The recent failure of the British Chiropractic Associations attempt to sue the science writer Simon Singh for defamation1 has resulted in a number of important developments in terms of academic free speech and, almost certainly, the standing of the chiropractic profession.This failed legal action followed similar actions in New Zealand whereby the New Zealand Medical Journal faced legal threats after publishing a paper about chiropractors2 and a formal complaint was made to the Broadcasting Standards Association after comments made on television by one of the authors of this letter.3The Singh case has resulted in widespread support from UK politicians for major reforms of their libel laws, which are widely regarded as being cout of kilter with the rest of the democratic world, encouraging 'libel tourism' and the erosion of free speech in other countriesd.4Somewhat ironically, the BCAs case against Singh appears to have triggered a backlash against the chiropractic professions attempt to suppress scientific debate, resulting in their practices and claims being scrutinized by academics, health professionals, journalists and, not least, bloggers. The overwhelming consensus appears to be that there is a dearth of evidence to support many of the claims made by chiropractors, which are mostly based upon a highly dubious anti-science rationale.We conducted an informal analysis of current material that is critical about chiropractic practices and noted criticism based upon the following themes: Stifling free speech Unsupported claims that they can treat non-musculoskeletal diseases such as asthma, ear infections, colic etc Treating children Dangerous advice and quackery, such as advice not to vaccinate children Use of the title \"Doctor\" Concerns there is a causal link between neck manipulation and stroke Biological implausibility of treating non-musculoskeletal disease by manipulating the spine Overuse of X-rays An evidence-based approach to medicine means that chiropractors, doctors and any other practitioners who offer to treat patients should have their claims and practices questioned to make sure that they are safe and effective.Until recently, many have feared to raise questions about alternative practitioners for fear of litigation. However, the recent Singh case means that concerns such as those outlined above may be debated with far less fear of legal action. Shaun Holt Tauranga Andrew Gilbey Palmerston North

The recent failure of the British Chiropractic Associations attempt to sue the science writer Simon Singh for defamation1 has resulted in a number of important developments in terms of academic free speech and, almost certainly, the standing of the chiropractic profession.This failed legal action followed similar actions in New Zealand whereby the New Zealand Medical Journal faced legal threats after publishing a paper about chiropractors2 and a formal complaint was made to the Broadcasting Standards Association after comments made on television by one of the authors of this letter.3The Singh case has resulted in widespread support from UK politicians for major reforms of their libel laws, which are widely regarded as being cout of kilter with the rest of the democratic world, encouraging 'libel tourism' and the erosion of free speech in other countriesd.4Somewhat ironically, the BCAs case against Singh appears to have triggered a backlash against the chiropractic professions attempt to suppress scientific debate, resulting in their practices and claims being scrutinized by academics, health professionals, journalists and, not least, bloggers. The overwhelming consensus appears to be that there is a dearth of evidence to support many of the claims made by chiropractors, which are mostly based upon a highly dubious anti-science rationale.We conducted an informal analysis of current material that is critical about chiropractic practices and noted criticism based upon the following themes: Stifling free speech Unsupported claims that they can treat non-musculoskeletal diseases such as asthma, ear infections, colic etc Treating children Dangerous advice and quackery, such as advice not to vaccinate children Use of the title \"Doctor\" Concerns there is a causal link between neck manipulation and stroke Biological implausibility of treating non-musculoskeletal disease by manipulating the spine Overuse of X-rays An evidence-based approach to medicine means that chiropractors, doctors and any other practitioners who offer to treat patients should have their claims and practices questioned to make sure that they are safe and effective.Until recently, many have feared to raise questions about alternative practitioners for fear of litigation. However, the recent Singh case means that concerns such as those outlined above may be debated with far less fear of legal action. Shaun Holt Tauranga Andrew Gilbey Palmerston North