Most consumers seem to think all alternative treatments are natural and therefore safe. I have repeatedly pointed out that this is not necessarily true. Some alternative therapies are associated with very significant risks. Chiropractic, for instance, has left many patients in wheelchairs and some have even died.1 Yet most chiropractors vehemently deny any responsibility.
A recent article by researchers from the Anglo-European College of Chiropractic in Bournemouth started with the telling statement that "the risk associated with cervical manipulation is controversial".2 This is certainly true. About every second patient experiences transient adverse effects after chiropractic, and several hundred cases of permanent neurological deficits or death are on record.1,3,4 Most of these serious complications are caused when an artery in the neck gets damaged during extreme manipulations of the upper spine. When this happens, the patient suffers a stroke and, as we all know, one can die of a stroke.
The Bournemouth team sent questionnaires about risk-related issues to 200 randomly selected UK chiropractors and received 92 responses. Their results show, among other things, that "only 45% indicated they always discuss [the risks of cervical manipulation] with patients ... "2
In plain language, this means that the majority of UK chiropractors seem to violate the most basic ethical standards in healthcare. If we assume that the 92 responders were from the more ethical end of the chiropractic spectrum, it might even be the vast majority of UK chiropractors who are violating the axiom of informed consent.
I applaud the authors for their courage in publishing their findings. They conclude that, "notwithstanding legal obligations, reluctance to disclose risk ... still remains, despite acknowledgement of moral and ethical responsibility."2 There is nothing to add to this clear message.
References
1. Terrett, AGJ (2001). Current Concepts in Vertebrobasilar Complications Following Spinal Manipulation. Iowa, USA: NCMIC Chiropractic Solutions.
2. Langworthy, JM, Forrest, L (2010). Withdrawal rates as a consequence of disclosure of risk associated with manipulation of the cervical spine. Chiropractic and Manual Therapies; 18: 27.
3. Stevinson, C, Ernst, E (2002). Risks associated with spinal manipulation. American Journal of Medicine; 112: 566-570.
4. Ernst, E (2010). Deaths after chiropractic: a review of published cases. International Journal of Clinical Practice; 64(8): 1162-1165.
