Foundation Responds to Anti-Subluxation Position Statement

The Foundation for Vertebral Subluxation has reviewed the Position Statement on Clinical and Professional Chiropractic Education recently released by the following Chiropractic Educational Institutions: 

• Anglo-European College of Chiropractic
• Welsh Institute of Chiropractic
• The Education of Clinical Biomechanics – University of Southern Denmark
• Chiropractic Medicine – University of Zurich
• The French-European Institute of Chiropractic
• Department of Chiropractic – University of Johannesburg 

The Position Statement contains factual errors that must be corrected – both to provide truthful information to the public we serve and to ensure that the profession does not look foolish in the eyes of the scientific, healthcare and chiropractic communities. 

The European document contains the following statement: 

“The teaching of vertebral subluxation complex as a vitalistic construct that claims that it is the cause of disease is unsupported by evidence. Its inclusion in a modern chiropractic curriculum in anything other than an historical context is therefore inappropriate and unnecessary.” 

The use of the term Vertebral Subluxation Complex implies that the statement applies only to one model of vertebral subluxation since the complex model of subluxation is but one of many operational models of subluxation. That 6 educational institutions purporting to be training chiropractors and opining on subluxation are not aware of such basic knowledge about the clinical focus of the profession should concern all of us. 

These schools suggest that there is an organized and respected group within chiropractic that suggests subluxation is the sole cause of disease. We are unaware of the existence of  any such group. If these schools are aware of the existence of such a group(s) we recommend that they identify them and direct their concerns to the appropriate regulatory bodies instead of casting a negative light on the entire profession. 

Because of this intentionally deceptive wording, the Position Statement ties the concept of vertebral subluxation to a vitalistic construct and resultant health outcomes concluding there is no evidence of such a relationship. 

Unfortunately such a contention contradicts their own position. The opening paragraph in their Position Statement reads:   

“Chiropractic education and training must adhere to the biopsychosocial model of health care and be underpinned by biologically plausible theory and peer-reviewed research. It should embrace the value of clinical experience, shared decision-making and a patient-centered approach to care.”

It is well understood that the biopsychosocial model of health, along with the evidence based model, includes consideration of patient values in making determinations about health care decisions. Consideration of patient values are an inherent part of health belief models which are utilized to determine the extent to which people are motivated to change their health behavior. In the biopsychosocial model, health and disease are socially constructed.

Personal values have to do with the beliefs patients have concerning the care that is being offered to them and are related to the patient’s philosophical, spiritual and even religious beliefs. Evidence based health care demands that we honor the personal autonomy of our patients and assist them in making health care decisions that are consistent with current scientific understanding, their clinical circumstance and their worldviews.  

Inherent in the biopsychosocial and evidence based health models is the understanding that quality of life is a valuable factor in evaluating a person’s level of health and wellness. In fact, various methods have been developed to objectively measure quality of life and one of these includes measuring vitality.

In the United States, Health-Related Quality of Life & Well-Being is a distinct Topic Area in the Healthy People 2020 initiative. Despite our colleagues assertions, vitality can actually be measured and is done so routinely using objective, valid and reliable instruments. The Institute of Medicine recently released a report titled: Vital Signs: Core Metrics for Health and Health Care Progress. Number two on their list is the measuring of Well Being through the measuring of self reported health status.   

It is well accepted that the nervous system controls and coordinates all functions in the living body. It is also well accepted that vertebral subluxations alter neurological function in the human body. There is a growing body of scientific research demonstrating that reduction of vertebral subluxation leads to improved health outcomes and such health outcomes occur due to the improved vitality of the individual. The location, analysis, and correction of vertebral subluxation and the effects of such care is a well accepted, biologically plausible vitalistic construct.   

The blatant disregard of the evidence by these institutions should be a serious concern for all chiropractors, regulatory boards and trade organizations within the profession. They have misinformed the public and the very chiropractors and students they serve. Their statement has put chiropractors throughout the world in a compromising position.

The Foundation for Vertebral Subluxation calls on all chiropractors to denounce this Position Statement and urges these schools to retract or otherwise revise the statement so that it reflects the facts on the matter.