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In 1995, chiropractors in Canada began campaigning for an affiliation between Canadian Memorial Chiropractic College (CMCC) and York University. An intense controversy developed because York's administration favored the affiliation but the university's science faculty vigorously opposes it. On February 1, 1999, Barry L. Beyerstein, Ph.D., sent expressed his concern to York University's administration. Dr. Beyerstein is a biopsychologist at Simon Fraser University in Burnaby, British Columbia, Canada.
M3J 1P3I am writing to express my grave concern over the possibility that York University might enter into an affiliation with the Canadian Memorial Chiropractic College. I believe that this would be an unwise move that would significantly harm the excellent reputation York University rightly enjoys in the scientific and broader academic community.
Allow me to state my qualifications for offering the foregoing opinion. First, I teach physiological psychology and am therefore familiar with the relevant bodily mechanisms, particularly those in the nervous system, that chiropractors claim to affect with their treatments. As a psychopharmacologist, I have had a longstanding interest in the scientifically-supportable side of herbal medicines; i.e., pharmacognosy. Growing familiarity with the unsupportable side of herbalism, however, has led me to become more interested in the area of medical quackery in general. I now teach and write in various areas regarding medical quackery and I conduct a seminar on these topics at SFU. In addition, I am a consulting editor of The Scientific Review of alternative Medicine, a peer reviewed journal devoted to scientific critiques of unproven medical interventions. I am also an invited member of The Council for Scientific Medicine, a panel founded by several U.S. Nobel Laureates in Medicine who formed it as a vehicle for alerting the public and the academic community about the scientific shortcomings of various popular but unproven (and possibly dangerous) "alternative" remedies. I am also a member of the Executive Council of The Committee for the Scientific Investigation of Claims of the Paranormal (CSICOP), a U.S.-based organization that provides scientific criticism of occult and pseudoscientific claims. I am on the editorial board of CSICOP's journal. In addition, I sit on a committee that advises the Insurance Corporation of British Columbia as to the scientific status of various questionable treatments that its policy holders ask the corporation to pay for. And finally, I am a founding member of the steering committee for a new organization, Canadians for Rational Health Policy. This is a group of experts in various fields that assembles scientific information relevant to healthcare issues for use in public policy debates, particularly with regard to the legitimacy of various "fringe" treatments.
Although in this letter I am speaking for myself, rather than on behalf of any of the foregoing groups, I list them as a way of assuring you that I have an extensive background in the area of unconventional medical treatments and that I have studied the claims of chiropractors quite thoroughly.
In fact, I have a much longer exposure to the field of chiropractic than this, for my late father was a chiropractor. I grew up in a household where chiropractors came and went frequently and where they freely discussed their beliefs, attitudes, and practices in my presence. As a youngster enthused by science, it soon became apparent to me, even in high school, that many claims of chiropractors were at variance with the best scientific information of the day. My father's colleagues confidently asserted that they could cure diabetes, migraines, earaches, asthma, and deafness, among other things-all with spinal manipulation. They spoke of supposed "blockages of vital energies," and were adamantly opposed to the use of antibiotics. They were avid consumers diagnostic "black boxes" such as the "neurocalometer" that had no scientific rationale. When my younger brother was stricken with diabetes, he was sent to various chiropractors who asserted that their special brand of spinal manipulation would cure him. I still have my father's books and papers and have since looked in vain for evidence that the field has really repudiated the pseudo-scientific theories that permeated it when he was in practice. To aid me in this search for what ' current chiropractors believe, I have repeatedly sent my students out to interview individual chiropractors and to gather their office literature. The results have been far from encouraging.
Belief in "subluxations," dietary pseudoscience, and highly dubious diagnostic devices and procedures remains high when these practitioners are quizzed informally, despite their attempts to downplay these beliefs in the profession's public pronouncements and its official negotiations with universities. For instance, we have found that antipathy toward childhood immunization still remains high among many chiropractors. A colleague of mine who is an emergency room physician here in Vancouver has been alarmed by the declining levels of proper immunization he sees in children coming through the emergency wards. He has begun to ask parents of nonimmunized children why they have failed to take this sensible precaution. The majority answer that they were cautioned by their chiropractors to avoid "dangerous" vaccines. In my own case, I was never permitted by my father to have any of the standard immunizations as a child -- I had to be vaccinated for polio as a young adult before I could visit a number of Third World Countries and I had to get the full series of vaccinations for other diseases that I had been denied as a child before I was allowed to enroll as a graduate student in the U.S. Likewise, many chiropractors we have discussed the issue with still actively oppose fluoridation of community water supplies. I had hoped that such anti-scientific thinking had been abandoned by the current generation of chiropractors, but my debates with practitioners and reading of their promotional literature convinces me otherwise. A recent article sent to me by a chiropractor regarding the resurgence of bleeding patients by the use of leeches displays such fundamental misunderstanding of scientific principles as to be alarming. The lack of understanding of the need for randomized controlled clinical trials for any putative therapy was particularly glaring. Recently, I was sent a brochure for a seminar conducted by two chiropractors from the U.S. They were extolling a huge variety of pseudoscientific devices. A colleague of mine at the University of Oregon recently testified as an expert witness in a court case against a chiropractor charged with using similar devices. Another chiropractor of my acquaintance uses an antibiotic tablet as a pendulum weight. He explained that, being a "bad substance," the antibiotic will resonate over diseased parts of the body, helping him to diagnose "weak points" for treatment.
It could be argued that such cases are only a few "bad apples" in the barrel. If so, chiropractors who want credibility in the scientific community must actively and publicly weed out practices such as these among their members. An unequivocal official rejection of such pseudoscientific beliefs by the various chiropractic associations would be an absolute minimum first step in gaining scientific credibility for the field, but I see little political will among chiropractic governing boards to "rein in" their members in this way. Likewise, if chiropractic governing bodies would officially disavow claims to treat anything but purely musculoskeletal complaints, and discard claims to be a totally distinct and "alternative" philosophy of disease and therapeutics, outside the scientific biomedical sphere, there might be a place for them inside a university dedicated to the highest standards of scientific research and teaching. However, if York were to put its imprimatur on chiropractic degrees before such repudiations were forthcoming and enforced by the field, your university would be seen as condoning these beliefs and its reputation would suffer accordingly.
In addition to widespread espousal of pseudoscience in the field of chiropractic, the scientific case for the effectiveness of what chiropractors do is very shaky. Recently, I had reason to review the scientific evidence for chiropractic procedures on two separate occasions. One was when I was asked to sit in on discussions of a committee of the B.C. Medical Association that was charged with recommending what the BCMA's policy ought to be concerning possible chiropractic certification being offered by the British Columbia Institute of Technology. On that occasion, one of the proponents of the BCIT/chiropractic affiliation defended the scientifically nonsensical practice of homeopathy and refused, after a direct question from me, to repudiate iridology. The other occasion for reviewing the status of chiropractic was during the debate that sprang up at Simon Fraser University when our administration was approached by a delegation of chiropractors suggesting an affiliation much like that which has been proposed to York University.
There have been a number of well-controlled studies of chiropractic manipulation recently. Professor De Robertis of your Physics Department has ably summarized them on his website. Additional reviews of this literature can be found on the websites "Chirowatch" and "HealthWatcher." To mention just one recent example, a study assessing treatment of low back pain was published recently in the New England Journal of Medicine. It found chiropractic treatment only marginally more effective than massage or self-performance of the exercises contained in a $2.00 pamphlet. A companion article in the same issue found no support for the widely-held belief among chiropractors that they can alleviate asthma. Given the poor empirical case for chiropractic, the fact that spinal manipulation is not without risk assumes greater importance. A recent death following neck manipulation by a chiropractor here in Canada highlights the fact that manipulation of the upper spine can have grave consequences. I have references to other similar cases. After I and others had presented a review of the scientific status of chiropractic to the relevant bodies at my university, the chiropractors' proposal was turned down. In spite of the attractiveness of the various financial incentives that were suggested by the chiropractors, the relevant authorities at SFU decided that the drawbacks for the reputation our institution of such a course of action would far outweighed these short-term benefits.
Thus, I would urge York University to reconsider any plans it might have
to affiliate with the CMCC. At this time I do not see enough evidence that
the profession of chiropractic has distanced itself sufficiently from its
occult and pseudoscientific roots to merit association with a respected
Barry L. Beyerstein, Ph.D.
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