Simon Singh wins the right to a full appeal: UPDATED

Simon Singh was granted the right to a full appeal at the Courts of Justice this morning by the presiding Judge, Justice Laws, in the on-going libel case started by the British Chiropractors Association.

The judge overturned*, the original judgment by Justice Eady on Simon's use of the word 'bogus' in a Guardian article to describe claims by chiropractors to treat certain childhood illnesses. He said that there was no question of the good faith of the appellant (Simon) who wrote what he honestly believed with the purpose of serving the public interest. *[Edit: not overturned, but effectively reversed]

Laws also questioned whether Eady's ruling could have serious implications for the application of Article 10 of the Human Rights Act, which concerns freedom of expression, and said that there was a disproportionate burden of proof on the appellant.

He also commented that the 47 pages of written evidence presented in Simon's defence were on the 'voluminous' side.

The BCA, who were informed of the decision in advance, did not show up.

Simon's case will now go to full appeal, probably in the spring - just in time for the next Chiropratic Awareness Week.

I was there representing the National Secular Society, which defends freedom of expression and evidence-based rationalism.

After the hearing we all re-convened at the pub for a celebration.

The full legal details can be found at Jack of Kent's blog.

Update: The BCA's response.

Update: A fuller response from the chiromancers (sorry, chiropractors):

Dr. Simon Singh has been granted permission to appeal against the decision of Mr. Justice Eady. As the Claimant is not permitted to be represented in a hearing of this nature, the Judge of the Court of Appeal, Lord Justice Laws, did not have the benefit of being able to consider all the issues, nor indeed, has he heard any argument from the BCA.

Dr. Singh has used this case as a platform to argue that science writers should be immune from the law of libel and be free to write what they please. [No he hasn't] Ever since the Eady decision of 7th May 2009, he has engaged in a high profile media campaign to assert that the BCA's action is a restriction of the freedom of speech. It is nothing of the sort.

The BCA supportes and would never seek to stifle legitimate open scientific debate [legitimate meaning 'not critical of the BCA'?] . However, this action is actually a simple libel claim based on the fact that the BCA was maliciously attacked by Dr. Singh in the Guardian newspaper. When given the opportunity to retract his words and apologise, Dr. Singh refused. This claim has been brought to restore the good reputation of the BCA and that of its members.[Good luck with that]

Dr. Singh may now put his case before a full Court of Appeal. Here the BCA will, for the first time, have the opportunity to present its case. The BCA remains confident that once in possession of all the facts the presiding judges will refuse the Appeal.

And comment on it here.

And an excellent article by Allen Green (Jack of Kent's alter ego) here.

Update: The BCA has now changed its press release to remove the possibly libellous accusation. The words 'maliciously attacked' (in bold above) have been replaced by 'libelled'. They have now pretty much run out of feet to shoot themselves in.

Beware the spinal trap

Sense about Science have asked as many people as possible to publish today the article by Simon Singh in The Guardian in April 2008 that sparked off the libel trial with the BCA. This is to prove that threatening libel or bringing a libel case against a science writer won’t necessarily shut down the debate. This is it -with the 'bogus' part removed.

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.