A healthy women, told by her chiropractor she needed her subluxations treated by forceful manipulation of her neck to “improve her health and wellness” ended up a quadraplegic. She and others hurt by chiropractors in Canada have filed a class-action lawsuit, not only against the chiropractors but against the state government. The government, of course, is trying to get itself out of the lawsuit, which alleges that it bears some responsibility for the harm done to healthy people by chiropractors.
While it is no surprise to anyone that governments set health policy based on money and influence rather than science, it has always disappointed me how easily ineffective, unproven, and even potentially dangerous medical treatments get the imprimatur of the state. When I begin to tell people about the lack of evidence for benefit from chiropractic manipulations, the second objection they make after reporting some anecdotes and testimonials is that it is licensed by the government so how could it not work? It’s difficult to explain to them simply why money and influence trumps science, and why our faith in government regulation of medicine is not justified when it comes to CAM. By not insisting on real evidence of safety and efficacy for all medical therapies, government not only contributes to the harm CAM does to its citizens, but it undermines its own credibility as guardian of the public health.
A lawsuit like this, though I doubt it will be successful, makes a stark and important point. People rely on their government to protect them from harmful and useless treatments when they are suffering and vulnerable to peddlers of snake oil. Because mainstream medicine has been so successful in the last 200 years, people are accustomed to trusting that anyone who calls themselves a doctor knows what they are about. Otherwise, wouldn’t the government step in and stop them? Unfortunately, the economic power of the CAM lobby and the zeal of true believers in government, like our own Sen. Tom Harkin here in the U.S., interfere with the mechanisms the government would normally use to protect people from dangerous treatments.
Ironically, mainstream scientific medicine, and even the quintessential bogeyman of Big Pharma, is heavily scrutinized and regulated, and it is a costly and time-consuming process to get a treatment that actually works approved. And when uncommon problems are identified, by virtue of post-marketing surveillance mechanisms the government requires, instead of seeing this as evidence for the success of the science and the system, CAM proponents use it as more evidence that their own therapies are safer alternatives.
Undoubtedly, less harm is reported subsequent to CAM treatments simply because no one is watching or keeping track. What’s The Harm, Victims of Chiropractic Abuse, and other private groups try to warn people of the dangers, but many of the dangers are not even known, and such small advocacy groups cannot match the resources and influence of government. I hope the government of Alberta is made to acknowledge it has abdicated its responsibility to its citizens to protect them from dangerous medical treatments, though I am not optimistic. And here in the U.S., President Obama has promised to see that science resumes “it’s rightful place” in the setting of public policy. He will undoubtedly have a very hard time keeping that promise. But for the sake of all those who the government might save from the harm of untested treatments, I hope he can.
Stories of case studies are sexy and it’s impossible to eradicate the placebo effect from complimentary medicine. Doesn’t everyone “feel” better after a massage and nice discussion with a chiropracter, but does the practice they illness or minimize symptoms? Show me evidence. Now if the case story of what went wrong w/someone far away could outlast what is perceived as helpful by those next door, at least there would be some balance. It’s not “interesting” to read statistics on total # patients in a double-blind study and parcel out which efficacy results make sense and what safety factors are real vs minimal (ok, well I think it’s fun) but the layperson finds it’s easier to read a story about someone next door than sit and shuffle through tables, listings and graphs. It’s easier to ask, “what did you think” of Joe next door than do the research ourselves. Until we can critically analyze what we read, we are in trouble. Put more money in education!
A good point well put! Our brains simply respond more and more deeply to moving anecdotes than to statistics, and it takes a great deal of education and effort to go with what we “know” is right rather than what we “feel” is right.