I read this sad and anger inducing article about chiropractic associations in Connecticut refusing to endorse informed consent to neck manipulations even though there have been plenty of cases worldwide that show a very real risk of stroke and death caused by cervical artery dissection and stroke following neck manipulation.
I’ll let you read the referenced article for details. What I want to talk about is how pseudoscience such as chiropractic has gained widespread acceptance in our society. It is taught in colleges and universities where degrees in this, and other pseudoscientific subjects are awarded. It is backed by very powerful lobbies in most state legislatures and can pour millions of dollars into advertising each year. We see all of this even though there is very little scientific evidence of the efficacy of any of the treatments that these pseudoscientific techniques offer beyond that of the placebo effect.
First, let me explain the placebo effect; what it is and how it works. The placebo effect is when you are given a treatment, be it a sugar pill, a shot, a massage or whatever to treat a health issue you are having. The treatment, even though it does not have any active mechanism to actually affect the issue, still causes an improvement.
For example, say you are having back pain and you are given a pill that you are told will help ease the pain. You may find that your pain does actually get better, even though it turns out that the pill was just a sugar pill.
The reason why this happens is that your brain is conditioned to relate certain treatments with certain effects. Or, you have trust in someone who tells you they can relive your pain and that trust sets up an expectation that you will improve with their treatment.
The reasons why it works this way isn’t fully understood, but it is believed to possibly have something to do with the relief of the associated physical and emotional stress that pain or illness can cause. You believe that you are being successfully treated; your stress goes down, your body responds by relaxing, thereby easing muscle tension that may be leading to your pain.
This is just one possible way the placebo effect may work. What we do know is that the placebo effect works best on subjective maladies like pain, stomach upset, depression, for instance. In these cases the placebo effect can be very powerful with up to 50% of people given placebo treatments seeing an improvement.
What the placebo treatments do not have much effect on are problems that are not subjective, like asthma, diabetes, or cancer. In these cases, placebo effect does not come into play and treatments with a real physiological active mechanism must be used, for instance, drugs that open up airways, or lower blood sugar or kill cancer cells.
Now, back to chiropractors and their wily ways. Chiropractors don’t want to tell their patients of the possibly deadly risks caused by cervical artery dissection and stroke following neck manipulation simply because it will affect their bottom line. If there is another compelling reason not to do so, I would like to hear it. What possible reason could someone who is supposedly treating someone for a medical condition have to not explain all the possible risks of their treatment? Considering that the patient’s welfare should come first, what justification can there be to avoid informed consent, especially considering that the risk is stroke or death?
The real issue here (besides the callousness and greediness of chiropractors) is that too many people believe in “alternative” medicine treatments because they are supported by supposedly respectable institutions like universities and state governments. Not enough people have the critical thinking skills needed to differentiate well tested, well researched and proven treatments from snake oil.
Even those who we give the power of legislation and regulation to protect us from fraud and untested and unsafe treatments don’t have the critical thinking skills needed to make a really informed decision. Instead, they allow lobbyists and special interest guide their opinions which results in, at the least, little or no regulation of bad treatments, or worse, outright recognition and licensing of them.
This is why critical thinking skills need to be taught in grade school through high school in every school in this country. Otherwise, you end up with perfectly well meaning people who are unable to critically evaluate the facts to make the important decisions that affect public health policy. You also end up with dead and disabled people who might have otherwise forgone a treatment had they only been giving an assessment of the possible risks of a chiropractic treatment.