage) are perfectly legal.
Just up into the scale at "C" are various tranquillisers and sleeping pills which, like heroin are addictive and like heroin have a high overdose potential.
The drugs that cause the most health problems of all - alcohol and tobacco - are, like solvents, not on the scale at all.
So should there be a sliding scale of penalties corresponding to the harmfulness of drugs? Could the scale be adjusted and made coherent?
I submit not.
Part of the problem is that the harms caused by drugs are simply too complex to represent meaningfully on an ABC scale. Some drugs, eg tobacco and cannabis (when smoked), have long term cumulative health effects on the respiratory system. Others, eg alcohol and heroin can easily cause the very short term health effect of sudden death by overdose. Despite this, and the fact that alcohol also causes lots of other long term health problems, moderate social drinking can be a life long pursuit for most people without them coming to very much grief. Cannabis (assuming some of the more worrying research turns out to be indicative of real effects) may be a particular danger for young people whose brains are still developing and less of a problem for older people. The question of how drugs are taken is also highly relevant. If you obtain your nicotine high from smoking cigarettes you stand a significant chance of contracting lung cancer. If you obtain your nicotine high from chewing gum. you don't.
But a more fundamental objection here concerns the very principle that criminal law should be used to inflict criminal penalties on people who do things that may cause them harm. We all know that drinking bleach and standing too near the edges of cliffs are extremely hazardous, but we don't feel that it is necessary or appropriate to make such activities illegal. It would be very foolish of me to begin smoking cigarettes or injecting myself with heroin every day, and I accept that it is quite appropriate for the state to discourage me from such pursuing such activities. In the end, however, it should be up to me - providing I don't inflict my smoke on others or sell my spare heroin to minors or whatever.
The only argument for making drugs illegal that seems to hold any (a priori) merit whatsoever, is the argument that illegality is likely to discourage use. The evidence for this contention is, however, thinner than a Rizla paper. Cannabis use is higher in the UK than it is in the Netherlands where users and retailers of the drug incur no criminal penalties and when the classification of cannabis was lowered from B to C here in the UK, use actually declined. The 30 odd year long war on drugs in the USA has seen an unremitting growth in the availability and use of all types of drugs whereas experiments with decriminalization in many countries have not led to explosions in use. Even if legalization led to a slight growth in consumption (which I doubt would be the case) there is still a strong argument in favour of legalization if this massively reduces the harm cased be drugs overall.
So, what should be done?
Nobody is suggesting that we put crack on the supermarket shelves. A well thought through programme of legalization would see clean drugs with regulated potency supplied in a controlled fashion to adults and an end to the black market and the huge international criminal enterprise it supports.
Meanwhile, we should increase the supply of accurate and believable information about the health (and other drawbacks) of all drugs - including the ones which are currently legal.
We have been remarkably successful at reducing the incidence and social acceptability of tobacco smoking in this country and we have achieved this without imprisoning a single smoker or tobacconist.
There has to be a lesson in that experience somewhere.
2009-10-25
Clive James on knowledge, scepticism, and climate change denialism
Clive James on knowledge, scepticism, and climate change denialism
.... and my email to him:
.... and my email to him:
Dear Clive
I have derived a great deal of pleasure from your writings and broadcasts over many years but your broadcast this morning on Radio 4 filled me with dismay.
I’m afraid that your assessment of the climate science debate was profoundly mistaken – on a number of counts.
Don’t worry, I don’t intend to bombard you with the scientific evidence that counters the claims of the denialists (you can read this for yourself if you wish at sites such as http://www.newscientist.com/article/dn11462) but I do wish to explain why the climate change deniers really are on a par with Holocaust deniers.
First of all, most of the science is about what has already happened and what is happening now. Nobody (except the scientifically illiterate - I think here of “journalists” such as Melanie Phillips) disputes the figures for the amount of carbon in the atmosphere and the growth of those figures in response to the burning of fossil fuels. Nobody (except the scientifically illiterate) disputes the claim that CO2 in the atmosphere leads (ceteris paribus) to a “greenhouse effect”. This much is basic physics and chemistry.
Of course scientists also claim that there has been a long term increase in average global temperatures and here they are on slightly shakier ground. The written records only go back so far and many of the figures have to be inferred from all kinds of other disparate evidence. The accuracy of historical records and the validity of such inferences may be disputed (on perfectly reasonable scientific grounds). Nonetheless, there is a very very wide consensus amongst scientists that there has been a warming trend in average global temperatures since we began burning lots of fossil fuels.
The claims of many denialists that climate scientists are engaged in some kind of conspiracy to delude the rest of us are belied by the fact that those same scientists have reported a slight cooling trend in very recent years. Of course, the assumption is that this is a short term blip in an otherwise relentless upward trend…
…which brings me to my final point; and your most serious error:
None of the science described above is based on “modelling”. Computer modelling of the climate is designed to predict what might happen in the future. Of course, nobody knows for certain what will actually happen in the future. For example, the super-volcano under Yellowstone Park may blow and plunge us all into a decades long winter. But computer models can provide educated guesses as to what is most likely to happen given certain assumptions about continuing trends. There is far less scientific consensus here (especially when it comes to the details) but there is a very widespread scientific consensus that (assuming current trends do continue unabated) some pretty dreadful things are very likely to happen over the next couple of hundred years.
There are some who have genuine scientific concerns about things like the measurement of average sea temperatures and the rate of ice sheet melting and so on; but they are in a minority. Most of the “scientists” who tend to get quoted by journalists seeking to discredit the theory of global warming are scientists in the same sense that David Irving is an historian.
2009-09-25
Striking a "fair balance" between sense and nonsense
I wrote to the BBC the other day objecting to the fact that their article "Autism rates back MMR jab safety" provides (alongside links to perfectly sensible bodies like the NHS and the National Autistic Society) a link to the "JABs" website that promotes mis-information about vaccines and supports Dr Andrew Wakefield's discredited notions about a link between MMR and autism.
My initial salvo (in the form of a completed BBC web-form):
I had a reply (which is always nice even if the reply is full of nonsense):
I have replied:
Not as restrained and polite as I often try to be, but I was in a bad mood when I received the BBC response and my mood then took a turn for the worse.
My initial salvo (in the form of a completed BBC web-form):
Re: the link to the "Jabs" website from: http://news.bbc.co.uk/1/hi/health/8268302.stm
{Complaint:} The "information" on this site has been thoroughly and repeatedly discredited. The BBC should not include a link as though the Jabs site had some kind of valid contribution to make to scientific debate.
Children are dying because of the low uptake of MMR. This is a direct result of misinformation peddled by the Jabs site and other anti vaccination media.
This is not balance, it is gross irresponsibility.
Dr Schroedinger99
I had a reply (which is always nice even if the reply is full of nonsense):
Dear Mr Schroedinger99,
Many thanks for your message, and interest in the site.
All our coverage of the debate on the safety of MMR for many years now has emphasised that the jab is perfectly safe, and is backed by the medical and scientific establishment.
However, there are still people who remain unconvinced, arguing that there is no conclusive scientific proof, only epidemiological studies.
That is why, until their concerns can be disproved with absolute certainty, we link to the Jabs website. As you say, we are committed to a fair balance.
Kind regards,
Richard Warry
Health editor
BBC News website
news.bbc.co.uk/1/hi/health/
I have replied:
Dear Mr Warry
Thank you for your email - which I find rather extraordinary.
I take it then that, although you are the health editor for BBC News website, you do not have a science background?
If you did have such a background, you would be aware that things in science and medicine are never proved or disproved "with absolute certainty". This can only happen in mathematics and logic.
Nobody can "prove with absolute certainty" that the phlogiston theory is false or "disprove with absolute certainty" the theory that measles is caused by demonic possession. Indeed, I am sure there are some websites out there promoting such "theories". Perhaps, in the interests of "fair balance", you should link to them too.
There are limits to the notion of "fair balance" - otherwise whenever you included an item on the "Holocaust" you would also be duty bound to include a link to some nutty neo-Nazi website where the whole thing is dismissed as a hoax; and whenever you had an item on moon exploration, you would have to include an equally preposterous link.
There is not a shred of credible scientific evidence that the MMR vaccine causes autism and (while there may be contexts where it is appropriate for the BBC to link to sites promoting barmy conspiracy theories - such as in news items about barmy conspiracy theories) it is grossly irresponsible of the BBC to present the link to the JABs site alongside a link to an NHS information site as though the two were somehow on a par with one another.
I am extremely disappointed by your response.
Dr Schroedinger99
Not as restrained and polite as I often try to be, but I was in a bad mood when I received the BBC response and my mood then took a turn for the worse.
2009-09-20
TEA CUTS RISK OF DIABETES
From the Daily Express (aka "Tits By Christmas" - though this epithet was coined several Christmases ago and now, I suppose, has to be regarded as undeserved).
This all began when I tweeted on this headline. I had not, at that stage, actually read the article. I had simply walked past a news-stand with my son Max in tow. "Is that really true?" he asked as our eyes fell on the banner headline.
Now I don't think I've ever actually explicitly said to Max "Never believe anything you read in the Daily Express - especially if it's to do with science" (nor would I entirely go along with this bald statement); but I have obviously, unconsciously transmitted this sentiment to him over the years.
I remarked on the fact that Max seemed to be developing a healthy scepticism towards journalism in general and scientific journalism in particular in one of my tweets. Since then several people have kindly re-tweeted my original tweet, but the original context has been lost and I thought it was time I looked at the text below the headline - before the Express lawyers see one of my cropped tweets in a new context and begin libel proceedings against me.
The first thing to note is that the article concerns Type 2 diabetes (which is typically - though not exclusively - a problem for older people and is much more strongly associated with lifestyle factors than Type 1 diabetes). Although Type 2 is far more common that Type 1, it is Type 1 - and its associated treatment regime of insulin injections - which pops into many people's minds when the term "diabetes" is used.
Even if the research reported in the article is "kosher", there is no suggestion here that forcing your kids to drink tea will help protect from developing "insulin dependent diabetes" (as it used to be called) or that drinking tea will help your kids if they already have this condition. The same considerations apply to adults with Type 1 of course, but they can make their own decisions. In either case, I think the article - though it does say that the findings apply to Type 2 diabetes - ought (to be on the safe side) to say explicitly that the findings do not apply to Type 1.
To move on the research itself, there is (and this is, unfortunately, the rule rather than the exception in science articles in newspapers) no link the the original paper(s) or conference proceedings on which this article is based. Looking at what is reported, this was a "study of more than 40,000 people whose consumption was monitored for 10 years". This sounds impressive, but there is no indication of how the 40,000 people were recruited. Further down we read "They got participants to fill in a daily food questionnaire".
There are several potential problems here. Were the original recruits randomly chosen? Haw many of those approached agreed to take part? How many dropped out? How reliable were their recollections of what they had consumed? None of these considerations should be regarded as damning, but (depending on whether and, if so, how they have been addressed - something we are not told) we need to make (and above all report) inferences from research like this with caution.
Another more fundamental problem with research programmes of this kind concerns the direction of the causal relationship. If, as the reported research seems to suggest, there is a correlation between tea drinking and failure to develop Type 2 diabetes, this may be because drinking tea provides protection, or it may be that Type 2 diabetics (or those going on to develop the condition) drink fewer cups of tea. Such issues can, of course, often be settled by further research. But we are not told whether or how the second explanation was excluded. Again, this consideration does not necessarily damn the research in any way, but it does mean that we have to be circumspect in our conclusions.
A few lines further down comes an even more worrying bit: "Dr Carrie Ruxton, of Britain’s Tea Advisory Panel, said". Forget what he said (which was about black versus green tea), why is his opinion being reported here at all? Did the "Tea Advisory Panel" commission or fund this research? Did they bring it to the attention of the Daily Express? No suggestion of impropriety even if they did, but I think we should be told.
The article ends with some perfectly good stuff:
And you can see why "The best way to prevent Type 2 diabetes remains keeping active and eating a healthy, balanced diet that is low in fat, salt and sugar with plenty of fruit and vegetables." would not make a great headline; but "TEA MIGHT HELP CUT RISK OF TYPE 2 DIABETES" is reasonably snappy and would actually reflect the information cited.
I think, on balance, the last word on Daily Express journalism should go to John Cooper Clarke.
This all began when I tweeted on this headline. I had not, at that stage, actually read the article. I had simply walked past a news-stand with my son Max in tow. "Is that really true?" he asked as our eyes fell on the banner headline.
Now I don't think I've ever actually explicitly said to Max "Never believe anything you read in the Daily Express - especially if it's to do with science" (nor would I entirely go along with this bald statement); but I have obviously, unconsciously transmitted this sentiment to him over the years.
I remarked on the fact that Max seemed to be developing a healthy scepticism towards journalism in general and scientific journalism in particular in one of my tweets. Since then several people have kindly re-tweeted my original tweet, but the original context has been lost and I thought it was time I looked at the text below the headline - before the Express lawyers see one of my cropped tweets in a new context and begin libel proceedings against me.
The first thing to note is that the article concerns Type 2 diabetes (which is typically - though not exclusively - a problem for older people and is much more strongly associated with lifestyle factors than Type 1 diabetes). Although Type 2 is far more common that Type 1, it is Type 1 - and its associated treatment regime of insulin injections - which pops into many people's minds when the term "diabetes" is used.
Even if the research reported in the article is "kosher", there is no suggestion here that forcing your kids to drink tea will help protect from developing "insulin dependent diabetes" (as it used to be called) or that drinking tea will help your kids if they already have this condition. The same considerations apply to adults with Type 1 of course, but they can make their own decisions. In either case, I think the article - though it does say that the findings apply to Type 2 diabetes - ought (to be on the safe side) to say explicitly that the findings do not apply to Type 1.
To move on the research itself, there is (and this is, unfortunately, the rule rather than the exception in science articles in newspapers) no link the the original paper(s) or conference proceedings on which this article is based. Looking at what is reported, this was a "study of more than 40,000 people whose consumption was monitored for 10 years". This sounds impressive, but there is no indication of how the 40,000 people were recruited. Further down we read "They got participants to fill in a daily food questionnaire".
There are several potential problems here. Were the original recruits randomly chosen? Haw many of those approached agreed to take part? How many dropped out? How reliable were their recollections of what they had consumed? None of these considerations should be regarded as damning, but (depending on whether and, if so, how they have been addressed - something we are not told) we need to make (and above all report) inferences from research like this with caution.
Another more fundamental problem with research programmes of this kind concerns the direction of the causal relationship. If, as the reported research seems to suggest, there is a correlation between tea drinking and failure to develop Type 2 diabetes, this may be because drinking tea provides protection, or it may be that Type 2 diabetics (or those going on to develop the condition) drink fewer cups of tea. Such issues can, of course, often be settled by further research. But we are not told whether or how the second explanation was excluded. Again, this consideration does not necessarily damn the research in any way, but it does mean that we have to be circumspect in our conclusions.
A few lines further down comes an even more worrying bit: "Dr Carrie Ruxton, of Britain’s Tea Advisory Panel, said". Forget what he said (which was about black versus green tea), why is his opinion being reported here at all? Did the "Tea Advisory Panel" commission or fund this research? Did they bring it to the attention of the Daily Express? No suggestion of impropriety even if they did, but I think we should be told.
The article ends with some perfectly good stuff:
A spokeswoman for campaign group Diabetes UK gave the research a cautious welcome, but stressed there was much more that people could do to prevent developing type 2 diabetes.
She said: “This is interesting research, however it does not prove that coffee and tea protect against type 2 diabetes...It is impossible to know what other factors might affect a person’s risk of developing the condition.
“The best way to prevent it remains keeping active and eating a healthy, balanced diet that is low in fat, salt and sugar with plenty of fruit and vegetables.”
Earlier this week it emerged that drugs to treat type 2 diabetes caused by obesity were costing the NHS £600million a year, the biggest drug bill it faces.
And you can see why "The best way to prevent Type 2 diabetes remains keeping active and eating a healthy, balanced diet that is low in fat, salt and sugar with plenty of fruit and vegetables." would not make a great headline; but "TEA MIGHT HELP CUT RISK OF TYPE 2 DIABETES" is reasonably snappy and would actually reflect the information cited.
I think, on balance, the last word on Daily Express journalism should go to John Cooper Clarke.
2009-08-25
More thoughts on Lockerbie, Compassion, and Truth
I came across a rather thought provoking article directed not at the question of Megrahi's guilt but at the wisdom (or not) of freeing him on compassionate grounds and at the hypocrisy of some of those who criticise this decision.
I tweeted a link to this "interesting" article and a number of fellow tweeters kindly re-tweeted my link. One re-tweeter, however, prefaced her re-tweet with the words: "The right decision". This is not a phrase I should necessarily go along with.
If I thought Megrahi were guilty beyond reasonable doubt of murdering 270 people, I think my feelings about releasing him on "compassionate" grounds would be (at the very least) equivocal - especially given his complete failure to exhibit any remorse or repentance.
The problem is, I am not convinced beyond reasonable doubt that Megrahi is guilty. Nor, I suspect, is Kenny MacAskill or anyone else in the higher echelons of the Scottish or British governments. Even if they are (or at one stage were) the impending second appeal - referred back by the Scottish Criminal Cases Review Commission - must have been concentrating minds.
In a rather silly (for him) article and even sillier follow up comment, Michael White of the Guardian suggests that we should put our trust in the judges (NB not a "conviction by jury" as FBI chief Robert Mueller claims) who originally found Megrahi guilty and that anyone who suggests otherwise is some kind of conspiracy theorist.
In response to Michael White I think it should be pointed out that miscarriages of justice have (historically) been the rule rather than the exception in high profile UK terrorist trials (even going back to the days of the Angry Brigade trials after which one of those convicted said that at least, in his case, "they framed a guilty man") and that the Scottish Criminal Cases Review Commission do not immediately strike me as being the sort of people who would concoct some kind of "it was all done by the CIA in league with the Martians" scenario.
As this article also argues, it is reasonable to assume that Megrahi was freed in order to avoid an appeal that. at the very least, would have raised serious questions over the Scottish justice system and the Lockerbie inquiry.
I tend to find that what politicians avoid talking about is more instructive than the things they do talk about. It is interesting that there is no mention whatsoever of the Scottish Criminal Cases Review Commission in Kenny MacAskill's statement on Megrahi.
Odd that, is it not?
I tweeted a link to this "interesting" article and a number of fellow tweeters kindly re-tweeted my link. One re-tweeter, however, prefaced her re-tweet with the words: "The right decision". This is not a phrase I should necessarily go along with.
If I thought Megrahi were guilty beyond reasonable doubt of murdering 270 people, I think my feelings about releasing him on "compassionate" grounds would be (at the very least) equivocal - especially given his complete failure to exhibit any remorse or repentance.
The problem is, I am not convinced beyond reasonable doubt that Megrahi is guilty. Nor, I suspect, is Kenny MacAskill or anyone else in the higher echelons of the Scottish or British governments. Even if they are (or at one stage were) the impending second appeal - referred back by the Scottish Criminal Cases Review Commission - must have been concentrating minds.
In a rather silly (for him) article and even sillier follow up comment, Michael White of the Guardian suggests that we should put our trust in the judges (NB not a "conviction by jury" as FBI chief Robert Mueller claims) who originally found Megrahi guilty and that anyone who suggests otherwise is some kind of conspiracy theorist.
In response to Michael White I think it should be pointed out that miscarriages of justice have (historically) been the rule rather than the exception in high profile UK terrorist trials (even going back to the days of the Angry Brigade trials after which one of those convicted said that at least, in his case, "they framed a guilty man") and that the Scottish Criminal Cases Review Commission do not immediately strike me as being the sort of people who would concoct some kind of "it was all done by the CIA in league with the Martians" scenario.
As this article also argues, it is reasonable to assume that Megrahi was freed in order to avoid an appeal that. at the very least, would have raised serious questions over the Scottish justice system and the Lockerbie inquiry.
I tend to find that what politicians avoid talking about is more instructive than the things they do talk about. It is interesting that there is no mention whatsoever of the Scottish Criminal Cases Review Commission in Kenny MacAskill's statement on Megrahi.
Odd that, is it not?
2009-08-23
Lockerbie, Compassion, and Truth
On 1986 April 15, the USA bombed a number of targets in Libya killing 40 people (including Gaddafi's 15-month-old adopted daughter Hanna) and injuring many (including two of Gaddafi's sons). This attack was in retaliation for terrorists attacks such as the Achille Lauro hijacking of 1985 October 7, the Rome and Vienna airport attacks of 1985 December 27, and the 1986 April 5 bomb attack on a West Berlin disco, "La Belle", that killed two American servicemen and a Turkish woman and wounded 200 others. Libya (it was alleged, though this is denied by Libya) had a hand in each of these outrages (ref).
In 1993 October Margaret Thatcher (the UK prime minister from 1979 to 1990 and thus PM during the events related above) published her memoires: "The Downing Street Years". In this book she indicates her support for the bombing of Libya saying that, following this bombing raid "Libya never again mounted a serious attack on the West". Now this is a rather odd thing to say, because in 1988 December 21, flight Pan Am 103 was blown out of the sky half an hour after take-off by a suitcase-bomb (with - according to the "official" account - a long delay "Mebo" timer) allegedly sent from Malta to Frankfurt to London by Libyan intelligence officer Abdelbaset Ali al-Megrahi. This action resulted in 270 deaths - including that of Jim Swire's eldest daughter, Flora.
When Dr Swire wrote to Margaret Thatcher to ask about this apparent contradiction in her book, he "got a pompous letter back saying she had nothing to add." (ref).
Why has Margaret Thatcher "nothing to add"? The only possible explanation is that she knows something that she is reluctant to talk about.
Since she will not tell us what she knows, we shall have to speculate.
I speculate that she knows that Libya was not behind the Lockerbie attack.
If she knows this, then, I further speculate, so does Gordon Brown.
Let's look at the curious choreography of events: The withdrawal of al-Megrahi's appeal - an appeal that could have continued in spite of al-Megrahi's compassionate release or (alternatively) al-Megrahi's death in custody - followed by al-Megrahi's compassionate release; followed by a deafening silence from Number 10.
Forget "compassion" for someone who supposedly murdered 270 people; forget "oil deals"; the British and Scottish governments (I submit) know al-Megrahi is innocent and they fear that the appeal would have established this - with all the embarrassing consequences that such an outcome would imply. They have chosen the "least-worst" way out.
(Anyone inclined to dismiss all this a some kind of nutty conspiracy theory needs to bear in mind that any skulduggery practised by British and US intelligence was not intended to frame al-Megrahi in a trial that nobody (at the time) thought would ever take place, it was simply intended make Libya look bad. This sort of thing - spreading misinformation for geopolitical ends - goes on all the time. You can read what the chap who played the main role in setting up the al-Megrahi's trail (Robert Black QC) now thinks about the whole thing here: THE LOCKERBIE CASE.)
In 1993 October Margaret Thatcher (the UK prime minister from 1979 to 1990 and thus PM during the events related above) published her memoires: "The Downing Street Years". In this book she indicates her support for the bombing of Libya saying that, following this bombing raid "Libya never again mounted a serious attack on the West". Now this is a rather odd thing to say, because in 1988 December 21, flight Pan Am 103 was blown out of the sky half an hour after take-off by a suitcase-bomb (with - according to the "official" account - a long delay "Mebo" timer) allegedly sent from Malta to Frankfurt to London by Libyan intelligence officer Abdelbaset Ali al-Megrahi. This action resulted in 270 deaths - including that of Jim Swire's eldest daughter, Flora.
When Dr Swire wrote to Margaret Thatcher to ask about this apparent contradiction in her book, he "got a pompous letter back saying she had nothing to add." (ref).
Why has Margaret Thatcher "nothing to add"? The only possible explanation is that she knows something that she is reluctant to talk about.
Since she will not tell us what she knows, we shall have to speculate.
I speculate that she knows that Libya was not behind the Lockerbie attack.
If she knows this, then, I further speculate, so does Gordon Brown.
Let's look at the curious choreography of events: The withdrawal of al-Megrahi's appeal - an appeal that could have continued in spite of al-Megrahi's compassionate release or (alternatively) al-Megrahi's death in custody - followed by al-Megrahi's compassionate release; followed by a deafening silence from Number 10.
Forget "compassion" for someone who supposedly murdered 270 people; forget "oil deals"; the British and Scottish governments (I submit) know al-Megrahi is innocent and they fear that the appeal would have established this - with all the embarrassing consequences that such an outcome would imply. They have chosen the "least-worst" way out.
(Anyone inclined to dismiss all this a some kind of nutty conspiracy theory needs to bear in mind that any skulduggery practised by British and US intelligence was not intended to frame al-Megrahi in a trial that nobody (at the time) thought would ever take place, it was simply intended make Libya look bad. This sort of thing - spreading misinformation for geopolitical ends - goes on all the time. You can read what the chap who played the main role in setting up the al-Megrahi's trail (Robert Black QC) now thinks about the whole thing here: THE LOCKERBIE CASE.)
2009-08-19
Should the scientists counter-sue the chiropractors?
Let's just remind ourselves, the British Chiropractors Association is suing science writer Simon Singh because he wrote that the chiroprators don't have any evidence for many of their "treatments" but go ahead and use them anyway. (read Simon's side of the story here)
The BCA insisted that they did have evidence and went on to publish it. This "evidence" was promptly demolished by various bloggers: (see here for one of the demolition jobs and links to others)
But here's the thing:
Simon Singh also pointed out that chiropractic manipulation is not risk free and may, for example, be a cause of stroke
The BCA did not sue Simon over this, but if you go the the site of the General Chiropractic Council, you find a letter from one of their board members to Dr Miriam Stoppard (who had mentioned this danger in a Daily Mirror article):
The bit about confusing association and causality is itself confused. Consistent association between A and B does imply causality - it's just that the causality may be from A to B; from B to A; or from C to both A and B.
Moreover the statement that there is "no evidence" is untrue (see for example: here, here, here, and here - Thanks to @Blue_wode for these!)
Perhaps some pro-chiropractic bloggers might like to demolish these references.
But to come (finally) to the point (and leaving aside the question of who is right and who really has evidence) we have here a strange asymmetry:
Scientist accuses chiropractors of having no evidence and chiropractors sue.
Chiropractor accuses scientist of having no evidence and scientists don't sue.
Perhaps we should ;)
Jack?
At the very least, we should expose their hypocrisy - which I hope I've just done.
The BCA insisted that they did have evidence and went on to publish it. This "evidence" was promptly demolished by various bloggers: (see here for one of the demolition jobs and links to others)
But here's the thing:
Simon Singh also pointed out that chiropractic manipulation is not risk free and may, for example, be a cause of stroke
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. (ref)
The BCA did not sue Simon over this, but if you go the the site of the General Chiropractic Council, you find a letter from one of their board members to Dr Miriam Stoppard (who had mentioned this danger in a Daily Mirror article):
There is no evidence that examination or manipulation of the neck causes stroke. Journalists, and a few others, routinely confuse association with cause but as a registered medical practitioner you will be aware of the distinction. (ref)
The bit about confusing association and causality is itself confused. Consistent association between A and B does imply causality - it's just that the causality may be from A to B; from B to A; or from C to both A and B.
Moreover the statement that there is "no evidence" is untrue (see for example: here, here, here, and here - Thanks to @Blue_wode for these!)
Perhaps some pro-chiropractic bloggers might like to demolish these references.
But to come (finally) to the point (and leaving aside the question of who is right and who really has evidence) we have here a strange asymmetry:
Scientist accuses chiropractors of having no evidence and chiropractors sue.
Chiropractor accuses scientist of having no evidence and scientists don't sue.
Perhaps we should ;)
Jack?
At the very least, we should expose their hypocrisy - which I hope I've just done.
2009-08-16
How I survived the Aporkalypse
I could be pretentious and describe this as a "case-study", but it is really more a rambling anecdote and, as "eni fule kno" (apart, of course, from the BCA and other assorted purveyors of woo) anecdotal evidence is not the sort of thing you should base health policy on.
The subject of this blog was suggested by @carmenego and, since I am quite incapable of resisting flattery from attractive young women, here it is:
I can only assume that I picked up the H1N1 virus at Manchester Airport when dropping off my wife and kids. They were bound for three weeks in Germany with my parents in law. I was bound for three weeks of peace and quiet back home and chance to get a few things done – like building a garden wall.
First sign that anything was amiss was a slight sore throat a few days later. A couple of days after that, the sore throat was much much worse and accompanied by fever, headache, coughing on a scale I've never previously experienced, and those aches and pains and chills that go though every bone and joint in your body.
I got up to feed the cats and myself every so often, but for five days I could do little more than lie in bed. Couldn’t really enjoy TV (though that could have been to do with the fact that 90% of TV is utter rubbish) or reading or anything. I just didn't have the concentration.
Of course the same flu can affect different people in different ways: anywhere on a scale from not noticing you have it to being dead. It all depends on your immune status and what else might be wrong with you. I am in my early 50s and, like most men, suffer from hypochondria. I wasn’t always a hypochondriac. When I was young, I thought I was invulnerable; but then I started getting all sorts of nasty things wrong with me and this made me start to worry about things like my health.
One thing I had wrong with me was sarcoidosis. I won’t bore you with the gory details, but sarcoidosis is not great for your lungs and the fact of getting it rather suggests that something is awry with your immune system. So I worry about things like flu and new insults to my lungs.
I went on the internet and checked the list of symptoms. Of course, I had all of them and several more besides. I have an encyclopaedia of "Family Health" on my book shelf. I have the symptoms of everything in it. I am just like Jerome K Jerome in this respect, except that I have house-maid’s knee too. As I said, I’m a hypochondriac – though I never go near a doctor unless forced to by my wife.
Of course I have not been tested for the H1N1 virus, but H1N1 seems to be the only virus currently doing the rounds whose constellation of symptoms matches what I had.
Anyway, if you tick all the right boxes on the website, and fill in your details, they give you a reference number to pick up a supply of antivirals from your nearest distribution centre. They also said I should ring my GP, but certainly not go there. So I rang my wife for instructions. She also said I should contact the GP (I decided against this; what would be the point? In any case you can never get through to my GP) and that I should collect the Tamiflu. Max (aged 14) suggested that I re-sell the Tamilflu on the US eBay site (I hope he was joking). I decided to go and lie down instead. When I woke up I felt much worse and I decided that I needed something to supplement my diet of analgesics and tap water – and the occasional rum toddy.
Now it ought to be easy to kill viruses. It’s easy enough to destroy nucleic acids and that’s (by and large) what viruses are made out of. Trouble is, nucleic acid is also what some rather vital bits of us are made of too. Viruses can only work if they get inside your cells. Once they are inside a cell, that cell is basically buggered, but to move on to another cell, each virus (having made squillions of copies of itself inside the cell) has to build itself a new protein envelope and escape from the dying host cell. One of the ways of trying to stop viruses (none of which work terribly well) is to try to interfere with the process I’ve described. This is what Tamiflu does …… a bit.
So I rang up my "flu buddy" (she didn't actually know that she was my flu buddy until I rang her up but she very kindly "stepped up to the plate") and sent her off with my reference number, my photo driving licence (swabbed with CD cleaner); and her photo ID to collect my Tamiflu.
My flu buddy "@fiftynotout" came round, posted the Tamiflu through the letterbox, left me a bag of groceries, and painted a black cross on the door. She has been keeping me supplied with groceries all week since she drives out each day with her daughter who is learning to drive. I gather that if you don’t have anyone who can collect the anti-virals for you, you can arrange for somebody from the NHS (or "Death Panel" as Sarah Palin and co would have it) to drop you some off at your home.
(BTW @fiftynotout does not tweet very much. I think she joined because she had a crush on @StephenFry – though I gather she may have transferred her affections to @ProfBrianCox)
Did the Tamiflu work in my case? Impossible to say of course; it’s like the old joke about the man sprinkling elephant powder. But I did get better after taking it: post hoc but not necessarily propter hoc. The first two doses did seem to make me feel very queasy for while, but I did not actually vomit. From the third dose on, I had no problems – they give you ten doses to last five days.
Of course, given that Tamiflu is not terribly effective, can (like any drug) cause side effects (though these seem to be minimal), and will (sooner or later) almost certainly promote the emergence of resistance in the HIN1 virus, there is still an ongoing debate as to the wisdom of mass distribution. On the other hand, H1N1 can be fatal, Tamiflu may already be saving lives, and H1N1 may suddenly mutate a get a lot worse - if we did not have a working distribution system in place we'd be stuffed when this happened. Also, scientist are busy developing a vaccine - which will be very effective in preventing infection. The use of Tamiflu is just a stop-gap.
How bad is swine flu? Well again, I can only report my experience – which may not be yours. Apart from the coughing, I’d say that the acute symptoms get 8/10 – where the worse flu I ever had gets 10/10. The duration of incapacity and general malaise – eight days and counting – and the coughing are, however, much worse than anything I’ve experienced with normal seasonal flu.
Tweeting certainly helps with flu. It provides the vicarious sensation of having lots of people around expressing concern and interacting with you – not to be sneezed at (hah!) when you are stuck at home on your own. Also, though you can’t concentrate (or, in my case, even stay awake) for long enough to read a chapter of a book or watch a TV programme, you can sit up in bed with your laptop for five minutes and fire off the odd flurry of 140 character messages.
Of course I can’t offer medical advice but, I stayed in bed, drank lots of water and took paracetamol (2x500 mg) every eight hours alternated with ibuprofen. (NB Paracetamol is extremely safe if you stick to the correct dosages and extremely dangerous if you don’t!)
In conclusion: Thanks to my family for their frequent concerned phone calls, thanks to the Death Panel of the NHS for supplying me with free anti-viral drugs, thanks to everyone on Twitter who kept my spirits up during this experience, and a really big thank you to @fiftynotout – the best flu buddy anyone could have had.
The rest of you: Keep washing your hands!
The subject of this blog was suggested by @carmenego and, since I am quite incapable of resisting flattery from attractive young women, here it is:
I can only assume that I picked up the H1N1 virus at Manchester Airport when dropping off my wife and kids. They were bound for three weeks in Germany with my parents in law. I was bound for three weeks of peace and quiet back home and chance to get a few things done – like building a garden wall.
First sign that anything was amiss was a slight sore throat a few days later. A couple of days after that, the sore throat was much much worse and accompanied by fever, headache, coughing on a scale I've never previously experienced, and those aches and pains and chills that go though every bone and joint in your body.
I got up to feed the cats and myself every so often, but for five days I could do little more than lie in bed. Couldn’t really enjoy TV (though that could have been to do with the fact that 90% of TV is utter rubbish) or reading or anything. I just didn't have the concentration.
Of course the same flu can affect different people in different ways: anywhere on a scale from not noticing you have it to being dead. It all depends on your immune status and what else might be wrong with you. I am in my early 50s and, like most men, suffer from hypochondria. I wasn’t always a hypochondriac. When I was young, I thought I was invulnerable; but then I started getting all sorts of nasty things wrong with me and this made me start to worry about things like my health.
One thing I had wrong with me was sarcoidosis. I won’t bore you with the gory details, but sarcoidosis is not great for your lungs and the fact of getting it rather suggests that something is awry with your immune system. So I worry about things like flu and new insults to my lungs.
I went on the internet and checked the list of symptoms. Of course, I had all of them and several more besides. I have an encyclopaedia of "Family Health" on my book shelf. I have the symptoms of everything in it. I am just like Jerome K Jerome in this respect, except that I have house-maid’s knee too. As I said, I’m a hypochondriac – though I never go near a doctor unless forced to by my wife.
Of course I have not been tested for the H1N1 virus, but H1N1 seems to be the only virus currently doing the rounds whose constellation of symptoms matches what I had.
Anyway, if you tick all the right boxes on the website, and fill in your details, they give you a reference number to pick up a supply of antivirals from your nearest distribution centre. They also said I should ring my GP, but certainly not go there. So I rang my wife for instructions. She also said I should contact the GP (I decided against this; what would be the point? In any case you can never get through to my GP) and that I should collect the Tamiflu. Max (aged 14) suggested that I re-sell the Tamilflu on the US eBay site (I hope he was joking). I decided to go and lie down instead. When I woke up I felt much worse and I decided that I needed something to supplement my diet of analgesics and tap water – and the occasional rum toddy.
Now it ought to be easy to kill viruses. It’s easy enough to destroy nucleic acids and that’s (by and large) what viruses are made out of. Trouble is, nucleic acid is also what some rather vital bits of us are made of too. Viruses can only work if they get inside your cells. Once they are inside a cell, that cell is basically buggered, but to move on to another cell, each virus (having made squillions of copies of itself inside the cell) has to build itself a new protein envelope and escape from the dying host cell. One of the ways of trying to stop viruses (none of which work terribly well) is to try to interfere with the process I’ve described. This is what Tamiflu does …… a bit.
So I rang up my "flu buddy" (she didn't actually know that she was my flu buddy until I rang her up but she very kindly "stepped up to the plate") and sent her off with my reference number, my photo driving licence (swabbed with CD cleaner); and her photo ID to collect my Tamiflu.
My flu buddy "@fiftynotout" came round, posted the Tamiflu through the letterbox, left me a bag of groceries, and painted a black cross on the door. She has been keeping me supplied with groceries all week since she drives out each day with her daughter who is learning to drive. I gather that if you don’t have anyone who can collect the anti-virals for you, you can arrange for somebody from the NHS (or "Death Panel" as Sarah Palin and co would have it) to drop you some off at your home.
(BTW @fiftynotout does not tweet very much. I think she joined because she had a crush on @StephenFry – though I gather she may have transferred her affections to @ProfBrianCox)
Did the Tamiflu work in my case? Impossible to say of course; it’s like the old joke about the man sprinkling elephant powder. But I did get better after taking it: post hoc but not necessarily propter hoc. The first two doses did seem to make me feel very queasy for while, but I did not actually vomit. From the third dose on, I had no problems – they give you ten doses to last five days.
Of course, given that Tamiflu is not terribly effective, can (like any drug) cause side effects (though these seem to be minimal), and will (sooner or later) almost certainly promote the emergence of resistance in the HIN1 virus, there is still an ongoing debate as to the wisdom of mass distribution. On the other hand, H1N1 can be fatal, Tamiflu may already be saving lives, and H1N1 may suddenly mutate a get a lot worse - if we did not have a working distribution system in place we'd be stuffed when this happened. Also, scientist are busy developing a vaccine - which will be very effective in preventing infection. The use of Tamiflu is just a stop-gap.
How bad is swine flu? Well again, I can only report my experience – which may not be yours. Apart from the coughing, I’d say that the acute symptoms get 8/10 – where the worse flu I ever had gets 10/10. The duration of incapacity and general malaise – eight days and counting – and the coughing are, however, much worse than anything I’ve experienced with normal seasonal flu.
Tweeting certainly helps with flu. It provides the vicarious sensation of having lots of people around expressing concern and interacting with you – not to be sneezed at (hah!) when you are stuck at home on your own. Also, though you can’t concentrate (or, in my case, even stay awake) for long enough to read a chapter of a book or watch a TV programme, you can sit up in bed with your laptop for five minutes and fire off the odd flurry of 140 character messages.
Of course I can’t offer medical advice but, I stayed in bed, drank lots of water and took paracetamol (2x500 mg) every eight hours alternated with ibuprofen. (NB Paracetamol is extremely safe if you stick to the correct dosages and extremely dangerous if you don’t!)
In conclusion: Thanks to my family for their frequent concerned phone calls, thanks to the Death Panel of the NHS for supplying me with free anti-viral drugs, thanks to everyone on Twitter who kept my spirits up during this experience, and a really big thank you to @fiftynotout – the best flu buddy anyone could have had.
The rest of you: Keep washing your hands!
2009-08-14
One of the most ridiculous pieces of "journalism" I have ever come across
Heroin laced cannabis heading to Brighton streets, police fear
8:53am Thursday 13th August 2009
By Naomi Loomes
Dealers are lacing cannabis with highly addictive heroin to get users hooked on the deadly drug.
Secret off-the-record discussions between police and a supplier in London have revealed how recreational drug users are being tricked into becoming addicted to Class A drugs.
Officers fear it could lead to a surge in addicts in Brighton and Hove, which is already known as the drug death capital of England.
They believe cannabis users are becoming accidentally dragged into heroin use.
It follows the discovery that potent, paranoia-inducing cannabis, known as skunk, was being sold in large quantities in Brighton and Hove last year.
Detective Sergeant Hari McCarthy, of Sussex Police, said: "People buy it thinking it’s just very strong weed."
"It’s not being sold as skunk, just good weed, but it’s an easy way to get users hooked on heroin."
She added that dealers mixed various chemicals with cannabis before selling it, including tranquillisers and even urine.
There are believed to be 2,300 heroin addicts in Brighton and Hove.
The revelation was made during an inquest in Brighton into the death of 34-year-old electrician Lee Donlan from a heroin overdose.
Clinical and forensic toxicologist Peter Sharpe confirmed that taking mixtures of drugs was becoming more and more common in Brighton and Hove, in particular the highly dangerous combination known as speedballing.
He said: “There’s a mixture called speedballing – it’s heroin with a bit of cocaine, usually injected into the arm or ankle.
"People like the mixture of heroin and cocaine because the cocaine reduces the low that comes after the heroin."
Okay, lets take the first claim:
"Dealers are lacing cannabis with highly addictive heroin to get users hooked on the deadly drug" - an urban myth that I can remember doing the rounds as far back as the early 1970s.
Let's think this one through: I am a cannabis dealer (I'm not BTW, I'm just pursuing a thought experiment). I start somehow mixing heroin (usually a brown powder) with my cannabis (a brown or black resin or - more likely these days - a green herbal substance). I do this in such a way that my customers don't notice the extra brown powder. Because heroin is quite expensive in relation to the profit I normally make on my cannabis and because I am not telling my customers about the heroin and therefore can't charge for it, I am now selling my cannabis at a loss .... but I have a cunning plan. Providing my customers don't notice that the cannabis I'm selling them has a completely different effect from normal cannabis and keep coming back to me to buy their cannabis for several months, I shall, one day be able to say to them: "Ha! I've been giving you heroin all these months and now you are addicted so you will have to keep buying heroin from me now." Okay, they had been regular customers in order for me to get this far, but this will absolutely ensure their continued customer loyalty .. unless, of course, they beat me to a pulp with my bong and go and buy their heroin elsewhere.
I'm sorry, but this is complete and utter nonsense.
Second claim (part of the first one in fact): "heroin is a deadly drug" - at least I assume this is what the author intended to imply. The claim is worded as though she believes that cannabis is the deadly drug.
Heroin causes constipation. That's about it. It's addictive and street heroin (cf the legal kind that addicts could get if we did not have such crazy drug laws) is full of crap. I suppose that the point being made here is that you can overdose on heroin, but, again, much of the problem here arises from the fact that heroin is traded on the black market and there are therefore no controls on strength and purity. Heroin is certainly not a deadly drug in the sense that tobacco is.
I'm not suggesting anyone takes heroin by the way. It's much better to do something worthwhile with your life.
Third claim: "Dealers mix various chemicals with cannabis before selling it, including tranquillisers and even urine"
Tranquillizers usually come as white pills these days. They are far less readily available than they used to be since it was discovered that they can lead to addiction. They are sold on the black (or "grey" - as it is sometimes called) market in their own right as recreational drugs. But, according to this article, some dealers are crushing them up and mixing the resulting white powder with cannabis. I'm not sure what effect the cannabis smokers (who are presumably too stoned to notice the white powder) are supposed to derive from inhaling the smoke from burning valium and lactose, but I can't imagine it's a very peasant effect.
And as for urine.....
So the dealer urinates over his cannabis supply - which he then has to dry out again. To what end? To increase the weight of the weed with a few milligrams of urea? I think I'd just reach for the oregano and sprinkle a bit of that in.
Claim three: "People like the mixture of heroin and cocaine because the cocaine reduces the low that comes after the heroin."
The effects of heroin wear off after several hours. The effects of cocaine start wearing off after about twenty minutes. Hard to imagine cocaine injected at the same time as heroin would help much with any come-down after the heroin wore off.
The rest of the article (which I've not reproduced) goes on to list the names of various people who have died from drug overdoses and includes some confused nonsense about dosages. The correct information is that the LD50 for heroin is between 1 and 5 mg/kg of body weight.
I suppose that there is an argument that, because we all wish to see (especially young people) taking as few drugs as possible and suffering as little harm as possible, it's perfectly okay to write complete nonsense about drugs. Anything that puts people off! But this argument only holds water if we assume that everyone is as stupid as the author of this article. In fact, most young people will read this sort of thing, and fall about laughing. While this would be the most appropriate response in this case, there is always the danger that other articles on the dangers of drugs (written by people who actually know what they are talking about) will elicit a similar response.
There is growing evidence that cannabis in general (and skunk in particular) may have long term deleterious effect on young people whose brains are still developing. (By the way, the problem with skunk is not really its strength - high strength, leads to less being smoked and therefore less lung damage - but the particular balance of psychoactive compounds it contains; though more research is required on this.)
How on earth are we going to get this genuine science across to young people who have grown up on the diet of tripe provided by newspapers like the Brighton & Hove Argus?
2009-08-08
Harry Patch, War, and Human Nature
I caught part of "Any Answers" today (2009-08-08) on Radio 4. They were discussing Harry Patch’s misgivings about war – something which had presumably been discussed in the antecedent edition of "Any Questions" which I did not hear.
The first caller opined that the propensity to engage in war was a fundamental part of human nature and that the hope for a future without war was futile. Other callers took the view that human nature was not like this at all.
I think the first caller, rather than the others, was actually correct (at least partially) in his analysis of human nature; but I think his conclusion was false. I think he was making an mistake analogous to one of the mistakes people make when discussing Richard Dawkin’s "selfish gene".
The warlike disposition of groups of hunter-gathers (ancient and modern) is discussed by (inter alia) Stephen Pinker in his excellent book The Blank Slate. I do not agree with everything Pinker says in this book and I think that he somewhat overstates his case when it comes to his forthright rejection of the notion of the notion of the "noble savage". Nevertheless, I think that Pinker is probably right in concluding that humans almost certainly do have an innate disposition to declare "We are tribe X; tribe Y are over there and they are not tribe X; let’s go and kick the shit out of them all".
Variations on this theme have played out throughout human history and we see examples of this disposition even in modern times: in Rwanda; in the behaviour of the (Gentile) German population during Kristallnacht; in Northern Ireland; in the behaviour of football hooligans; and in many other situations.
The good news is that humans are also capable of deciding that, actually, the members of tribe Y are members of “our” tribe after all; and the communication age has made this easier then ever. Of course we still have vile organizations like the BNP, but most British people today cry as many tears over the TV picture of a dying child, with a different skin colour, on the other side of the world as they do over the TV picture of a dying child, with the same skin colour, in the next county.
It is these considerations (and others) that make the segregation of school children along religious lines so utterly pernicious.
Anyway, back to Harry Patch. Does our innate warlike nature (assuming this is our nature) make war inevitable? Let’s take a recent example: the Iraq War. Did the Brits all work themselves up into frenzy and decide: "Let’s go off and kill the Iraqis, they’re not a bit like us."? Urm, "No!". That’s not how it happened. Tony Blair decided to go to war. Okay, he had the support of the Cabinet, but (so far as one could tell) not one single Cabinet member really thought it was a good idea. Tony Blair then got the support of Parliament but, again, one had the impression that most MPs were thinking about their careers rather than baying for Iraqi blood.
Did Tony then lead his tribe into battle with the other tribe? No; he stayed safely at home and made vacuous speeches on TV.
Did the troops behave like a bunch of hunter gatherers intent on murder and mayhem in the enemy "tribe’s" camp? Well actually, in one or two cases, they may have done. But these really were isolated incidents. By and large, they went off to war because they had been ordered to do so and were not driven by a sense of hatred towards the Iraqi people or by a sense that the Iraqis were "other" and therefore worthless.
We could say the same (concerning the gap between the decision makers and the people going off to do the actually fighting) about almost any large scale modern conflict.
In other words, while it may well be true that humans organized in small groups of hunter gatherers - which have little contact with other groups – are genetically predisposed (because of the way we evolved) to violence in certain circumstances; the notion that the genesis of modern wars is somehow an expression of that propensity is highly questionable.
It is rather like the wrong-headed argument that because genes are (metaphorically) selfish and because human behaviour is (to a large extent) determined by our genetic make-up, humans must be innately selfish.
There are lots of reasons why "selfish" genes lead to altruistic behaviour in humans and there are many reasons why an innate propensity for violence toward "the other" in individual humans does not lead inevitably towards war between nation states.
Perhaps Harry Patch’s vision of a future without war will one day be realized.
Let us hope so.
The first caller opined that the propensity to engage in war was a fundamental part of human nature and that the hope for a future without war was futile. Other callers took the view that human nature was not like this at all.
I think the first caller, rather than the others, was actually correct (at least partially) in his analysis of human nature; but I think his conclusion was false. I think he was making an mistake analogous to one of the mistakes people make when discussing Richard Dawkin’s "selfish gene".
The warlike disposition of groups of hunter-gathers (ancient and modern) is discussed by (inter alia) Stephen Pinker in his excellent book The Blank Slate. I do not agree with everything Pinker says in this book and I think that he somewhat overstates his case when it comes to his forthright rejection of the notion of the notion of the "noble savage". Nevertheless, I think that Pinker is probably right in concluding that humans almost certainly do have an innate disposition to declare "We are tribe X; tribe Y are over there and they are not tribe X; let’s go and kick the shit out of them all".
Variations on this theme have played out throughout human history and we see examples of this disposition even in modern times: in Rwanda; in the behaviour of the (Gentile) German population during Kristallnacht; in Northern Ireland; in the behaviour of football hooligans; and in many other situations.
The good news is that humans are also capable of deciding that, actually, the members of tribe Y are members of “our” tribe after all; and the communication age has made this easier then ever. Of course we still have vile organizations like the BNP, but most British people today cry as many tears over the TV picture of a dying child, with a different skin colour, on the other side of the world as they do over the TV picture of a dying child, with the same skin colour, in the next county.
It is these considerations (and others) that make the segregation of school children along religious lines so utterly pernicious.
Anyway, back to Harry Patch. Does our innate warlike nature (assuming this is our nature) make war inevitable? Let’s take a recent example: the Iraq War. Did the Brits all work themselves up into frenzy and decide: "Let’s go off and kill the Iraqis, they’re not a bit like us."? Urm, "No!". That’s not how it happened. Tony Blair decided to go to war. Okay, he had the support of the Cabinet, but (so far as one could tell) not one single Cabinet member really thought it was a good idea. Tony Blair then got the support of Parliament but, again, one had the impression that most MPs were thinking about their careers rather than baying for Iraqi blood.
Did Tony then lead his tribe into battle with the other tribe? No; he stayed safely at home and made vacuous speeches on TV.
Did the troops behave like a bunch of hunter gatherers intent on murder and mayhem in the enemy "tribe’s" camp? Well actually, in one or two cases, they may have done. But these really were isolated incidents. By and large, they went off to war because they had been ordered to do so and were not driven by a sense of hatred towards the Iraqi people or by a sense that the Iraqis were "other" and therefore worthless.
We could say the same (concerning the gap between the decision makers and the people going off to do the actually fighting) about almost any large scale modern conflict.
In other words, while it may well be true that humans organized in small groups of hunter gatherers - which have little contact with other groups – are genetically predisposed (because of the way we evolved) to violence in certain circumstances; the notion that the genesis of modern wars is somehow an expression of that propensity is highly questionable.
It is rather like the wrong-headed argument that because genes are (metaphorically) selfish and because human behaviour is (to a large extent) determined by our genetic make-up, humans must be innately selfish.
There are lots of reasons why "selfish" genes lead to altruistic behaviour in humans and there are many reasons why an innate propensity for violence toward "the other" in individual humans does not lead inevitably towards war between nation states.
Perhaps Harry Patch’s vision of a future without war will one day be realized.
Let us hope so.
2009-08-03
Using Paypal: A cautionary tale
Executive summary:
1) Paypal is a convenient way of transferring money to people who are not set up to receive credit card payments (eg eBay sellers).
2) Paypal purports to be “safer than using your credit card, but this is highly misleading. For payments over £100 you are protected if you use your credit card by something called “Section 75”. You lose this protection if you pay using Paypal – even if your Paypal account draws from your credit card account. (Paypal does offer some protection on purchases within ebay however).
3) Paypal have poor customer service, are not interested in discussing questions about whether their sellers may be engaged in fraudulent activity, and may unilaterally close a dispute thereby preventing further buyer communication with Paypal or the seller complained about.
4) Paypal state that they do not “tolerate fraud or illegal activities”. Judging by my experience, this claim would appear to be untrue.
Our story:
My wife and daughter bought two pairs (a pair each) of “UGG” boots from http://www.australia-ugg-boots.com/ and paid using Paypal. The domain “australia-ugg-boots.com” is registered in Australia:
And the site makes the following claim:
A complication here (it should perhaps be noted) is that "UGG" is not a protected trade mark in Australia, but it is in the UK and other countries outside Australia.
When we received the boots (we did receive them) the parcel came not from Melbourne but from Shanghai. The boots were perfectly well made, but clearly counterfeit (with counterfeited "UGG" "trademarks" all over them) and lined with synthetic fur rather than sheepskin. The main problem, however, was that both pairs were each a couple of sizes smaller than ordered and than stated on the sewn in labels. Apparently this is one of the features of counterfeit UGG boots – quite why these firms can fake the boots so expertly and yet fail to size them correctly is, to say the least, puzzling. As we have real UGG boots at home we are able to compare like with not-like.
So we raised a dispute on Paypal.
AUSTRALIA-UGG-BOOTS (of China) got straight back and said we could return the boots and get a full refund. Trouble is that this costs rather a lot of money and they take no responsibility if goods are "lost in the post". The Royal Mail will only cover you up to £39 – unless you pay them shed-loads of money first.
Forgive my cynicism and scepticism, but I do not have a great deal of confidence that, if I sent these boots back to Shanghai, I would ever see my boots or my £130 again.
On to Paypal, the "safer" alternative to using your credit card.
It would by an understatement to say that Paypal have been unhelpful. They simply refused to help and then closed the case without consulting me further. This means that I can no longer communicate with them or the seller about this case. More worryingly, Paypal are (it would appear) continuing to trade with this company (which would certainly seem to be committing offences under UK law) and refusing to warn other potential buyers about the pitfalls of buying from the website in question.
As our experience illustrates, the fact that Paypal accepts a seller onto its books is no guarantee (or even indication) that that company is "kosher". In fact, the fact that a company only accepts Paypal and does not accept direct credit card payments may well be an indication that further scrutiny of that company is required before buying from it.
If you make payments over £100 using your credit card– even to companies in China – you enjoy buyer protection. If you use Paypal you lose that protection – it is not "safer" at all.
I shall, in future, use Paypal (if at all) only as a means of last resort to pay for goods and services and I suggest anyone reading this does the same.
1) Paypal is a convenient way of transferring money to people who are not set up to receive credit card payments (eg eBay sellers).
2) Paypal purports to be “safer than using your credit card, but this is highly misleading. For payments over £100 you are protected if you use your credit card by something called “Section 75”. You lose this protection if you pay using Paypal – even if your Paypal account draws from your credit card account. (Paypal does offer some protection on purchases within ebay however).
3) Paypal have poor customer service, are not interested in discussing questions about whether their sellers may be engaged in fraudulent activity, and may unilaterally close a dispute thereby preventing further buyer communication with Paypal or the seller complained about.
4) Paypal state that they do not “tolerate fraud or illegal activities”. Judging by my experience, this claim would appear to be untrue.
Our story:
My wife and daughter bought two pairs (a pair each) of “UGG” boots from http://www.australia-ugg-boots.com/ and paid using Paypal. The domain “australia-ugg-boots.com” is registered in Australia:
Whois Record
Registrant:
Jackie Beament
PO Box 3950
Joondalup, Western Australia 6027
Australia
Domain Name: AUSTRALIA-UGG-BOOTS.COM
Created on: 28-Feb-09
Expires on: 28-Feb-10
Last Updated on: 01-Mar-09
Administrative Contact:
Beament, Jackie
PO Box 3950
Joondalup, Western Australia 6027
Australia
894048411 Fax --
Technical Contact:
Beament, Jackie
PO Box 3950
Joondalup, Western Australia 6027
Australia
894048411 Fax --
Domain servers in listed order:
NS1.AUSTRALIA-UGG-BOOTS.COM
NS2.AUSTRALIA-UGG-BOOTS.COM
And the site makes the following claim:
Australia-Ugg-Boots.com is a family business manufacturing ugg boots here in our home town Melbourne, Australia since 2007. We manufacture high quality sheepskin footwear made from first grade double faced Australian Sheepskin. Australia-Ugg-Boots.com has been successfully wholesaling and retailing to many satisfied customers within Australia and Overseas. Our website was established in 2007 successfully providing customers all over the world with our great product, cheap prices and fast, reliable, friendly customer service.
A complication here (it should perhaps be noted) is that "UGG" is not a protected trade mark in Australia, but it is in the UK and other countries outside Australia.
When we received the boots (we did receive them) the parcel came not from Melbourne but from Shanghai. The boots were perfectly well made, but clearly counterfeit (with counterfeited "UGG" "trademarks" all over them) and lined with synthetic fur rather than sheepskin. The main problem, however, was that both pairs were each a couple of sizes smaller than ordered and than stated on the sewn in labels. Apparently this is one of the features of counterfeit UGG boots – quite why these firms can fake the boots so expertly and yet fail to size them correctly is, to say the least, puzzling. As we have real UGG boots at home we are able to compare like with not-like.
So we raised a dispute on Paypal.
AUSTRALIA-UGG-BOOTS (of China) got straight back and said we could return the boots and get a full refund. Trouble is that this costs rather a lot of money and they take no responsibility if goods are "lost in the post". The Royal Mail will only cover you up to £39 – unless you pay them shed-loads of money first.
Forgive my cynicism and scepticism, but I do not have a great deal of confidence that, if I sent these boots back to Shanghai, I would ever see my boots or my £130 again.
On to Paypal, the "safer" alternative to using your credit card.
It would by an understatement to say that Paypal have been unhelpful. They simply refused to help and then closed the case without consulting me further. This means that I can no longer communicate with them or the seller about this case. More worryingly, Paypal are (it would appear) continuing to trade with this company (which would certainly seem to be committing offences under UK law) and refusing to warn other potential buyers about the pitfalls of buying from the website in question.
As our experience illustrates, the fact that Paypal accepts a seller onto its books is no guarantee (or even indication) that that company is "kosher". In fact, the fact that a company only accepts Paypal and does not accept direct credit card payments may well be an indication that further scrutiny of that company is required before buying from it.
If you make payments over £100 using your credit card– even to companies in China – you enjoy buyer protection. If you use Paypal you lose that protection – it is not "safer" at all.
I shall, in future, use Paypal (if at all) only as a means of last resort to pay for goods and services and I suggest anyone reading this does the same.
2009-07-31
My response to a pro chiropractic response to Simon Singh's article
A critique of Simon's article by Richard Lanigan can be found at: chiropracticlive.
I address some of the points Richard Lanigan makes below:
Beware the spinal trap
by Simon Singh
Simon: This is Chiropractic Awareness Week. So let’s be aware. How about some awareness that may prevent harm and help you make truly informed choices? First, 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.
Richard: If I was going to criticise a health care profession, I would say it was important to have all my facts and provide accurate information. DD Palmer was 15 in 1860, worked as a teacher in the mid 1860s, worked as a bee keeper and small famer in the early 70s. The first mention of DD Palmers involvement in “healing” was in 1885 when he became a magnetic healer. It would seem he was in fact developing “developing his theories” in the 1880s rather 1860s, I suspect Simon Singh has confused DD with Andrew Still who founded Osteopathy and was developing his theories about manipulation in the 1860s.
DD Palmer's hypothesis was that interfering with nerve function would affect optimal well-being, he explained his theory around “displaced vertbrae”. Palmer’s understanding of the effects of spinal manipulation should be viewed in its time (the late 19th century) when surgery had a mortality rate of 76%. I know of no 21st century chiropractor who would explain chiropractic as Palmer did, or a surgeon who would operate in his street clothes without a mask. To define chiropractic along these lines is like defining medicine the way Harold Shipman practised.
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.
Stranger things have happened. Here we have a news report in 2008 stating a chiropractor restored a mans [sic] sight. I think its fair to say if Palmer had observed Harvey Lillard getting his hearing back he may have thought that he had discover the holy grail of healing. Look at the competition at the time 1895??
Simon: You might think that modern chiropractors restrict themselves to treating back problems, but in fact they still possess some quite wacky ideas. The fundamentalists argue that they can cure anything. And even the more moderate chiropractors have ideas above their station. The British Chiropractic Association claims that their members can help treat children with colic, sleeping and feeding problems, frequent ear infections, asthma and prolonged crying.
Richard: Whether sceptics want to believe it or not, I have helped children with all these problems. Lets look at “Ear infections” and I will try not to let my “ideas rise above my station”. For many years ear problems have been misdiagnosed by medics and treated ineffectively with grommets and antibiotics.
So what is a clinician to do. Angela Peel White my anatomy tutor at The Anglo European College of Chiropractic was a qualified GP. I never held it against her because she was a brilliant tutor. She told us know the anatomy of the region you are examining. If you look at the inner ear it has “drain” called the eustachian tube. Its narrower at the top, children with small little necks have only a small gradient and the tube does not drain very well. The blockage causes pain due to the discrepancy of the air pressure outside the ear drum and inside. This can also be a problem for inexperienced divers. Who are not able to “equalise” ear pressure as they decent in water.
The biological explanation as to why “manipulation” could help a child with otis media is very similar to how experienced divers equalise when the eustachian tubes are blocked and unable to relieve the pressure on the inner ear as they descend in the water. They crack their TMJ as if blowing rings smoking dope (I am a child of the 60s), this helps open the eustachian tube and equalise the pressure on the ear drum.
There is also a neurological explanation, I will spare the details suffice to say when Professor Ernst or chiropractic sceptics say there is “no biological reason why spinal manipulation should with help ear Infections” the anatomy shows clearly they are talking through their collective arses.
I have four children, young children cannot crack their jaw themselves, the adjustment requires skill and practise, not all chiropractors can do it and that’s a problem when chiropractors enter these clinical trials. I am not an academic, I am just a clinician.
Richard: Then Simon continues to the bit that upset the BCA
Simon: ……..even though there is not a jot of evidence. This organisation is the respectable face of the chiropractic profession and yet it happily promotes bogus treatments.
Richard: First I would question whether the BCA leadership is the respectable face of chiropractic. No One would dispute that the “scientific evidence” is weak for these conditions, which account for a very small part of my practice 5% and I probably see more children than most chiropractors. However if we look at Professor Ernsts own “Hierarchy of Evidence” at the bottom there are “case reports” and “observational studies”. Yes the chiropractic evidence is at the bottom of Ernsts pyramid however “not a jot of evidence” would only be accurate statement if Professor Ernst were to remove the bottom of his pyramid. In addition anyone with a limited knowledge of the politics of the chiropractic profession would know that the BCA leadership with rather stick to musculoskeletal pain syndromes and probably puts childhood disorders on their website to prevent more members from leaving the association. If Simon had directed those comments at the UCA or the McTimoney association the BCA leadership would have been leading the applause.
Simon: I can confidently label these treatments as bogus because I have co-authored a book about alternative medicine with the world’s first professor of complementary medicine, Edzard Ernst.
Richard: What does that prove? Margaret Thatcher was the first women prime minister we can only pray the second one is better. The chapter on chiropractic in “Trick or Treatment” has only three chiropractic references all by the co-author Professor Ernst which should have set alarm bells ringing in a science journalist with a PhD. To pad out the chiropractic chapter they finish it talking about homeopaths and vaccines. I told Simon I did not believe he had written that chapter and it was all Ernsts [sic] work but he says he did write it.
Simon: Ernst learned chiropractic techniques himself and used them as a doctor.
Richard: I can carve a joint, this does that make me a surgeon? Chiropractors spend five years learning to adjust spinal joints. Simon has not visited the Anglo European College of Chiropractic to see how chiropractors develop their skills and Guardian readers are expected to believe professor Ernst thought himself these “chiropractic techniques” over a few weekends and it would appear he was not very good at it, many failed practitioners end up in academia.
Simon: 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.
Richard: Arthritis is a chronic condition suffered by millions of British people often it has developed because it was not managed properly when it was just a small ache ( Pain killers and anti inflammatory medication to mask a mechanical problem). In May, the National Institute for Clinical Excellence in the UK published its guidelines for the management of Low back pain http://guidance.nice.org.uk/CG88 . What was extraordinary about these guidelines is that they were stating that doctors should no longer offer; Spinal injections, Traction, Lumbar Supports, Ultrasound, Interferential, Laser and should consider a course of spinal manipulation by a chiropractor or an osteopath or acupuncture instead.
In effect NICE is stating that the orthodox methods for treating back pain has not worked and the evidence is suggesting that it would be cost effective for the NHS to pay for complementary treatments like chiropractic and acupuncture in the future.
Simon: 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 Professor 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.
Bearing all of this in mind, I will leave you with one message for Chiropractic Awareness Week – 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.
Richard: Which drugs, Viox, Celebrex, statins etc,etc. In 1998 Lazarou et al estimated that 106,000 people die each year from adverse reactions to prescribed medications. Thats [sic] the equivalent of a jumbo jet crash every 2 days and no public enquiry? Professor Ernst has spent the last ten years trying to convince the British and Irish public that chiropractic is more dangerous than medicine.
The tragic story of Laurie Mathiason who suffered a stroke ten years ago while receiving chiropractic treatment in Canada is not convincing “evidence” that chiropractic is dangerous. Every five minutes someone in England will have a stroke(National Audit Office), there are no epidemiological studies that would even hint that this finding has anything to do with chiropractic, yet Professor Ernst goes on repeating his opinion.
I have practised in the same area for almost fifteen years, I adjust the cervical spine of the vast majority of my patients and I don not recognise the “dangerous” practise Simon describes. I have never had a complaint or hurt anyone, occasionally a patient feels worse after the first visit, but thats about it. If patients were having strokes surely I would have heard something and the fact Ernst wont let poor Laurie Mathiason rest in peace because he needs this anecdote to bases the theory on which has created his media profile, dont kid youselfs Professor Ernst is not well known for his research he has become the Jordan of the EBM community, I wonder what David Sackett makes of Ernsts evidence base? The inconsistencies in these arguments by the sceptics are staggering, something happens after a vaccine and its coincidence, anything happens after a chiropractic adjustment and its the chiropractors fault. For a small profession we must be good at hiding our bodies, perhaps thats [sic] where Harold Shipman learned how to kill his patients without anyone noticing.
I address some of the points Richard Lanigan makes below:
Beware the spinal trap
by Simon Singh
Simon: This is Chiropractic Awareness Week. So let’s be aware. How about some awareness that may prevent harm and help you make truly informed choices? First, 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.
Richard: If I was going to criticise a health care profession, I would say it was important to have all my facts and provide accurate information. DD Palmer was 15 in 1860, worked as a teacher in the mid 1860s, worked as a bee keeper and small famer in the early 70s. The first mention of DD Palmers involvement in “healing” was in 1885 when he became a magnetic healer. It would seem he was in fact developing “developing his theories” in the 1880s rather 1860s, I suspect Simon Singh has confused DD with Andrew Still who founded Osteopathy and was developing his theories about manipulation in the 1860s.
DD Palmer's hypothesis was that interfering with nerve function would affect optimal well-being, he explained his theory around “displaced vertbrae”. Palmer’s understanding of the effects of spinal manipulation should be viewed in its time (the late 19th century) when surgery had a mortality rate of 76%. I know of no 21st century chiropractor who would explain chiropractic as Palmer did, or a surgeon who would operate in his street clothes without a mask. To define chiropractic along these lines is like defining medicine the way Harold Shipman practised.
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.
Stranger things have happened. Here we have a news report in 2008 stating a chiropractor restored a mans [sic] sight. I think its fair to say if Palmer had observed Harvey Lillard getting his hearing back he may have thought that he had discover the holy grail of healing. Look at the competition at the time 1895??
Me: Daniel David Palmer was born in 1845 (according to Wikipedia at least) so Richard my be right here and Simon may be wrong. On the other hand, the BCA is not suing Simon for getting his date wrong so I'm not sure how relevant this is. [By the way, "magnetic healing" had nothing to do with magnets and was rather a cross between massage and meridian therapies (according to this source; so Richard's suggestion that Palmer was thinking about magnets rather than manipulation at this stage is misleading.)
As for anecdotal claims that sight or hearing was restored in particular individuals by chiropractic, there is a even a name for this kind of fallacy: The "post hoc ergo propter hoc fallacy."
Simon: You might think that modern chiropractors restrict themselves to treating back problems, but in fact they still possess some quite wacky ideas. The fundamentalists argue that they can cure anything. And even the more moderate chiropractors have ideas above their station. The British Chiropractic Association claims that their members can help treat children with colic, sleeping and feeding problems, frequent ear infections, asthma and prolonged crying.
Richard: Whether sceptics want to believe it or not, I have helped children with all these problems. Lets look at “Ear infections” and I will try not to let my “ideas rise above my station”. For many years ear problems have been misdiagnosed by medics and treated ineffectively with grommets and antibiotics.
So what is a clinician to do. Angela Peel White my anatomy tutor at The Anglo European College of Chiropractic was a qualified GP. I never held it against her because she was a brilliant tutor. She told us know the anatomy of the region you are examining. If you look at the inner ear it has “drain” called the eustachian tube. Its narrower at the top, children with small little necks have only a small gradient and the tube does not drain very well. The blockage causes pain due to the discrepancy of the air pressure outside the ear drum and inside. This can also be a problem for inexperienced divers. Who are not able to “equalise” ear pressure as they decent in water.
The biological explanation as to why “manipulation” could help a child with otis media is very similar to how experienced divers equalise when the eustachian tubes are blocked and unable to relieve the pressure on the inner ear as they descend in the water. They crack their TMJ as if blowing rings smoking dope (I am a child of the 60s), this helps open the eustachian tube and equalise the pressure on the ear drum.
There is also a neurological explanation, I will spare the details suffice to say when Professor Ernst or chiropractic sceptics say there is “no biological reason why spinal manipulation should with help ear Infections” the anatomy shows clearly they are talking through their collective arses.
I have four children, young children cannot crack their jaw themselves, the adjustment requires skill and practise, not all chiropractors can do it and that’s a problem when chiropractors enter these clinical trials. I am not an academic, I am just a clinician.
Me: Not quite sure how to respond to this. Yes, "cracking" your jaw can (temporarily) relieve pressure in your inner ear. There are other ways of doing this, and I am not qualified to say whether jaw cracking is the most appropriate strategy for children, but what has this got to do with neurology? Also, what has Richard's claim that he can crack kids' jaws, and some chiropractors can't, got to do with anything? Any sensibly designed clinical trial would address such considerations.
Richard: Then Simon continues to the bit that upset the BCA
Simon: ……..even though there is not a jot of evidence. This organisation is the respectable face of the chiropractic profession and yet it happily promotes bogus treatments.
Richard: First I would question whether the BCA leadership is the respectable face of chiropractic. No One would dispute that the “scientific evidence” is weak for these conditions, which account for a very small part of my practice 5% and I probably see more children than most chiropractors. However if we look at Professor Ernsts own “Hierarchy of Evidence” at the bottom there are “case reports” and “observational studies”. Yes the chiropractic evidence is at the bottom of Ernsts pyramid however “not a jot of evidence” would only be accurate statement if Professor Ernst were to remove the bottom of his pyramid. In addition anyone with a limited knowledge of the politics of the chiropractic profession would know that the BCA leadership with rather stick to musculoskeletal pain syndromes and probably puts childhood disorders on their website to prevent more members from leaving the association. If Simon had directed those comments at the UCA or the McTimoney association the BCA leadership would have been leading the applause.
Me: Here we start to get to the heart of the matter. What Richard omits here is the consideration that real medicine is expected to move up the pyramid of evidence.
If a treatment or observation about a certain existing treatment or lifestyle is novel then “case reports” and “observational studies” do constitute a jot of evidence. If, after a hundred years plus of chiropractic, we still only have “case reports” and “observational studies” as evidence and nothing at higher levels in the pyramid (thinking here of the conditions over which Simon is being sued) then it is perfectly reasonable comment for Simon to say that there is not a jot of evidence.
There is, after all, some annecdotal evidence for almost every nutty thing that can be thought of. Are we to conclude that the phrase "not a jot of evidence for X" be banished from the language?
Simon: I can confidently label these treatments as bogus because I have co-authored a book about alternative medicine with the world’s first professor of complementary medicine, Edzard Ernst.
Richard: What does that prove? Margaret Thatcher was the first women prime minister we can only pray the second one is better. The chapter on chiropractic in “Trick or Treatment” has only three chiropractic references all by the co-author Professor Ernst which should have set alarm bells ringing in a science journalist with a PhD. To pad out the chiropractic chapter they finish it talking about homeopaths and vaccines. I told Simon I did not believe he had written that chapter and it was all Ernsts [sic] work but he says he did write it.
Me: The fact that Simon has written a book proves nothing, it does, however, suggest that Simon has researched the matter thoroughly and that (given that we know that Simon is a highly respected science journalist) his views and claims are worth investigating.
Simon: Ernst learned chiropractic techniques himself and used them as a doctor.
Richard: I can carve a joint, this does that make me a surgeon? Chiropractors spend five years learning to adjust spinal joints. Simon has not visited the Anglo European College of Chiropractic to see how chiropractors develop their skills and Guardian readers are expected to believe professor Ernst thought himself these “chiropractic techniques” over a few weekends and it would appear he was not very good at it, many failed practitioners end up in academia.
Me: The fact that Edzard Ernst learned chiropractic techniques is interesting background information. As, I suppose, Richard indirectly implies, this is of little ultimate relevance to the question as to whether what Ernst says about the generally efficacy of chiropractic is true.
Simon: 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.
Richard: Arthritis is a chronic condition suffered by millions of British people often it has developed because it was not managed properly when it was just a small ache ( Pain killers and anti inflammatory medication to mask a mechanical problem). In May, the National Institute for Clinical Excellence in the UK published its guidelines for the management of Low back pain http://guidance.nice.org.uk/CG88 . What was extraordinary about these guidelines is that they were stating that doctors should no longer offer; Spinal injections, Traction, Lumbar Supports, Ultrasound, Interferential, Laser and should consider a course of spinal manipulation by a chiropractor or an osteopath or acupuncture instead.
In effect NICE is stating that the orthodox methods for treating back pain has not worked and the evidence is suggesting that it would be cost effective for the NHS to pay for complementary treatments like chiropractic and acupuncture in the future.
Me: First of all we are back to back pain here - not the subject of the libel action or of Simon's more derogatory statements concerning chiropractic. Moreover, the argument used here: "There is growing evidence that many accepted medical treatments for chronic back pain don't really work therefore we should replace them with treatments for which there is no real evidence at all" does not really hold a lot of water - even if some people at NICE are using this argument too.
To those who say that there is real evidence, I say: "show me it" - a test which the BCA have spectacularly failed (again talking of the claims which are the subject of their libel action against Simon.
Simon: 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 Professor 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.
Bearing all of this in mind, I will leave you with one message for Chiropractic Awareness Week – 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.
Richard: Which drugs, Viox, Celebrex, statins etc,etc. In 1998 Lazarou et al estimated that 106,000 people die each year from adverse reactions to prescribed medications. Thats [sic] the equivalent of a jumbo jet crash every 2 days and no public enquiry? Professor Ernst has spent the last ten years trying to convince the British and Irish public that chiropractic is more dangerous than medicine.
The tragic story of Laurie Mathiason who suffered a stroke ten years ago while receiving chiropractic treatment in Canada is not convincing “evidence” that chiropractic is dangerous. Every five minutes someone in England will have a stroke(National Audit Office), there are no epidemiological studies that would even hint that this finding has anything to do with chiropractic, yet Professor Ernst goes on repeating his opinion.
I have practised in the same area for almost fifteen years, I adjust the cervical spine of the vast majority of my patients and I don not recognise the “dangerous” practise Simon describes. I have never had a complaint or hurt anyone, occasionally a patient feels worse after the first visit, but thats about it. If patients were having strokes surely I would have heard something and the fact Ernst wont let poor Laurie Mathiason rest in peace because he needs this anecdote to bases the theory on which has created his media profile, dont kid youselfs Professor Ernst is not well known for his research he has become the Jordan of the EBM community, I wonder what David Sackett makes of Ernsts evidence base? The inconsistencies in these arguments by the sceptics are staggering, something happens after a vaccine and its coincidence, anything happens after a chiropractic adjustment and its the chiropractors fault. For a small profession we must be good at hiding our bodies, perhaps thats [sic] where Harold Shipman learned how to kill his patients without anyone noticing.
Me: All medical interventions (both conventional and so called "alternative") have potential risks and benefits. That's why we need to base medical interventions on real evidence. Real evidence is collected when researcher's move up the evidence pyramid cited above. The notion that we can have one kind of evidence to conventional medicine and another "alternative" kind of evidence for "alternative" medicine is simply nonsense.
The real difference between science and woo (in all it's forms) is not that science is all true and woo is all bollocks; the real difference is that (true) scientists (of course individual scientists can be just as irrational as anyone else) constantly revise their ideas and practices in the light of the ever growing body of evidence.
When they found out that Shipman had killed lots of people, the medical profession investigated the evidence that the case provided, concluded that administrative practices had been woefully inadequate, and changed their administrative practices to try and prevent this happening again in the future. Similarly, when the medical profession discovered that Cox-2 inhibitors had an unacceptably high risk for the (far from insubstantial) benefit they were providing, the medical profession changed their practice and stopped prescribing these drugs.
Where are the clinical studies documenting the risks and benefits of chiropractic for infant colic? where are the stories of the chiropractic "profession" changing its treatment of infant colic in response to such clinic studies? Chiropractic just doesn't work like that.
There is some evidence that (non-cracking) massage and manipulation provided by an osteopath, chiropractor, or physiotherapist might help a bit with back pains and aching joints. All the rest is woo!
2009-07-29
Simon Singh: Beware the Spinal Trap
Edited version (the "libellous" bit about chiropractic being "bogus" has been removed)of the Simon Singh 2008 Guardian article for which Simon is being personally sued for libel by the British Chiropractic Association (please re-blog):
BEWARE THE SPINAL TRAP
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.
BEWARE THE SPINAL TRAP
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.
2009-06-24
Woo in the Telegraph - a response (of sorts)
24 June 2009
Dear Dr [Schroedinger99],
I am writing in response to your email concerning Annabel Croft article, which appeared in the Telegraph.
Your comments have been passed on to our editorial team for their future reference on this topic and I would like to thank you for taking the time and trouble to write to us on this matter. We value your readership and appreciate our readers' comments.
I hope you shall continue to enjoy The Daily Telegraph.
Yours sincerely,
Andy King
hmmm........
Well, let's just say that if I ever hear that someone has died because he/she relied on ingredient-free homoeopathic remedies rather than seeking the medical intervention he/she required, I shall remind Andy King of this email.
2009-06-22
Woo in the Telegraph
Someone may die after reading this tosh!
Article about treating ovarian cysts with magic water
Footnote to anyone reading this who might be inclined to believe that there is something in homoeopathy:
I suppose, to be fair, I should at least consider the possibility of "water memory":
Article about treating ovarian cysts with magic water
Sir
It is grossly irresponsible of the Telegraph to publish an article like this without any accompanying opinion from a genuine health professional.
If people choose to “treat” their hay-fever using “homeopathic medicines” (i.e. “medicines” with no ingredients) that’s fine by me. If people choose to treat their ovarian cysts using “homeopathic medicines”, they could die.
Yours faithfully
Dr Schroedinger99
Footnote to anyone reading this who might be inclined to believe that there is something in homoeopathy:
Let’s take one of the remedies mentioned: Nux Vomica. This is an extract from the Strychnos Nux Vomica tree which contains a number of highly poisonous alkaloids – none of which, to my knowledge, have any useful role in the treatment of hangovers. Fortunately for Annabel Croft, homoeopaths do not supply this extract in its pure form. They dilute it first. They really really dilute it:
As you will find if you follow the http://www.healthroughhomeopathy.com/ link for this article: “Over the counter remedies tend to come in 6c and 30c potencies. A solution labelled as '6c' has been diluted six times at a ratio of one part substance to 99 parts alcohol and water, whereas a solution labelled as '30c' has been diluted 30 times at a ratio of one part substance to 99 parts alcohol and water. 6c potency is typically used for long standing conditions, such as rheumatic pain. 30c potency is typically used for first aid or acute situations, such as the onset of a cold or bruising after a knock or fall.”
What this means is that homeopathic Nux Vomica with a potency of 6c has one part Nux Vomica to 100 to the power 6 parts alcohol and water – eg 1 ml Nux Vomica in 1000000000000 ml of alcohol and water; homeopathic Nux Vomica with a potency of 30c has one part Nux Vomica to 100 to the power 30 parts alcohol and water – eg 1 ml Nux Vomica in 1000000000000000000000000000000000000000000000000000000000000 ml of alcohol and water (which won’t even display on my calculator).
(I hope I've got these figures right, but, hey, I could be out by several million and still make the same point)
This alcohol and water is sprinkled onto pillules (typically containing lactose) and these are then dried – ie the alcohol and water is allowed to evaporate. The pillules can then “be dissolved in warm water” (I am not making this up) which the patient can (presumably) either drink or dilute 1000000000000000000000000000000000000000000000000000000000000 times and begin the whole process again.
Anyone who believes that these remedies could possibly have any effect is, IMHO, in serious need of clinical help.
I suppose, to be fair, I should at least consider the possibility of "water memory":
It has been suggested that one way to explain the alleged efficacy of homoeopathic remedies may be that water somehow "remembers" what used to be in it. There is, in should be noted, no scientific evidence for such a mechanism or for the efficacy of homoeopathic remedies, but I think it is also worth pointing out that the notion of "water memory" is inherently implausible.
For example:
* The tap waster we all drink has had all sorts of things removed from it and would be extremely hazardous if it "remembered" those constituents in the sense suggested by homoeopathy.
* There are (I suppose) chemicals that "remember" other chemicals (in a certain sense) like antibodies; but injecting someone with rabies antibodies will not produce a similar effect to injecting someone with rabies antigens.
* Even if we allowed water to "remember" what had been in it, how are we to explain the transfer of that memory to pills (which may be made of lactose or calcium carbonate or almost anything and which have lost all the water put on them to evaporation) and from the pills back to water?
2009-06-08
Who would you rather have move in next door to you?
Sir Trevor McDonald OBE Newsreader & TV presenter
Freema Agyeman BA Actor
Dr Simon Singh Science jounalist & author
Shami Chakrabarti CBE Lawyer & Director of "Liberty"
Stephen Fry BA Jewish homosexual TV presenter, actor & author
Konnie Huq BA “Relaxed Muslim” TV Presenter
OR
Nick Griffin Fat white bog-eyed racist bigot, Holocaust denier & leader of the BNP
2009-06-07
Shami Chakrabarti in Bradford
My wife I took my teenage daughter to see Shami Chakrabarti of "Liberty" (formerly the National Council for Civil Liberties) speak at Bradford University last week (2009 June 03).
It was, in many ways, a wonderful experience. The "Great Hall" at Bradford was full to bursting, and it was nice to see that so many people were prepared to drag themselves away from things like Big Brother and Britain's Got Talent (not to mention their computers) to simply listen to someone speak in a hall. Shami was eloquent, entertaining, and self assured. A superb role model for my daughter.
Shami spoke movingly about the battles fought and won over the years, and the battles (e.g. on "rendition" and torture) still playing out today. She reminded us that the European Court of Human rights is not some kind of arm of Brussels's EU bureaucracy that forces us to eat straight bananas (as the Daily Mail might have it) it is the result of a process began, after the horrors of World War II, by Winston Churchill's brain child: The Council of Europe. Sir David Maxwell-Fyfe (who oversaw the drafting of Convention and whose moniker hardly conjures up an image of Johnny Foreigner) said at the time that it was designed to incorporate a traditional civil liberties approach to securing "effective political democracy", from the strongest traditions in the United Kingdom, France and other member states of Europe.
But then Shami said a few words about religion .......
First of all she contrasted states where a single compulsory state religion that permeates all aspects of life (citing Afghanistan under the Taliban and England under the Tudors as examples) with states where religion was more or less outlawed (the French Republic and Soviet Russia) and indicated that her position lay somewhere between these extremes. Fair enough! Shami then went on to suggest that (Professor) Richard Dawkins (who she insisted on referring to as "Mr Dawkins") was an advocate of the Soviet approach to religion and that he denied the contribution of religion to art, culture, and music. This is quite simply false in every respect and a gross calumny against Richard Dawkins.
Shami went on to provide an example of how Liberty had helped forge a righteous path between these two extremes by (for example) championing the case of Sarika Watkins-Singh who wished to wear her kara (Sikh bracelet) to school that had rules against the wearing of any jewellery.
Now, don't get me wrong, I'm not generally against people wearing karas or crosses round their necks or any other symbols and I don't really understand why the school thought it necessary to ban jewellery - other than (perhaps) in the laboratories and on the playing fields - but the judgement in this case (endorsed by Liberty) seems just plain barmy.
The judges ruled that though it was perfectly okay for schools to impose general bans on jewellery, they have to make exceptions for individuals who claim that their jewellery is religious in character. In other words, the judges and Liberty have endorsed the principle of different laws for people of different faiths.
As we have seen in many parts of the world, this is the road to tyranny not the road to liberty.
It was, in many ways, a wonderful experience. The "Great Hall" at Bradford was full to bursting, and it was nice to see that so many people were prepared to drag themselves away from things like Big Brother and Britain's Got Talent (not to mention their computers) to simply listen to someone speak in a hall. Shami was eloquent, entertaining, and self assured. A superb role model for my daughter.
Shami spoke movingly about the battles fought and won over the years, and the battles (e.g. on "rendition" and torture) still playing out today. She reminded us that the European Court of Human rights is not some kind of arm of Brussels's EU bureaucracy that forces us to eat straight bananas (as the Daily Mail might have it) it is the result of a process began, after the horrors of World War II, by Winston Churchill's brain child: The Council of Europe. Sir David Maxwell-Fyfe (who oversaw the drafting of Convention and whose moniker hardly conjures up an image of Johnny Foreigner) said at the time that it was designed to incorporate a traditional civil liberties approach to securing "effective political democracy", from the strongest traditions in the United Kingdom, France and other member states of Europe.
But then Shami said a few words about religion .......
First of all she contrasted states where a single compulsory state religion that permeates all aspects of life (citing Afghanistan under the Taliban and England under the Tudors as examples) with states where religion was more or less outlawed (the French Republic and Soviet Russia) and indicated that her position lay somewhere between these extremes. Fair enough! Shami then went on to suggest that (Professor) Richard Dawkins (who she insisted on referring to as "Mr Dawkins") was an advocate of the Soviet approach to religion and that he denied the contribution of religion to art, culture, and music. This is quite simply false in every respect and a gross calumny against Richard Dawkins.
Shami went on to provide an example of how Liberty had helped forge a righteous path between these two extremes by (for example) championing the case of Sarika Watkins-Singh who wished to wear her kara (Sikh bracelet) to school that had rules against the wearing of any jewellery.
Now, don't get me wrong, I'm not generally against people wearing karas or crosses round their necks or any other symbols and I don't really understand why the school thought it necessary to ban jewellery - other than (perhaps) in the laboratories and on the playing fields - but the judgement in this case (endorsed by Liberty) seems just plain barmy.
The judges ruled that though it was perfectly okay for schools to impose general bans on jewellery, they have to make exceptions for individuals who claim that their jewellery is religious in character. In other words, the judges and Liberty have endorsed the principle of different laws for people of different faiths.
As we have seen in many parts of the world, this is the road to tyranny not the road to liberty.
2009-06-06
Writing to the The General Chiropractic Council
Me first:
The first reply - which came straight back:
Ths was quickly followed up by another response:
This all seemed rather irrelevant, so I worte back again:
I then received a very polite phone call from Ms YYYYYY from which the following emerged:
1) As XXXXX indicated, the Investigating Committee of the General Chiropractic Council investigates complaints relating to the fitness to practise of individual chiropractors - not chiropractic businesses.
2) XXXXX did not pass on my complaint to YYYYY for her to deal with instead. XXXX passed on my complaint so that she could advise me on the sort of evidence the GCC use and how they assess that evidence.
3) If I wish my complaint to be considered, I shall have to resubmit it naming the individual chiropractors who work at the firm I am complaining about.
I note that the GCC seem to be very professional (unlike other "regulators" I have dealt with - e.g PhonepayPlus) and obviously take their role seriously.
I hope this helps others making complaints to the GCC about chiropractors who make bogus claims on their own websites.
Dear Sir/Madam
I note that your CoP contains the following entry:
C1.6 may publicise their practices or permit another person to do so consistent with the law and the guidance issued by the Advertising Standards Authority.
As you may be aware, the ASA recently declared in a ruling against Chiropractors “Dr Carl Irwin and Associates” (http://www.asa.org.uk/asa/adjudications/Public/TF_ADJ_46281.htm) that
“We considered that, whilst some of the studies indicated that further research was worth pursuing, in particular in relation to the chiropractic relief of colic, we had not seen robust clinical evidence to support the claim that chiropractic could treat IBS, colic and learning difficulties.
On these points the ad breached CAP Code clauses 3.1 (Substantiation), 7.1 (Truthfulness) and 50.1 (Health and Beauty Products and Therapies).”
It has come to my attention that Huddersfield Chiropractic (http://www.huddersfieldchiropractic.co.uk/BCAD02_Babies.asp) make the following claim on their website:
"Birth and early infancy can sometimes be a very difficult and traumatic time for both mother and baby. After the baby's head has engaged, usually during the eighth month of pregnancy, there can be a lot of stress on its head and back as it continues to move within the womb. This stress can increase further during the birth process, particularly if it is prolonged or involves breech presentation or forceps delivery. As the child grows up, and starts to walk, climb and run, the inevitable falls and bumps can affect the still-developing bones of the spine and skull. Once at school, the child carries heavy bags, sits on badly-designed chairs and participates in a variety of sporting activities.
These stresses and injuries can result in the tightening of muscles in the neck or back, so causing the bones of the spine to lose their normal motion or position. This can irritate or put stress onto the nerve roots that branch off the spinal cord to the organs and tissues of the body. In babies and young children this may lead to symptoms including:
• asthma
• colic
• hyperactivity
• bedwetting
instead of treating the symptoms with drugs, or assuming that the child will 'grow out of it', the chiropractor will gently adjust a child's spine to remove the nerve stress and return his/her body to healthy healing."
Unsurprisingly, the cited Danish research is not regarded as "robust clinical evidence" by the ASA - it would seem to fall well short of the standards applied in conventional medical research.
The claim concerning “colic” would seem to be in breach of the ASA Code. While this is not an advertisement in the sense defined by the ASA, Huddersfield are publicizing their practice and would, therefore, appear to be in breach of your code.
Please could you inform me whether you consider Huddersfield’s claims to be appropriate and whether you intend to take action against this company.
Yours faithfully
Dr* Schroedinger99
*non clinical
The first reply - which came straight back:
Dear Dr Schoedinger99,
Thank you for your email of 4 June 2009. With regard to the final sentence of your email, the Investigating Committee of the General Chiropractic Council investigates complaints relating to the fitness to practise of individual chiropractors, rather than complaints against companies or organisations. In this respect please contact us if you wish to make a complaint about a chiropractor or wish to receive a copy of our complaint information pack.
As your email refers in part to a ruling made by the ASA against a chiropractor, I have referred your email to the Chief Executive & Registrar, Margaret Coats, who will provide a separate response to your email.
Yours sincerely
XXXXX
Specialist Officer (Regulation)
General Chiropractic Council
Ths was quickly followed up by another response:
Dear Mr Schoedinger99
Your email of 4 June has been brought to my attention because it refers to the recent ASA adjudication against a chiropractor – Carl Irwin. I thought you might be interested to see that the GCC’s patient information leaflet (copy attached) includes the following statements
Chiropractors mainly treat
• back, neck and shoulder problems
• joint, posture and muscle problems
• leg pain and sciatica
• sports injuries
You may also see an improvement in some types of
• asthma
• headaches, including migraine; and
• infant colic
It’s important to emphasise that the GCC doesn’t claim that chiropractors 'treat' asthma, headaches (including migraine) and infant colic. It is possible that chiropractic care may help to alleviate the symptoms of some of these conditions. Chiropractors are trained in differential diagnosis and should refer any patient for appropriate care from another health professional when necessary. It is important that, where appropriate, there is good co-management of patient care. But the statement about the possibility of improvement has been included on the basis of the currently available evidence.
I'm not sure what level of detail to go into but as you may know there are a number of ways of measuring, or rating, evidence levels. One relevant example is Brønfort G. Efficacy of Manual Therapies of the Spine, Amsterdam: Thesis Publishers, 1997. This study rates the levels of evidence available at the time and provides a measuring tool to do it - I've cut and pasted the 'ratings table' below for your information. If there's anything that's unclear please do get back to me.
The available evidence of the efficacy of the chiropractic contribution to the management of some types of asthma, migraine headache and infant colic is inconclusive (i.e. level D in the measuring tool used by Brønfort).
Further, with regard to some types of asthma:
• Brønfort concluded in 1997 that there is moderate evidence (Level B) that SMT is a non-efficacious therapy for chronic to moderately severe asthma in adults. There was insufficient data (Level D) to draw conclusions about the efficacy of spinal manipulative therapy (SMT) for other respiratory diseases (including childhood asthma)
• In 2001, Brønfort et al ( see c. below) concluded that after three months of combining chiropractic SMT with optimal medical management for childhood asthma, the children rated their quality of life substantially higher and their asthma severity substantially lower. The observed improvements were thought unlikely to be as a result of the specific effects of chiropractic SMT alone, but other aspects of the clinical encounter that should not be dismissed readily.
So although some clinical trials had positive results there is insufficient data to make strong statements about efficacy. There is a higher level of available evidence (i.e. level B) with regard to some types of headache (such as tension-type and cervicogenic headache) and there appears to be a clinical advantage, of both SMT and exercises, both of which chiropractors use, compared to placebo and at least equivalence with commonly used therapies.
Other studies which appear to echo the evidence levels outlined in the paragraphs above are:
a. Nielsen NH, Brønfort G, Bendix T. et al 1995. Chronic asthma and chiropractic spinal manipulation: a randomized clinical trial. Clin Exp Allergy Jan;25(1):80-8
b. Balon J, Aker PD et al 1998. A comparison of active and simulated chiropractic manipulation as adjunctive treatment for childhood asthma. NEJM 339 (15): 1013-1020
c. Brønfort G , Evans RL, Kubic P, Filkin P 2001. Chronic pediatric asthma and chiropractic spinal manipulation: a prospective clinical series and randomized pilot study. JMPT 24(6):369-77
d. Brønfort G, Nilsson N, Haas M, Evans RL, Goldsmith CH, Assendelft WJJ, Bouter LM. Non-invasive physical treatments for chronic/recurrent headache. Cochrane Database of Systematic Reviews 2004, Issue 3 Art. No.: CD001878. DOI: 10.1002/14651858.CD001878.pub2
e. Wiberg JMM, Nordsteen J, Nilsson N. 1999. The short-term effect of spinal manipulation in the treatment of infantile colic: a randomised controlled clinical trial with a blinded observer, JMPT 22 (8): 517-22.
This isn’t an exhaustive list but I do hope that this level of detail is helpful.
Please don't hesitate to contact me if you have any questions.
Yours sincerely
YYYYYY
Chief Executive & Registrar
This all seemed rather irrelevant, so I worte back again:
Dear Ms YYYYYY
Thank you for your email, but I do not feel that you have addressed the complaint I raised.
To summarize:
the GCC’s CoP states that 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.”
The ASA have made it clear that it is not acceptable for chiropractors to claim that they can treat infant colic – a judgement which you appear to endorse in your email to me.
Huddersfield Chiropractic claim that they can treat infant colic.
I suggest, therefore, that Huddersfield Chiropractic would seem to be in breach of your CoP and I am requesting that, in view of this, you take action against them.
Yours sincerely
Dr Schroedinger99
I then received a very polite phone call from Ms YYYYYY from which the following emerged:
1) As XXXXX indicated, the Investigating Committee of the General Chiropractic Council investigates complaints relating to the fitness to practise of individual chiropractors - not chiropractic businesses.
2) XXXXX did not pass on my complaint to YYYYY for her to deal with instead. XXXX passed on my complaint so that she could advise me on the sort of evidence the GCC use and how they assess that evidence.
3) If I wish my complaint to be considered, I shall have to resubmit it naming the individual chiropractors who work at the firm I am complaining about.
I note that the GCC seem to be very professional (unlike other "regulators" I have dealt with - e.g PhonepayPlus) and obviously take their role seriously.
I hope this helps others making complaints to the GCC about chiropractors who make bogus claims on their own websites.
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