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“We were pleased to see a call from Prof Alan Breen (at the Anglo-European College of Chiropractic, and on two GCC committees) for a move beyond or supplement to evidence-based medicine in order to achieve a “more democratic and inclusive…age” in “musculoskeletal practice”. However, it is unfortunate that Breen fails to follow through on the implications of his demand…We were also surprised that – given the the British Chiropractic Association is currently pursuing a libel case against the science journalist Simon Singh – Breen did not speak up for Singh’s right to speak freely. After all, surely a democratic and inclusive approach to muskuloskeletal practice must keep open the possibility of robust criticism – and robust examinations of the empirical and theoretical bases for chiropractic. Regrettably, it appears that what Breen is moving towards is not democracy and inclusivity. As Sackett et al argue, evidence-based medicine aims to integrate individual clinical expertise with the best available external clinical evidence from systematic research. Evidence-based medicine therefore draws on the experiences of patients, clinicians and patients. In contrast, Breen seems to be moving towards a privileging of the experiences of a small subset of medical professionals – chiropractors and associated practitioners – and he seems to be advocating this privileging at the expense of numerous other stakeholders: from patients to researchers. Evidence-based medicine is certainly not perfect – and there are important areas in which it should be improved, supplemented or superseded. However, compared to Breen’s approach – an odd kind of chiropractic-centric obligarchy – evidence-based medicine is a much more promising approach.” Evidence Matters (27th June 2009)