In my articles discussing the recent visit to Australia by science writer Simon Singh, I took the Chiropractors' Association of Australia (CAA) to task for using what I described as "weaselly words". So what are weasel words and why are they a problem?

Wikipedia defines weasel words as follows:
Weasel words is an informal term for words that are ambiguous and not supported by facts. They are typically used to create an illusion of clear, direct communication.
Wikipedia goes on to imply an intent to mislead though that is not how I've applied the term in the past or here. I think people can easily fall foul of weasel words when they either can't be bothered backing up their claims or, sometimes, when trying to avoid a defamation suit.

Wikipedia offers a list of examples which includes...

• "People say..." (Which people? How do they know?)
• "There is evidence that..." (What evidence? Is the source reliable?)
• "Experience shows that..." (Whose experience? What was the experience? How does it demonstrate this?)
• "It is known that..." (By whom and by what method is it known?)
• "Studies show..." (what studies?)

As you can see, what the wikipedia authors are looking for in each of these cases is evidence to back up the assertion. But why is this important?

Simply claiming that "there is evidence" for something is not, in itself, an indication that the evidence is worthwhile or conclusive. You might see this phrase when reading about dubious medical claims where the best evidence might well be the opinions of some patients and practitioners (anecdotal evidence). But anecdotal evidence can fall foul of the post hoc, ergo propter hoc fallacy ("after this, therefore because of this") and as such it is not generally regarded as good evidence. A person has an ache or pain, visits a practitioner who claims to be able to treat such pain and then the pain goes away or reduces. The patient can easily assume the treatment brought on the relief because of the timing of the events - but it may not be the case.

For example, men begin to grow facial hair around the same time as they get their driver's licence. Based solely on this knowledge, one could state, quite rightly, that there is evidence that drivers' licences cause the growth of facial hair in men. But is the evidence useful? Has it been tested? Were the tests positive for the assertion that licences do indeed cause facial hair to grow? Is the claim even plausible?

So, weasel words are not necessarily lies or incorrect. They can be absolutely true but fail to tell the whole story.

Let's look at some examples of claims related to complementary therapies. Here's one I discussed last month, from a story on Today Tonight. I've bolded some weaselly words...

Professor Clarke says mainstream medicine has had success with cancer vaccines and improvements in radiation therapies, but some of the most exciting work is being done with natural therapies -- like Chinese herbs -- to see if they can help chemotherapy patients avoid nasty side effects. "I am sure there are some that are beneficial. The Chinese have been using many of these treatments for thousands of years with efficacy", he said.

Working with Professor Clarke, is fourth generation Chinese herbalist Maria Wu. Maria is convinced herbs like agrimoniae, patrimiae, hedyotis, ganoderma spore (mushroom) and diffusa, have reduced deadly inflammation in cancer patients and assisted in recovery, in concentrated doses. "Building energy and building the immune system, then go through to doing the chemotherapy, people didn't have side effect. Hair no falling down, no vomiting, no tired, no diarrhoea -- all gone", Maria said.

Weasel words like those bolded above can easily slip by the uninitiated who fail to pick up on the fact that no conclusive statement was made about the usefulness of the "remedies" being discussed. One person "is sure" they're beneficial and the other "is convinced" they "assist" in recovery but no evidence is provided to explain how they reached these assumptions of efficacy except that apparently many (How many? Which ones?) of them proved efficacious (For what?) for thousands of years (but if that's known for a fact, why are they being tested now?). If you read or hear this and don't note the conditional nature of the statements, you could be forgiven for accepting them as authoratative and conclusive and assume they are based on sound, scientific evidence.

Another example comes from the CAA's response to a Lateline story featuring Simon Singh...

“It is important to realise that chiropractic doesn't "treat" any condition, pain or symptom. Chiropractic care reduces interferences to the body's ability to function optimally, and works to restore complete normal function. Chiropractors fundamentally see themselves as diagnosing and taking care of patients with dysfunctions in the neuromusculoskeletal system, including the spine and joints.

This one takes a slightly different approach in that there's an apparent attempt to redifine what "treatment" is, in a medical sense. According the dictionary.com, the appropriate definition of "treat" is...

• 3 - to deal with (a disease, patient, etc.) in order to relieve or cure.

If a chiropractor performs an action with the intent to alleviate some problem - like removing interferences - then it is hard to see how it could be argued that the action does not amount to "treating" that ailment. If we accept the CAA's definition of what they do to be something other than treating, then I'd argue no medical practitioner, mainstream or alternative, treats any condition at all in which case the CAA's objection seems redundant.

I consider this to be weaselly wordage because it would confuse the reader who is not familiar with weasel words. It appears authoritative but is ambiguous and apparently not supported by the facts (I might add that a quick search of chiropractic websites will show that few chiropractors have a problem with claiming to treat a whole range of ailments).

Another example, also from the CAA, followed on from the previous quote...

In doing so, this could potentially have corresponding effects in the nervous system that may impact on the patient's general health and well being. These outcomes may be experienced in addition to an individual's primary complaint or reason for consultation.”

As I understand this statement, it's arguing that while the chiropractor deals directly with "neuromusculoskeletal" problems, some seemingly unrelated problems (ear infections, bed wetting, infant colic?) might also be relieved. Weasel words like "could potentially" and "may be experienced" leave the door wide open for no patient to ever enjoy whatever secondary benefit is being discussed and yet the statement would remain fundamentally true since no benefit was promised.

"We fix cars, not mechanical problems!"

If the CAA are seriously saying their members don't treat babies for colic - but that colic may improve after manipulation, I'm left wondering if they charge parents who bring colicky babies in for colic treatment - and what the invoice says? If you took your car to a mechanic to have the brakes fixed and he changed the engine oil and said "that may improve your brakes", I imagine you'd be lodging a complaint forthwith - yet I'm having difficulty seeing how the CAA are not making a similar claim in regards to spinal manipulation for non-neuromuscoskeletal problems.

Sometimes, these ambiguous claims might be seemingly backed up by claims of evidence. In the Lateline story, for example, the CAA spokesperson claimed that there have been a number of studies indicating that "irritable baby syndrome" (colic), "has been successfully treated by chiropractors".

Indeed there have been, apparently. In the last few weeks I found myself looking at the conclusions of some of these "studies" and reading several "demolition jobs" by other, more experienced, bloggers and writers and I think the above statement could qualify as using weasel words because the most rigorous study to date (Olafsdottir, et al) dismisses any efficacy of chiropractic in the treatment of colic. The authors of perhaps the most promising, but flawed, trial (Wiberg, et al), commenting on that later study, stated that the question of efficacy remains open. In other words, there would appear, at the moment, to be no conclusive evidence that chiropractic is a useful treatment for colic, regardless of how many (less rigorous) studies there are "indicating" a positive effect.

So, the original statement is not wrong - there are studies indicating that chiropractic might be useful for treating colic. But are those studies conclusive? Are they the best studies available on the subject? It appears not. But of course, chiropractors supposedly don't claim to treat colic - they just say it might improve after treatment.

I should add that there are times where weasel words are likely acceptable. In casual conversation, for example, it would be ridiculous to expect the citation of studies. But if a stridently stated opinion is challenged, one should expect to be able to produce supporting evidence at some point. Where weasel words become a problem is when a statement appears to be authoratitive, especially when it is apparently intended to affect decision making.

Here's a few random "weasel word" phrases found on Australian websites promoting various alternative "therapies"...

• Homœopathy aims to treat the whole person (what does that mean?)
• Homœopathy can be of benefit for all ages (no evidence cited. What does it mean?)
• Homœopathy can treat the symptoms of a wide range of conditions (this is odd because mainstream medicine is often disparaged for treating symptoms rather than causes - but that's another issue.)(also - no evidence cited)
• [Homeopathy side effects?] ...Sometimes there is an immediate improvement. Sometimes healing begins with an increased feeling of well being, even though symptoms initially remain. In some cases, old symptoms recur as part of the healing process. Occasionally there is a temporary worsening of the symptoms prior to improvement. (no evidence cited and it sounds like the general course for a range of ailments even when not treated at all. It barely counts as a claim for anything.)
• Reiki can assist in shutting down stress responses... (no evidence cited. What does it mean?)
• [Reiki patients] Some experience relief immediately; others find that within a week or two their symptoms have diminished or disappeared. (no evidence cited and again, it sounds like the normal response for a wide range of self-limiting ailments)
  
• Reiki can assist the physical, emotions mental and spiritual balances. (no evidence cited. What does it mean?)
• However, since ADHD appears as a neurological disorder and chiropractic care helps reduce nervous system disturbances, many parents who want a natural, non-drug solution for their child have found chiropractic care helpful, even miraculous. (no evidence cited. Sounds anecdotal.)
• Chiropractic, however, has shown to be highly effective in reducing the amount of times babies with colic spend crying. (no evidence cited and we've already noted that the question of efficacy remains open, at best. Plus, if it works, why don't they claim to treat it?)
• Chiropractic care has shown to be effective in alleviating the symptoms related to asthma. (no evidence cited)
• Chiropractic corrections to problems within the spine or vertebral subluxations (nerve interference) in babies have long been acknowledged as an excellent therapeutic tool for calming infants. (no evidence cited - long been acknowledged by whom? Chiropractors? Accountants? Bloggers?)

You get the idea. These are largely authoritative statements and most were taken from sites actively engaged in promoting the treatment being discussed - that is, they are intended to affect decision making on matters of health - yet they use weasel words. It's not just that the claims themselves are not explicit so much as the fact that they are not coupled with supporting evidence.

But do the purveyors of complementary "therapies" realise they are using weasel words? It appears in some cases they do. David Colquhoun tells us on his blog about some teaching material from a UK university course in Chinese herbal "medicine". One example of a slide used in the course says:

Cancer Treatment and the Law:

• Legally, you cannot claim to cure cancer
• This is not a problem because:
  'we treat people, not diseases'.

Yes, the last statement is in quotes and italics, almost as if to reinforce that this is a mantra the graduate should repeat if challenged. It has a familiar ring to it. "We fix cars, not mechanical problems!"

I use weasel words a lot. Sometimes this is out of laziness. Sometimes it's out of an assumption that I'm preaching to the choir and have no need to elaborate. A lot of times it's because I'm trying hard to phrase things in such a way as to reinforce that I am expressing an opinion and don't want to be sued for defamation. There is some evidence that suggests that it's likely that up to 85% of bloggers apply similar rules some of the time.