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Clarification request: Pseudoscience

Initiated by ~Adjwilley (talk) at 06:56, 8 June 2014 (UTC)

• Comment. This discussion should focus specifically on whether manual medicine (manual and manipulative therapies) for musculoskeletal disorders is pseudoscientific and fringe, as opposed to mainstream. Previous discussions did not specify what precisely is being disputed in the form of of a clinical question. Given that this has scientific impact, we are going to take an evidence-based approach to the matter. All claims must be backed by evidence. Parties are asked to provide evidence that supports or refutes the clinical question, personal opinions are irrelevant in this matter.

Case or decision affected

Pseudoscience arbitration case (t) (ev / t) (w / t) (pd / t)

Link to relevant decision Misplaced Pages:Requests_for_arbitration/Pseudoscience#Final_decision

List of any users involved or directly affected, and confirmation that all are aware of the request:

• Adjwilley (talk · contribs · blocks · protections · deletions · page moves · rights · RfA) (initiator)
• username2 (talk · contribs · deleted contribs · logs · filter log · block user · block log)

Statement by Adjwilley

I recently stumbled across a dispute centered around Chiropractic, and became aware that the article and subject area are under discretionary sanctions under the Pseudoscience case. My question is: how does the pseudoscience case apply to alternative medicine generally? Where do alt-med (and chiropractic specifically) fall on the spectrum of "obvious pseudoscience", "generally considered pseduoscience", "questionable science", and "alternative theoretical formulations" that is outlined in the case? The case file doesn't seem to mention alternative medicine specifically, but apparently discretionary sanctions are being issued in the area, which is why I am asking for clarification. ~Adjwilley (talk) 06:56, 8 June 2014 (UTC)

• Reply to Kww, Enric Naval: I understand the reasons for Chiropractic specifically being covered; I want to understand the details, and how the pseudoscience case applies to other alt-med articles like Acupuncture which afaict is not sanctioned. For instance, can an administrator impose a topic ban or edit restriction under the discretionary sanctions clause of this case for all alternative medicine articles, or would such a topic ban only apply to articles that have the pseudoscience DS template on the talk page? And what is the criteria for adding the DS template to an article? I don't see a clear-cut answer to this, which is why I filed the request for clarification. ~Adjwilley (talk) 18:19, 8 June 2014 (UTC)

Statement by Enric Naval

Chiropractic is covered because it has has pseudoscientific elements. And it's doubly covered because the sanctions were expanded to cover fringe science, and chiropractic is fringe medicine (fringe medicine being a subset of fringe science). The arbitration case doesn't need to mention alternative medicine.

Sourced proof:

• Joseph C. Keating, Jr., Cleveland CS III, Menke M (2005). "Chiropractic history: a primer" (PDF). Association for the History of Chiropractic. Retrieved 2008-06-16. A significant and continuing barrier to scientific progress within chiropractic are the anti-scientific and pseudo-scientific ideas (Keating 1997b) which have sustained the profession throughout a century of intense struggle with political medicine.{{cite web}}: CS1 maint: multiple names: authors list (link) (this source is already in the article!)
• In Philosophy of Pseudoscience: Reconsidering the Demarcation Problem (pages 226-227), the Florida State University tried to start a chiropractic course, and it was denounced as pseudoscience by many professors.... but not by all of them. Then it discusses several aspects of fringe medical practices that are labelled as pseudoscience, including chiropractic as one of those practices.

--Enric Naval (talk) 15:54, 8 June 2014 (UTC)

Statement by Neuraxis

Enric has decided to cherry pick a sentence, used in a historical context. This is a common tactic. However, it ignores the fundamental question: Is manual and manipulative therapy for MSK conditions fringe? This impacts chiropractic since it is the largest purveyor of manipulative services, but also impacts on osteopathic medicine, physical therapy who also use manipulation as a means of relieving MSK pain. So, the findings here apply equally to all health professions who use manipulative therapy as a clinical intervention for dealing with MSK pain. While I do agree that the non-musculoskeletal use of manipulative therapies isn't mainstream, given that its only 10% of practice this should not be disproportionately weighed against the fact that 90% of manipulative treatment is directly towards spinal/MSK issues. Given that the mainstream of the chiropractic profession has evolved with a common identity focusing on conservative spine care, the notion that chiropractic practice (and spinal manipulation by extension) is 100% pseudoscientific does not reflect the current reality. This ongoing discussion specifically discusses this very topic and is relevant here. Lastly, we need use a global focus and not just a US-centric POV.

• National Institute of Health, viewpoint states "Most research on chiropractic has focused on spinal manipulation. Spinal manipulation appears to benefit some people with low-back pain and may also be helpful for headaches, neck pain, upper- and lower-extremity joint conditions, and whiplash-associated disorders." . This is a mainstream respected organization. The WHO was clear too in this regard .
• Whereas most chiropractic schools in the USA are in private colleges, most of the newer schools internationally are within the national university system (e.g. Australia, Brazil, Canada, Chile, Denmark, Japan, South Korea, Malaysia, Mexico, South Africa, Spain, Switzerland, and the UK). In some of these programs, for example, at the University of Southern Denmark in Odense and the University of Zurich in Switzerland, chiropractic and medical students take the same basic science courses together for three years before entering separate programs for clinical training. . Video proof
• Surveys demonstrate that the primary reasons patients consult chiropractors are back pain (approximately 60%), other musculoskeletal pain such as pain in the neck, shoulder, extremities, and arthritic pain (20%) and headaches including migraine (10%). About 1 in 10 (10%) present with a wide variety of conditions caused or aggravated by neuromusculoskeletal disorders (e.g. pseudo angina, dysmennorhea, respiratory and digestive dysfunctions, infant colic/irritable baby syndrome.).Practice demographics state that the majority (9/10) patients see chiropractors for spine/MSK conditions.
• "These data support the theory that patients seek chiropractic care almost exclusively for musculoskeletal symptoms and that chiropractors and their patients share a similar belief system."
• Back and neck pain are the specialties of chiropractic but many chiropractors treat ailments other than musculoskeletal issues . The source is Ernst, and the % of non-MSK issues being treated, as the 2013 status report shows is 10%. This was also stated in an earlier study where the percentage was 10.3%
• This source, (also being used at the mainpage but this section isn't allowed to be inserted by skeptical editors states "Chiropractic, the medical profession that specializes in manual therapy and especially spinal manipulation. The same article also states that "Even to call chiropractic "alternative" is problematic; in many ways, it is distinctly mainstream.
• Although chiropractors have many similarities to primary care providers, they are more similar to a medical specialty like dentistry or podiatry
• Spinal manipulative therapy gained recognition during the 1980’s by mainstream medicine , "As a result of this increased communication between the medical and chiropractic communities, chiropractors were offered and credentialed medical staff hospital privileges and began to co-manage patients with medical physicians" (Ibid.)
• The current advent of the evidence-based medicine era, chiropractic scholars have generated evidence-based systematic reviews and practice guidelines with respect to the management of acute/chronic low back pain, thoracic pain, neck pain, headache, radiography, and upper/lower extremity conditions. tendinopathy myofascial pain/trigger points, and non-musculoskeletal conditions.. Collectively, these can be found here which is an evience-based resource for chiropractic management.
• Evidence-based chiropractic generates 234 hits on PubMed . This suggest that, in modern times, evidence-based chiropractic is not a myth, like critics suggest, but a reality.
• There are several evidence-based textbooks of the topic of chiropractic published by mainstream medical publishers , , , , .
• Beijing Declaration (2008) "“This congress represented a major milestone for chiropractic” says WFC president Dr. Papadopoulos. “Chiropractic was seen by WHO, government officials from many countries and delegates from other professions as the most developed profession internationally in the field of manual healthcare, and the Beijing Declaration called upon all countries to recognize and regulate CAM professionals such as doctors of chiropractic.”
• Chiropractors holding unorthodox views may be identified based on response to specific beliefs that appear to align with unorthodox health practices. Despite continued concerns by mainstream medicine, only a minority of the profession has retained a perspective in contrast to current scientific paradigms.
• Pioneering of World Spine Care which is brings together a multidisciplinary group of doctors and therapists to help treat spinal disorders in 3rd world countries and has such notable sponsors as Elon Musk of Tesla and endorsements from the WHO, North American Spine Society, and other leading spine care organizations. "SC is a multinational not-for-profit organization, bringing together the full spectrum of health care professionals involved in spinal health – medical physicians and specialists, surgeons, chiropractors, and physiotherapists. WSC is focused on providing evidence-based, culturally integrated prevention, assessment, and treatment of spinal disorders in the developing world. The flagship project involves developing and initial deployment of a universal model of care for spinal disorders, designed for practical application by front-line health care workers in developing nations worldwide.
• 2013 WHO introduces World Spine Day, was directly related to the efforts of the chiropractic profession to draw awareness for spinal health disorders
• Collectively this small collection of diffs shows that the primary focus of chiropractic care as it currently stands is primarily dedicated to management of spinal/MSK disorders. The outdated one cause one cure has been rejected by the profession 'the monocausal view of disease has been abandoned by the profession preferring a holistic view of joint dysfunction/subluxation that is viewed as theoretical construct in web of causation along with other determinants of health..

This list is by no means exhaustive, but rather a starting point to show evidence that scientific practice and research is not uncommon, but reflects the mainstream of the profession currently. Regards, Neuraxis (talk) 18:02, 8 June 2014 (UTC)

1. "Management of chronic spine-related conditions: consensus recommendations of a multidisciplinary panel". JMPT. 33 (7): 484–492. 2010. PMID 20937426. {{cite journal}}: |access-date= requires |url= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help); Unknown parameter |month= ignored (help)
2. "Chiropractic management of low back disorders: report from a consensus process". JMPT. 31 (9): 651–658. 2008. PMID 19028249. {{cite journal}}: |access-date= requires |url= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help); Unknown parameter |month= ignored (help)
3. "Chiropractic clinical practice guideline: evidence-based treatment of adult neck pain not due to whiplash". JCCA. 49 (3): 158-209. 2005. PMID 17549134. {{cite journal}}: |access-date= requires |url= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help); Unknown parameter |month= ignored (help)
4. "Evidence-based guidelines for the chiropractic treatment of adults with headache". J Manipulative Physiol Ther. 34 (5): 274–89. 2011. PMID 21640251. {{cite journal}}: |access-date= requires |url= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help); Unknown parameter |month= ignored (help)
5. "Diagnostic imaging guideline for musculoskeletal complaints in adults-an evidence-based approach-part 2: upper extremity disorders". J Manipulative Physiol Ther. 31 (1): 2–32. 2008. PMID 18308152. {{cite journal}}: |access-date= requires |url= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help); Unknown parameter |month= ignored (help)
6. "Diagnostic imaging practice guidelines for musculoskeletal complaints in adults-an evidence-based approach-part 3: spinal disorders". JMPT. 31 (1): 33–88. 2008. PMID 18308153. {{cite journal}}: |access-date= requires |url= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help); Unknown parameter |month= ignored (help)
7. "Diagnostic imaging practice guidelines for musculoskeletal complaints in adults--an evidence-based approach: introduction". JMPT. 30 (9): 617-83. 2007. {{cite journal}}: |access-date= requires |url= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help); Unknown parameter |month= ignored (help)
8. "Manipulative therapy for lower extremity conditions: expansion of literature review". JMPT. 32 (1): 53–71. 2009. PMID 19121464. {{cite journal}}: |access-date= requires |url= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help); Unknown parameter |month= ignored (help)
9. "Chiropractic treatment of upper extremity conditions: a systematic review". JMPT. 31 (2): 146–159. 2008. PMID 18328941. {{cite journal}}: |access-date= requires |url= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help); Unknown parameter |month= ignored (help)
10. "Chiropractic management of tendinopathy: a literature synthesis". JMPT. 32 (1): 41–52. 2009. PMID 19121463. {{cite journal}}: |access-date= requires |url= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help); Unknown parameter |month= ignored (help)
11. "Chiropractic management of myofascial trigger points and myofascial pain syndrome: a systematic review of the literature". JMPT. 32 (1): 14–24. 2009. PMID 19121461. {{cite journal}}: |access-date= requires |url= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help); Unknown parameter |month= ignored (help)
12. "Chiropractic care for nonmusculoskeletal conditions: a systematic review with implications for whole systems research". J Altern Complement Med. 13 (5): 491–512. 2007. PMID 17604553. {{cite journal}}: |access-date= requires |url= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help); Unknown parameter |month= ignored (help)
13. Bergmann, T.F., Perterson D.H (2011). Chiropractic Technique: Principles and Procedures. Elsevier. ISBN 9780323049696.
14. Cite error: The named reference Henderson 2012 632–642 was invoked but never defined (see the help page).

Statement by Kww

I don't even see why this is a question. Chiropractic practices are firmly rooted in pseudoscience. That some small subset of their treatments have beneficial effects doesn't mean that the foundation is solid, it's simply an an example of the "even a stopped clock is right twice a day" principle. The same reasoning applies to the various alternative medicines.

In a very real sense, these are more important topics than the more esoteric pseudosciences. No one is going to hurt themselves because they believe in cold fusion. They can hurt themselves by forgoing legitimate medical treatment in favour of quackery.—Kww(talk) 16:03, 8 June 2014 (UTC)

Statement by {other user}

Clerk notes

This area is used for notes by the clerks (including clerk recusals).

Arbitrator views and discussion

Amendment request: Falun Gong 2

Initiated by TheSoundAndTheFury (talk) at 00:37, 2 June 2014 (UTC)

Case affected

Falun Gong 2 arbitration case (t) (ev / t) (w / t) (pd / t)

Clauses to which an amendment is requested

1. Amendment request: Falun Gong 2 / Motion

List of users affected by or involved in this amendment

• TheSoundAndTheFury (talk · contribs · deleted contribs · logs · filter log · block user · block log) (initiator)
• Ohconfucius (talk · contribs · deleted contribs · logs · filter log · block user · block log)

Confirmation that the above users are aware of this request

Information about amendment request

• Amendment request: Falun Gong 2
• Lifting the misbehaving user's indefinite topic ban lead to disruptive behavior, despite promises.

Statement by TheSoundAndTheFury

Last month, User:Ohconfucius appealed to ArbCom to lift the indefinite topic ban that prevented him from editing Falun Gong-related articles.

In his request he stated "Arbcom can have faith that I can stay away from articles about the movement and from drama relating thereto. I am seeking to remove a topic ban not so that I can go back to editing articles on ." He added "if it pleases Arbcom, I would add a voluntary undertaking not to edit any article directly connected with FLG." Instead, Ohconfucius said he wanted the ban lifted so that he could return to good standing and stop walking on eggshells when it comes to China-related articles.

On the basis of these promises Arbcom agreed to provisionally lift the topic ban for a period of one year, provided Ohconfucius not relapse into problematic editing patterns. One arbitrator noted the "request that Ohconfucius steer well clear of matters of controversy in this area."

Two weeks later, Ohconfucius returned to POV editing on a controversial Falun Gong article:

• Deletes what appears to be verifiable information on the grounds that he didn't like the source, which he referred to as a Falun Gong "front-organisation." (The source cited was a major Israeli newspaper, but a translation of the article was hosted on a Falun Gong website).
• Alters the source of torture allegations in apparent attempt to make them seem less credible (allegations were actually made by a Pulitzer Prize-winning journalist and confirmed through extensive investigative reporting). Edit summary calls it a copy edit.
• More of same. Edits article to (falsely) depict allegations from third party sources as coming from Falun Gong sources. Again, I imagine the intend was to make the reports seem less credible.

This is not the first time Ohconfucius has reneged on promises to refrain from editing on Falun Gong. He has on numerous occasions said he would stop editing in this area, and once even briefly "retired" with the apparent goal of trying to avoid sanctions (then promptly continued editing under another account). Given the opportunity he seems unable to avoid this subject, I suggest the topic ban be reinstated.

@John Carter: I would again like to bring to everyone's attention that Ohconfucius's topic ban was lifted on the provision that " steer well clear of matters of controversy in this area". Indeed, it was his original suggestion that he refrain from editing the Falun Gong articles altogether. Cordially, TheSoundAndTheFury (talk) 01:54, 5 June 2014 (UTC)

@EdJohnston: Thank you for the clarification. You are right and my comment was not well thought out, as there was no explicit provision in the decision. Let me rephrase: I thought it was implicitly understood that the ban was lifted based on Ohconfucius's promise to not return to editing in this area. TheSoundAndTheFury (talk) 12:02, 5 June 2014 (UTC)

Statement by EdJohnston

The committee might decline this on the grounds that they are not usually the first resort for enforcement. I did examine one diff of those submitted here and I agree that Ohconfucius's change was not a good idea. A Wall Street Journal reporter, Ian Johnson, got a Pulitzer in 2001 for a series of articles including this one about deaths of Falun Gong adherents in police custody. His statement that the people died was based on his own reporting. Changing the wording of this to say 'Falun Gong alleged..' seems ill advised. Also it was a bad idea to mark this in the edit summary as 'ce'. I hope that Ohconfucius will respond. EdJohnston (talk) 05:33, 2 June 2014 (UTC)

@TheSoundAndTheFury: It is inaccurate to say that Ohconfucius's ban "was lifted on the provision that " steer well clear of matters of controversy in this area". You are quoting from a comment by a single arb who was simply making a request along with his vote. The motion itself didn't restrict Ohconfucius from areas of controversy. EdJohnston (talk) 02:59, 5 June 2014 (UTC)

Statement by John Carter

The article and topic remain under discretionary sanctions, independent of the now-lifted sanctions against Ohconfucius. It is also unfortunate but true that the ArbCom having declared him as basically taking the side of the PRC in the last dispute is something which I can well imagine might leave a very bitter aftertaste for some time in someone accused in such a way. There has been, so far as I can tell from databanks, not much of a newsworthy nature on the topic in the past few years. I also agree that, unfortunately, it is possible for websites affiliated with organizations like FG to misrepresent/misquote sources in a prejudicial way. In such a case, I can reasonably say that it might well be reasonable to remove an alleged quote from a partisan source as being from a partisan source.

I have to say that it seems to me that reinstating the ban might well be ultimately counterproductive to the quality of the FG content here. The Sound and the Fury was not himself sanctioned in the FG2 case, but there was so far as I can remember a preponderence of evidence of he himself being a less than neutral and unbiased editor. That may also be worth considering here. And there is a very real chance that the existence of the discretionary sanctions, and the fact of there being two previous arbitrations on this matter, might well scare off many or most editors not previously invovled.

The edit summaries are and were problematic, and I cannot and will not attempt to defend them. But I do think Ohconfucius would be an invaluable editor to have around to help keep articles on this this highly contentious topic at a reasoanble level of quality. For all these reasons, I oppose the reinstatement of the ban. I think, on such potentially dubious potential misquotes (maybe?) from a group's internal propaganda opublications, such "questioning" of possible quotations is not unreasonable, and that there might also be a few rough spots in returning to edit such a contentious topic. These actions could well be accounted for on the basis of some lingering resentment as being labelled on the PRC side by ArbCom in the last case and "learning the ropes" about the topic again. Would there be, maybe, cause for discretionary sactions of some sort? Yes. A return to a full ban? So far as I can see, no. John Carter (talk) 22:58, 4 June 2014 (UTC)

Regarding Zujnie's points below. First, I question how qualified he/she is to compare the situation before and after Ohconfucius' ban, considering, so far as I can remember, Zujine had not been involved with the content at all prior to Ohconfucius' ban. Second, that he thinks Ohconfucius requested the ban be lifted on the provision he would refrain from editing in the topic, that statement is supported neither by the actual comments made or, even, common sense. Who would go through the effort of requesting a ban be lifted on a topic they would have no interest in editing in? Lastly, at least part of the alleged improvement (which I have not myself actually verified) could well be do to things other than Ohconfucius's absence, such as the reduced number of strident pro-FG POV pushers and, from what I can see in the databanks, a significantly reduced level of news coverage and developments related to FG. Having the topic itself be comparatively stable can and would in and of itself make it easier for the improvement of articles. For compelling reasons for his return, I think the fact that he is the person who played the greatest role in bringing FG's only FA article up to that level of quality is I believe possibly compelling enough reason.John Carter (talk) 15:35, 7 June 2014 (UTC)

Statement by Ohconfucius

• @Seraphimblade:It is true that I have been editing, but I can only manage minor editing while my RL workload is quite heavy, but that does not mean I am choosing not to reply to this. I am currently preparing my response in private, so please bear with me for a few days. Regards, -- Ohc  01:17, 5 June 2014 (UTC)

Statement by Zujine

In my view this issue is simple. Ohconfucius stated in his appeal that he would not edit Falungong articles. Based on my reading of the case, it seems the ban against him was suspended on basis of that promise, which he promptly broke. In that sense, the fact his edits were not neutral or accurate almost seems beside the point.

If we want to discuss whether Ohconfucius should be allowed to return to editing Falungong articles, a much more compelling case needs to be made to show, first, that he has recognised his past errors and won't repeat them (not off to a good start); and second, to assess potential risks and benefits to the project. Based on his track record I believe that no benefits could be derived, but there would be real risk for the Falungong topic area to again devolve into a battle ground. Over the last two years since Ohconfucius was barred from editing it has been refreshingly stable. Article quality has continually improved, with some pages achieving GA status. I doubt this could have been accomplished if our collective energies were instead directed toward addressing Ohconfucius' behaviour.—Zujine|talk 03:45, 5 June 2014 (UTC)

@John, I've been active in the falungong subject for the better part of five years. Ohconfucius has been banned for two. There was a period in which our editing on these pages overlapped. I was deeply unimpressed by what I witnessed from him in that time, especially his conduct on the FA you referred to. I understand you like this editor and have defended him at ArbCom on numerous occasions, but there was good reason for his indefinite topic ban. Besides, I'm guessing the Arbs are more concerned with recent events than with revisiting old evidence.—Zujine|talk 18:28, 7 June 2014 (UTC)

Clerk notes

This section is for administrative notes by the clerks (including clerk recusals).

Arbitrator views and discussion

• Awaiting statement from OhConfucius. I also would welcome brief comments on whether this should be addressed here or by the admins on arbitration enforcement, though the procedural issue shouldn't get in the way of addressing the merits. Newyorkbrad (talk) 01:32, 2 June 2014 (UTC)
• Recuse. T. Canens (talk) 03:22, 2 June 2014 (UTC)
• Also awaiting statements from Ohconfucius. To the issue Newyorkbrad raises, I don't see any issue addressing this here as that's where it's already been raised, but handling at AE would also be fine as the motion specifically allows reinstatement of the ban as an AE action if that were determined to be necessary. Seraphimblade 05:41, 2 June 2014 (UTC)
  • Ohconfucius: As you've continued editing since being notified but not responded here, I presume you do not wish to make a statement and we can proceed. If this is incorrect, please make your statement here at your earliest possible convenience. Seraphimblade 17:24, 4 June 2014 (UTC)
• That didn't take long. --Floquenbeam (talk) 19:45, 2 June 2014 (UTC)
• Awaiting statement from OhConfucius. GorillaWarfare (talk) 20:30, 5 June 2014 (UTC)