FROM THE PRESIDENT
Professor Rod Bonello
BSC(SYD), DO, DC(SCC), MHA(UNSW), FRCC BABIES AND BATHWATER AND A BRIGHT FUTURE. Recent media controversy February saw a media furor explode surrounding the appearance of a video of a chiropractor examining and treating a two-week old baby. Although the baby was in no danger, a public outcry followed based on the emotional reaction caused by the footage. Following that, familiar calls came from the Victorian Health Minister and various other sectors to review the rights of chiropractors to treat children. So let’s unpack this complex situation.
What was the problem? The video was almost universally found to be confronting because it showed a baby made to cry during a treatment. Additionally, the inverted neurological test was depicted which involved the baby being hung upside-down by one leg. While in itself innocuous, the inversion of a baby looks to be cruel. The video contained a number of statements made by the chiropractor which could not be supported by evidence and which lacked biological plausibility and it is this feature which is objectively offensive under current societal standards. A clear distinction exists between what can be said by a registered professional privately and publicly. Experimental, unconventional and poorly evidenced treatments can be appropriate in individual circumstances under certain conditions - such as failure of more conventional treatments and having genuinely informed consent. Public statements, such as a posted video, cannot be individualised and are not given sufficient context so they must be far more
circumspect and precise in the messages they convey. Discussion and display of poorly evidenced procedures can give an inaccurate picture of their status and, effectively is akin to false advertising.
Generally speaking, should videos of this nature be posted? Of course not. No matter how skilled the chiropractor is for example, video of neck manipulation is virtually always confronting. Such video footage disrespects the sanctity of the doctor-patient relationship and is usually delivered without the specific context of the case, and this is enormously problematic.
What are the repercussions? In the long run there are three effects of unwise postings of paediatric videos. Firstly, the chiropractor who posts the video becomes open to scrutiny and risks having conditions placed on their practise if not loss of licence. Secondly, the profession is at real risk of having its right to treat children under a certain age removed. Thirdly, the profession suffers a loss in cultural authority. Cultural authority is like having an excellent reputation; it is difficult to acquire but so easy to lose.
We have also participated vigorously in various media interviews and they are still ongoing in March 2019. Our role is to clarify for the public and other stakeholders that, notwithstanding the fact that the posting of such videos is usually wrong, and not necessarily seeking to defend any individual procedures depicted in that video, care for infants and children is a valid component of chiropractic practice. Although it is an emerging area of validated practice there are key areas for which the evidence is in fact reasonable. Further, the calls for the wholesale ban of chiropractic care for babies, infants and children are unfounded and not in the best interest of the little ones and their families. We have also sent out a communiqué to all members about paediatric care by chiropractors, its place in practice and the state of evidence at this time. We are also commencing a service for members to give advice on their website content to help ensure full compliance with applicable standards (see below).
Member Website Review The Board agreed to review member’s websites to help ensure that high standards of compliance are maintained. Like it or not, chiropractors’ on-line presence is under great scrutiny and we have determined that it is our role to facilitate members in having clear messaging for the benefit of their patients and content that will not jeopardise their status with the Chiropractic Board of Australia.
What is CA doing about this? Several things. At the time of writing this report the chiropractor who posted the video is under investigation by the Chiropractic Board of Australia, having already accepted not to see children under the age of 12 years until the investigation is concluded. Because this investigation is ongoing I have not commented on the specifics of his case. However we have reached out to the chiropractor at the heart of the controversy. Our role is educative as much as anything else.
Rod Bonello BSc(Syd), DO, DC(SCC), MHA(UNSW), FRCC President
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