On September 12, 1996, four days after her 45th birthday, Ontario resident Lana Dale Lewis died after suffering a stroke.

Lewis had been treated for migraine headaches by chiropractor Philip Emanuele. After her final visit she complained about the manner in which her neck had been manipulated and the intense pain which ensued. A couple of days after this visit, Lewis suffered a stroke. This was followed a few days later by a second stroke, which resulted in her death.

Dr. John Deck, neuropathologist from the Office of the Chief Coroner, Toronto, blamed the death on chiropractic manipulation. Deck said that there was no significant doubt in his mind that the chiropractic manipulation was the cause of the fatal stroke. His findings were certified by Dr. Robert Huxter, Regional Coroner for Ontario and by another Ontario coroner, Dr. Murray Naiberg.

An inquest was held into the death and ran from 2002 to 2004. At the inquest the Lewis family was represented by lawyers Amani and Neil Oakley. The Oakley’s previous cases had usually involved medical malpractice or human rights. Prior to taking on the Lewis case, they knew very little about chiropractic. They thought that it was used only for back pain, but further research showed that some chiropractors claimed they could treat a wide range of ailments, including allergies and cancer.

As the Oakleys delved deeper, they were shocked to learn how little evidence exists to back up the claims of chiropractors. While chiropractic uses a lot of jargon which sounds scientific, it is based on an untested hypothesis. Spinal manipulation is supposed to correct “subluxations” that interfere with the flow of innate energy through the body. According to chiropractic, this energy will flow properly only if the neck and spine are lined up properly.

The technique that chiropractors use for neck manipulation is quite different from that used by other health practitioners such as physiotherapists. Apparently it can make alarmingly loud crunching and cracking noises.

Chiropractors claim that everyone can benefit from their treatment. This includes healthy children, who they say may be suffering from subluxations caused by birth or normal childhood activities. They also claim that the risks of chiropractic treatment are small, and that the probability of a bad outcome is small. Amani Oakley however, whose firm now deals with many cases involving chirorparactic, counters that claim with a question: if a treatment has no benefit, then is any risk acceptable?

In a typical medical malpractice suit, the Oakleys generally argue that the treatment was not appropriate or was administered improperly. But it comes to chiropractic, they now take the position that someone coming in for maintenance care has no condition to be treated. If a specific ailment is being addressed, they argue there is insufficient evidence that the treatment accomplishes more than a placebo. In both cases, then, it seems inappropriate to take on any level of risk.

Before becoming lawyers, both Amani and Neil Oakley had obtained science degrees and had worked in the field. This helped them realize, after they started to delve into the inquest’s issues, that chiropractic has no solid science to support it. During the inquest they drew on their research to discredit the witnesses called to support neck manipulations and they laid out before the jury the evidence that such adjustments were dangerous.

Relying on arguments based on hard science, Amani was able to convince the jury in the Lewis case to return a verdict favourable to the family’s claims, even though she had to wrestle with countless procedural oddities. (For example, the counsel for the defence received three times as much time for its concluding statements since they had three sets of lawyers who represented the chiropractor, the chiropractic college, the chiropractors’ association and the chiropractors’ insurers.)

The victory in the Lana Dale Lewis case cast a harsh light on chiropractic and raised the public’s awareness of the risks of treatment. According to Amani, more people who go to chiropractors now tell them, “Don’t touch my neck.”