Then she discovered Judy suffered from osteo-arthritis, mild scoliosis (curvature of the spine), pronounced asymmetry and multiple subluxations that could lead to serious health problems. The cost of chiropractic therapy to deal with these problems, she was told, would be approximately $5,000.

However, Judy’s mother did not panic and pull out her check book. In fact, she was not alarmed at all, unlike most parents upon hearing such news. For she had taken her daughter to five chiropractors as part of an undercover investigation by a team of Toronto journalists.

Judy Matthews (a pseudonym to protect the youngster’s identity) was further examined by Dr. John Wedge, chief of surgery for Toronto’s famed Hospital for Sick Children, and found to be a “perfectly healthy girl” who needed no immediate or ongoing treatment.

Yet four out of five chiropractors in the Toronto area had found “serious” problems with Judy’s spine — specifically subluxations that needed chiropractic treatment.

Judy’s experience with chiropractors was part of the research undertaken by a team of journalists, headed by veteran reporters Paul Benedetti and Wayne MacPhail, to investigate pediatric chiropractic. Their investigation, which concluded that most chiropractic treatment of infants and children is “quackery”, was reported in a week-long series in Canada’s Sun Media newspapers and on the CANOE.CA news Web site in March 2001.

Among their findings were that as many as half the chiropractors in Canada may be using illegal tools for diagnosis, chiropractors often use scare tactics on parents of young children to build their practices, and more than 70 percent of Toronto-area chiropractors contacted in a random phone survey claim to be able to treat ear infections with chiropractic adjustments. Some chiropractors were found to claim they could treat attention-deficit disorder, hyperactivity, asthma, learning disabilities and even autism.

More damning, the journalists could find no evidence that subluxations even exist or that the treatments cured the problems said to be caused by subluxations.

The cost to Canadian taxpayers through medical insurance plans and user fees for pediatric chiropractic was estimated at $40 million a year (much of which is covered by government-funded medicare in Canada).

Not all chiropractors were found wanting however. The articles noted that not all chiropractors treat infants and children and that some restrict their practices to musculoskeletal problems.

In recognition of their work, Benedetti and MacPhail received on March 28, 2001 the Ontario Skeptics’ first Award for Critical Media Reporting, “exemplifying the skeptical ideals of open-minded investigation, critical thinking, and alerting the public to the dangers of pseudoscience”.

The Ontario Skeptics also wrote the Ontario minister of health and other government officials to demand an investigation of pediatric chiropractic and to “put an end to the tragic waste of taxpayers’ dollars which are urgently needed for established treatments for actual medical conditions”. The government has not responded.

This article is based on an article that first appeared in Skeptical Inquirer.

Lewis had been treated for migraine headaches by chiropractor Philip Emanuele. After her final visit she complained about the manner in which her neck had been manipulated and the intense pain which ensued. A couple of days after this visit, Lewis suffered a stroke. This was followed a few days later by a second stroke, which resulted in her death.

Dr. John Deck, neuropathologist from the Office of the Chief Coroner, Toronto, blamed the death on chiropractic manipulation. Deck said that there was no significant doubt in his mind that the chiropractic manipulation was the cause of the fatal stroke. His findings were certified by Dr. Robert Huxter, Regional Coroner for Ontario and by another Ontario coroner, Dr. Murray Naiberg.

An inquest was held into the death and ran from 2002 to 2004. At the inquest the Lewis family was represented by lawyers Amani and Neil Oakley. The Oakley’s previous cases had usually involved medical malpractice or human rights. Prior to taking on the Lewis case, they knew very little about chiropractic. They thought that it was used only for back pain, but further research showed that some chiropractors claimed they could treat a wide range of ailments, including allergies and cancer.

As the Oakleys delved deeper, they were shocked to learn how little evidence exists to back up the claims of chiropractors. While chiropractic uses a lot of jargon which sounds scientific, it is based on an untested hypothesis. Spinal manipulation is supposed to correct “subluxations” that interfere with the flow of innate energy through the body. According to chiropractic, this energy will flow properly only if the neck and spine are lined up properly.

The technique that chiropractors use for neck manipulation is quite different from that used by other health practitioners such as physiotherapists. Apparently it can make alarmingly loud crunching and cracking noises.

Chiropractors claim that everyone can benefit from their treatment. This includes healthy children, who they say may be suffering from subluxations caused by birth or normal childhood activities. They also claim that the risks of chiropractic treatment are small, and that the probability of a bad outcome is small. Amani Oakley however, whose firm now deals with many cases involving chirorparactic, counters that claim with a question: if a treatment has no benefit, then is any risk acceptable?

In a typical medical malpractice suit, the Oakleys generally argue that the treatment was not appropriate or was administered improperly. But it comes to chiropractic, they now take the position that someone coming in for maintenance care has no condition to be treated. If a specific ailment is being addressed, they argue there is insufficient evidence that the treatment accomplishes more than a placebo. In both cases, then, it seems inappropriate to take on any level of risk.

Before becoming lawyers, both Amani and Neil Oakley had obtained science degrees and had worked in the field. This helped them realize, after they started to delve into the inquest’s issues, that chiropractic has no solid science to support it. During the inquest they drew on their research to discredit the witnesses called to support neck manipulations and they laid out before the jury the evidence that such adjustments were dangerous.

Relying on arguments based on hard science, Amani was able to convince the jury in the Lewis case to return a verdict favourable to the family’s claims, even though she had to wrestle with countless procedural oddities. (For example, the counsel for the defence received three times as much time for its concluding statements since they had three sets of lawyers who represented the chiropractor, the chiropractic college, the chiropractors’ association and the chiropractors’ insurers.)

The victory in the Lana Dale Lewis case cast a harsh light on chiropractic and raised the public’s awareness of the risks of treatment. According to Amani, more people who go to chiropractors now tell them, “Don’t touch my neck.”

With these words in the Senate of York University on April 26th, 2001, the proposal for an affiliation with the Canadian Memorial Chiropractic College (CMCC) expired without so much as a whimper. The six-year nightmare was over.

This was in stark contrast to the divisive and often bitter struggle waged by faculty members concerned about the academic integrity of York University over the past few years. The consensus seems to be that without the intervention of Professors Alcock, Böhme, Jeffers and the author—dubbed the “gang of four”—CMCC would have finally succeeded in securing the academic legitimacy the worldwide chiropractic community has desperately craved over the past century.

Now is the time for post mortems. The most common question people ask at this point is, what finally turned the tide, given that only three years ago this initiative was regarded as a fait accompli?

I wish I could write that senators and faculty at York were swayed by compelling arguments involving scientific and ethical integrity.¹ But conversations with a number of professors tell a different story. Each seems to have his or her own reasons for rejecting the association, reasons that are often more political than scientific, even among scientists.

Equally frustrating was the almost complete lack of public support by academics who knew better. Dozens of prominent faculty expressed outrage at York’s chiropractic dalliance in private, condemning the administration for its anti-science initiative and wishing us “all the best.” But when it came to joining the public campaign, the silence was deafening.²

It may come as a shock that there were actually several scientists, largely biologists, who not only approved of the proposal, but also likely counselled and even encouraged the administration to proceed with the affiliation.³ While the biology department would have benefited tangibly from the merger, one might have expected scientists to unanimously disapprove of a proposal so scientifically flawed. Perhaps this illustrates that scientists are as susceptible as anyone else to the temptations of politics.

There is no question that this proposal was first and foremost politically driven. As Canada’s third largest university, York is anomalous in not having a medical school or large-scale health program. In my view, the senior administration at York University in 1994 regarded an affiliation with CMCC as an opportunity to become a “player” in health studies and health policy overnight, particularly since the prospects for securing a medical school were remote. In fact the Associate VP Research was quoted in an international publication as saying that the affiliation was intended more for social scientists than scientists.

When controversy first erupted over this initiative in 1998, proponents of the proposal were forced to defend it publicly, citing the following justifications on various occasions:

a) chiropractic is a licensed, regulated profession in Ontario and as such there could be no question of its legitimacy as a university discipline.

b) chiropractic lacks research maturity because the hegemonous medical establishment has marginalized it for years. Chiropractic today finds itself in an analogous position to conventional medicine a century ago.

c) chiropractic certainly needs reforming, and the best way to do so—and the most socially responsible way—is to bring it into a university environment.

d) chiropractic works.

e) the “buy-in” price of twenty-five million dollars.

Each of these is easily refutable: (a) has nothing to do with scientific legitimacy or the ability to establish a research culture which are essential. For example, massage therapy is licensed and regulated, but no one is suggesting York offer a degree in it (I hope!); (b) is simply inaccurate, though it may sound convincing to some academics for whom everything is political. (c) is entirely irresponsible until chiropractic renounces its anti-scientific practices and attitudes of its own volition; (d) there are no compelling studies that show that chiropractic therapies are safe and effective; (e) since when is academic integrity for sale?

As the gang of four began to draw attention to specific issues of biomedical concern in campus publications and private letters, the administration and senate became strangely silent. Not once did a York official address a single biomedical concern in a public forum. And right to the end, the Senate was adamant that the process had always been open and fair, even though it consistently refused to solicit information from the biomedical community (or from its Faculty of Science for that matter).

York had, however, solicited advice extensively from alternative medicine practitioners! Very curious behaviour from an institution committed to a search for truth in an open and rigorous manner. From the perspective of scientists, perhaps the most troubling aspect of the chiropractic experience was the magnitude of the ignorance of and antagonism toward science. One of York’s most senior administrators and a regular chiropractic patient approved of the proposal because chiropractic “works for me.”

Senior senators renounced Science’s objections to the proposal, accusing scientists of being “unwilling to admit there are other truths,” of failing to recognize that “alternative medicine is the way of the future and we should be leaders,” etc. York’s senior administration also ignored a petition signed by many well-known academics, including two Nobel Laureates in Medicine, asking York to reconsider its actions.

What does the future hold? If the past is any guide, CMCC will seek a partnership with yet another Ontario or Canadian university in a couple of years.⁴ The “gang” intends to document fully our story so that these institutions can benefit from our experiences.

Finally, it is important to note that while this marks the end of the York chiropractic campaign, a much larger and more important battle lies ahead, a battle in which we are all called to participate. Can there be any doubt that cash-strapped, post-secondary institutions will be wooed in the near future by major alternative medicine colleges—homeopathic, naturopathic, acupuncture, holistic, shiatsu, and chiropractic? “Have money, seek legitimacy. Are you for sale?”

And the moment the first university succumbs to this temptation, society will have taken a fork in the road that leads away from enlightenment.

Footnotes

¹ For example, chiropractic continues to lean heavily on its vitalistic roots. Until the community rejects these in favour of standard biomedical paradigms, it should not be offered a place at any research-based institution. And the burgeoning field of pediatric chiropractic is regarded by the Canadian Pediatric Society as entirely unnecessary and ineffective.

² This was in contrast to the many skeptics who courageously wrote York’s administration to express their concerns. These letters almost certainly had a positive effect.

³ There cannot be much doubt that this support prolonged the nightmare until two independent Faculties, Science (1998) and Atkinson College (2001), unconditionally rejected the affiliation

⁴ CMCC has been involved in over a dozen (unsuccessful) affiliation attempts with Canadian universities