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Former FDA Commissioner Dr. Herbert Ley stated: "The thing that bugs me is that people think the FDA is protecting them. It isn't. What the FDA is doing and what the public thinks it's doing are as different as night and day." "If people let the government decide what foods they eat and what medicines they take, "Unless we put medical freedom into the Constitution, the time will come when medicine will organize into an underground dictatorship . . . To restrict the art of healing to one class of men and deny equal privileges to others will constitute the Bastille of medical science. All such laws are un-American and despotic and have no place in a republic. The Constitution of this republic should make special privilege for medical freedom as well as religious freedom." "Let food be thy medicine, thy medicine shall be thy food", said Hippocrates, the Father of Medicine, who compiled a list of over four hundred herbs and their uses. He also said, "Nature is the healer of all disease." The doctor of the future will give no medicine, but will interest his patients in the care of the human body, in diet, and in the cause and prevention of disease. -- Thomas Edison "Unless we put medical freedom into the Constitution, the time will come when medicine will organize into an underground dictatorship . . . To restrict the art of healing to one class of men and deny equal privileges to others will constitute the Bastille of medical science. All such laws are un-American and despotic and have no place in a republic. The Constitution of this republic should make special privilege for medical freedom as well as religious freedom." I am appalled at the prospect of using water as a vehicle for drugs. Fluoride is a corrosive poison that will produce serious effect on a long-range basis. Any attempt to use the water this way is deplorable. -- Charles Gordon Heyd, M.D., Past President, American Medical Association. "Everyone should know that the "War on Cancer" is largely a fraud." -- Dr Linus Pauling (Nobel Prize (Chemistry) 1954, Nobel Peace Prize 1962 "For the medical profession this era may well be one of the most shameful and ethically questionable periods of its history." -- Stanley Wohl, M.D. - The Medical Industrial Complex (1984) "Dr. James Watson won a Nobel Prize for determining the shape of DNA. During the 1970's, he served two years on the National Cancer Advisory Board. In 1975, he was asked about the National Cancer Program. He declared, 'It's a bunch of shit.' "In 1953, a United States Senate Investigation reported that a conspiracy existed to suppress effective cancer treatments. The Senator in charge of the investigation conveniently died. The investigation was halted. It was neither the first nor the last of a number of strange deaths involving people in positions to do damage to those running the nation's cancer program. "In 1964, the Food and Drug Administration (FDA) spent millions of dollars to stop an alternative cancer treatment which had cured hundreds, if not thousands, of cancer patients according to documented records. It was later disclosed that the FDA had falsified the testimony of witnesses. The FDA lost the court case because the jury found the defendants innocent and recommended that the substance be objectively evaluated. It never was. Instead, it was totally suppressed. "In the early 1960's, two New York City doctors, one associated with the leading cancer center in America and the other the medical director of a Brooklyn hospital, decided to inject live cancer cells into 22 unknowing patients. When they were discovered, Dr. Chester M. Southam of the Memorial Sloan-Kettering Cancer Center and Dr. E.E. Mandel of the Jewish Chronic Disease Hospital of Brooklyn were put on "probation" for a year. The three physicians who "blew the whistle" on Dr. Southam and Dr. Mandel were dismissed. "For many years, the American Medical Association (AMA) and the American Cancer Society (ACS) coordinated their "hit" lists of innovative cancer reseachers who were to be ostracized. One investigative reporter declared the AMA and ACS "for a network of vigilantes prepared to pounce on anyone who promotes a cancer therapy that runs against their substantial prejudices and profits." "In the late 1950's, it was learned that Dr. Henry Welch, head of the FDA's Division of Antibiotics, had secretly received $287,000 from the drug companies he was supposed to regulate. In 1975, an independent government evaluation of the FDA still found massive "conflicts of interest" among the agency's top personnel. "In 1977, an investigative team from the prominent Long Island newspaper Newsday found serious "conflicts of interest" at the National Cancer Institute (NCI). In 1986, an organized cover-up of an effective alternative cancer therapy, orchestrated by NCI officials, was revealed during Congressional hearings. "These examples are only the tip of a huge iceberg. The cancer establishment now has a 50-year history of vast corruption, incompetence and organized suppression of cancer therapies which actually work. Millions of people have suffered terrible torture and death because those in charge took payoffs, played it safe, had closed minds to the innovative, or simply were afraid to do what was obviously and morally right... "The doctor's union (AMA), the cancer bureaucracy (NCI), the public relations fatcats (ACS) and the cancer cops (FDA) are conspiring to suppress a cure for cancer.... It would be easy for any Congressional committee, major newspaper, television network or national magazine to confirm and extend the evidence presented here in order to initiate radical reform of the critical cancer areas--the hospitals, the research centers, the government agencies, and especially state and local legislation regarding cancer treatment. "But that will not happen without a struggle. Neither Congress nor the media desire to lift the manhole cover on this sewer of corruption and needless torture. Only organized, determined citizen opposition to the existing cancer treatment system has any hope of bringing about the long-needed changes. I expect the struggle to be a long, difficult one against tough, murderous opposition. The odds against success are heavy. The vested interests are very powerful.... " -- Barry Lynes, author of "The Healing of Cancer, The Cures-The Cover-ups and the Solution Now" Everything your family doctor, oncologist or other allopathic doctor has been told since medical school has been heavily influenced by the big drug companies, and by a host of government agencies and special interest groups dedicated to keeping the gravy train on track. The facts speak for themselves: Merck knew for years that their pain reliever Vioxx caused heart attacks and they tried to cover it up! A recent study found that millions of unnecessary surgeries are performed each year, and that millions of patients take drugs that harm them, don't help them, or for which there are safer, more effective, less expensive alternatives. It can take up to 10 years for a better treatment to replace an existing drug or surgical procedure. Meanwhile, you get the outdated, less effective (or dangerous) drug or procedure -- unless you know better. Today your health, freedom from pain and suffering -- even your life -- depend on your ability to separate fact from fiction. This is why YOU must take charge of your own health, not delegate it to someone else and then ask "permission" when you suspect that there might be a better treatment or alternative for a drug. -- BottomLine Publications The greatest mistake in the treatment of diseases is that there are physicians for the body and physicians for the soul, although the two cannot be separated. -- Plato It is a mathematical fact that fifty percent of all doctors graduate in the bottom half of their class. --Author Unknown It is a wise mans part, rather to avoid sickness, than to wishe for medicines. ~Thomas More, Utopia The art of medicine consists in amusing the patient while nature cures the disease. ~Voltaire (François Marie Arouet) Drugs are not always necessary. Belief in recovery always is. ~Norman Cousins Symptoms, then are in reality nothing but the cry from suffering organs. ~Jean Martin Charcot, translated from French Poisons and medicine are oftentimes the same substance given with different intents. ~Peter Mere Latham He's the best physician that knows the worthlessness of the most medicines. ~Benjamin Franklin The fact that your patient gets well does not prove that your diagnosis was correct. ~Samuel J. Meltzer The public blabbers about preventative medicine, but will neither appreciate nor pay for it. You get paid for what you cure. ~Martin H. Fischer One doctor makes work for another. ~English Proverb Doctors are just the same as lawyers; the only difference is that lawyers merely rob you, whereas doctors rob you and kill you, too. ~Anton Chekhov, Ivanov Formerly, when religion was strong and science weak, men mistook magic for medicine; now, when science is strong and religion weak, men mistake medicine for magic. ~Thomas Szasz, The Second Sin, 1973 Anyone who believes that anything can be suited to everyone is a great fool, because medicine is practised not on mankind in general, but on every individual in particular. ~Henri de Mondeville My soul is dark with stormy riot, Directly traceable to diet. ~Samuel Hoffenstein When diet is wrong, medicine is of no use. When diet is correct, medicine is of no need. ~Ayurvedic Proverb The Lord hath created medicines out of the earth; and he that is wise will not abhor them. ~Ecclesiasticus 38:4 Leave your drugs in the chemist's pot if you can heal the patient with food. ~Hippocrates Let nothing which can be treated by diet be treated by other means. ~Maimonides A physician is obligated to consider more than a diseased organ, more even than the whole man - he must view the man in his world. ~Harvey Cushing I am convinced digestion is the great secret of life. ~Sydney Smith Indigestion is charged by God with enforcing morality on the stomach. ~Victor Hugo The longer I live the less confidence I have in drugs and the greater is my confidence in the regulation and administration of diet and regimen. ~John Redman Coxe, 1800 Foolish the doctor who despises the knowledge acquired by the ancients. ~Hippocrates One-quarter of what you eat keeps you alive. The other three-quarters keeps your doctor alive. -- Hieroglyph found in an ancient Egyptian tomb. Doctors give drugs of which they know little, into bodies, of which they know less, for Diseases of which they know nothing at all. -- Voltaire The physician should not treat the disease but the patient who is suffering from it. -- Maimonides And we have made of ourselves living cesspools, and driven doctors to invent names for Our diseases. -- Plato When you are sick of sickness, you are no longer sick. -- Old Chinese Proverb The work of the doctor will, in the future, be ever more that of an educator, and ever less that of a man who treats ailments. -- Lord Horder All that man needs for health and healing has been provided by God in nature, the Challenge of science is to find it. -- Philippus Theophrastrus Bombast of Aureolus Paracelsus (1493-1541) If we doctors threw all our medicines into the sea, it would be that much better for our Patients and that much worse for the fishes. -- Supreme Court Justice Oliver Wendel Holmes, MD It is not... That some people do not know what to do with truth when it is offered to them, But the tragic fate is to reach, after patient search, a condition of mind-blindness, in which The truth is not recognized, though it stares you in the face. -- Sir William Osler, physician, 1849-1919 We must admit that we have never fought the homeopath on matters of principle. We fought them because they came into our community and got the business. -- Dr. J.N. McCormack, AMA, 1903 It's supposed to be a secret, but I'll tell you anyway. We doctors do nothing. We only help and encourage the doctor within. -- Albert Schweitzer, M.D. One of the biggest tragedies of human civilization is the precedents of chemical therapy over nutrition. It's a substitution of artificial therapy over nature, of poisons over food, in which we are feeding people poisons trying to correct the reactions of starvation. -- Dr. Royal Lee, January 12, 1951 The human body heals itself and nutrition provides the resources to accomplish the task. -- Roger Williams Ph.D. (1971) What makes me so certain that the natural human lifespan is far in excess of the actual one is this. Among all my autopsies (and I have performed over 1000), I have never seen a person who died of old age. In fact, I do not think that anyone has ever died of old age yet. We invariably die because one vital part has worn out too early in proportion to the rest of the body. -- Dr. Hans Selye God, in His infinite wisdom, neglected nothing and if we would eat our food without trying to improve, change or refine it, thereby destroying its life-giving elements, it would meet all requirements of the body. -- Jethro Kloss You cannot poison your body into health with drugs, chemo or radiation. Health can only be achieved with healthful living. -- T.C. Fry Health requires healthy food. -- Roger Williams Nutrition can be compared with a chain in which all essential items are separate links. We know what happens if one link of a chain is weak or is missing. The whole chain falls apart. -- Patrick Wright, Ph.D. What is impossible to see from the viewpoint of those who believe in cures is that the very symptoms the good doctors have suppressed and turned into chronic disease were the body's only means of correcting the problem! The so-called disease was the only cure possible! -- Dr. Philip Chapman - 1981 It is time to lay to rest the notion that germs jump into people and cause diseases. -- Emanuel Cheraskin, M.D., D.M.D. It seems that some consideration should be given to the cause of our mounting physical disabilities, but instead of going to the root of our troubles -- wrong habits of eating and drinking -- we rush to the medicine shelf and smother our uncomfortable and distressing symptoms under an avalanche of pills, potions and palliatives. -- Brother Roloff The consideration of man's body has not changed to meet the new conditions of this artificial environment that has replaced his natural one. The result is that of perceptual discord between man and his environment. The effect of this discord is a general deterioration of man's body, the symptoms of which are termed disease. -- Professor Hilton Hotema Vitality and beauty are gifts of Nature for those who live according to its laws. -- Leonard Da Vinci When you're green inside, you're clean inside. -- Dr. Bernard Jensen If people only knew the healing power of laughter and joy, many of our fine doctors would be out of business. Joy is one of Nature's greatest medicines. Joy is always healthy. A pleasant state of mind tends to bring abnormal conditions back to normal. -- Catherine Ponder DO GERMS CAUSE DISEASE? Or could it be the other way around... first the disease, then the germs? Natural Hygiene contends that germs do not cause disease. They are not the originators. Most diseases occur when people allow themselves to become enervated, that is, low in nerve energy and low in immunity. As a consequence, the organs of excretion fail to function normally and waste material accumulates in the body. When this waste continues to build up, exceeding the body's toleration point, a crisis arises. The body, to offset this overabundance of poisonous matter, begins to react. The result of this reaction is sometimes a cold, the flu, pneumonia, or some such, depending on the individual. At this crisis point of elimination, germs may or may not be present. They are sure to come later, not to attack, but to assist in the cleanup or cleansing process. -- Dr. Alec Burton Disease is the warning, and therefore the friend - not the enemy - of mankind. -- Dr. George S. Weger Actually bacteria are our symbiotic partners in both health and disease. They serve a useful role. As scavengers, they make harmless or remove undesirable substances within our bodies. They also elaborate certain of our body needs. That is, they help build complex organic compounds from simple ingredients. A notable example of this is the production of vitamin B-12 in our intestines. -- T. C. Fry Infection is no war in which the body is fighting invaders. The bacteria that come to these sites are symbiotic and help the body in elaborating dead cells and tissues for expulsion - they are partners in the cleanup process. When this has been accumulated, the bacteria disappear and the wound heals. Infection...is a body cleaning process for a body burdened with toxic materials. -- T. C. Fry Germs do not cause disease! Nature never surrounded her children with enemies. It is the individual himself who makes disease possible in his own body because of poor living habits... Do mosquitoes make the water stagnant; or does stagnant water attract the mosquitoes? We should all be taught that germs are scavengers attracted by disease, rather than enemies causing disease... As their internal environment is, so will be the attraction for any specific micro-organism... The germ theory and vaccination are kept going by commercialism. -- Dr. Robert R. Gross The absorption and organization of sunlight, the essence of life, is derived almost exclusively through plants. Since light is the driving force of every cell in our bodies, that is why we need green plants. -- Dr. Bircher-Benner The medical profession has worked itself into hysteria over the germ theory and is using it to exploit an all too credulous public. Germs are ubiquitous. They are in the air we breathe, the food we eat, the water we drink. We cannot escape them. We can destroy them only to a limited extent. It is folly to attempt to escape disease by attempting to destroy or escape germs. Once they are in the body, the physician has no means of destroying them that will not, at the same time, destroy the patient. We cannot avoid germs. We must be proof against them. We have to accept them as one of the joys of life. -- Dr. Herbert Shelton (Natural) Hygienists object to the germ theory of disease because germs do not cause disease. They may be present in disease processes, and they may complicate a disease with their waste products which can be very toxic at times, but the germ or virus alone is never the sole cause of disease. -- Dr. Virginia V. Vetrano Forgiveness, love and our connection with the Divine is the medicine that is healing the sickness of our time. -- J. Artos Roske When you see the Golden Arches you are probably on the road to the Pearly Gates. -- William Castelli, MD - Director, Framingham Heart Study I am appalled at the prospect of using water as a vehicle for drugs. Fluoride is a corrosive poison that will produce serious effects on a long range basis. Any attempt to use water this way is deplorable. -- Dr. Charles Gordon Heyd - Past President of the American Medical Association According to the World Health Organization (WHO), America is the 37th healthiest nation in the world. Basically the American Medical Association's team is in 37th place. When was the last time you took the word of a 37th place team as Gospel? Steve Plog - Founder, Results Project. "Organized medicine's campaign to eradicate cancer cures" (http://www.newstarget.com/019852.html): People may wonder why the American public hasn't heard of Hoxsey, if his treatments were so effective and cured so many. The answer is because large-scale, vicious attacks by U.S. health agencies eventually sent Hoxsey packing to Mexico, where he could finally practice herbal healing in relative peace. One might also wonder what "health" agency would ever knowingly drive a cure for cancer out of the country. The American Medical Association (AMA), the Food and Drug Administration (FDA) and the National Cancer Institute (NCI) would, just to name a few. Though a large part of the AMA's stated mission is to be "an essential force for progress in improving the nation's health," it was without a doubt Hoxsey's biggest enemy, and is largely responsible for driving him and his treatments out of the country. Morris Fishbein, editor of the Journal of the American Medical Association (JAMA) -- the AMA's flagship medical journal -- from 1924 to 1949, particularly targeted Hoxsey and his therapy, labeling Hoxsey a "quack" while simultaneously refusing to study his therapies or their efficacy. Fishbein went out of his way to sully Hoxsey's name in JAMA publications, and was eventually found guilty of libeling Hoxsey in two 1947 suits. "Fishbein had written an 'excoriating editorial' in JAMA titled 'Hoxsey -- Cancer Charlatan.' He also co-authored an article in the Hearst newspaper chain's weekly newsmagazine, titled 'Blood Money,'" writes Moss in "Herbs Against Cancer." Without evidence, Fishbein's JAMA articles attacked Hoxsey's treatment, claiming it "ate into blood vessels" and killed patients, Moss writes. What the American Medical Association hopes you never learn about its true history To most Americans, the concept of "nonprofit" goes hand-in-hand with trust. If a person or an agency isn't driven by money, they seem more likely to be trustworthy and unbiased. They should have the public's best interests at heart, right? The AMA claims to support "progress," but history shows that the AMA has worked diligently to block much in the way of real progress in order to control medicine and shut out competition. Consider chiropractic medicine, which is categorized as an "alternative" treatment by most Americans. It involves healing the human body through adjusting the spinal column and other musculoskeletal structures in the body. More than 60,000 chiropractors are practicing in the United States today, and 10,000 students are studying to become doctors of chiropractic medicine, or DCs. It is a legitimate medical practice that often solves medical problems conventional medicine can't. As an agency that proclaims itself to be concerned with improving the nation's health, the AMA has a duty to accept the field of chiropractic medicine as having proven medicinal value. But history shows just the opposite. Until recently, the AMA viewed chiropractors as competition and tried to destroy the practice of chiropractic medicine in its entirety. In When Healing Becomes and Crime, Kenny Ausubel writes, "For over 12 years and with the full knowledge and support of their executive officers, the AMA paid the salaries and expenses for a team of more than a dozen medical doctors, lawyers and support staff for the expressed purpose of conspiring (overtly and covertly) with others in medicine to first contain, and eventually, destroy the profession of chiropractic in the United States and elsewhere." This was not speculation. The actions taken by the U.S. Court of Appeals 7th circuit support Ausubel's accusation. In 1990, chiropractic doctors Chester A. Wilk, James W. Bryden, Patricia B. Arthur and Michael D. Pedigo won a landmark antitrust lawsuit against the AMA. The court ruled that the AMA had violated the Sherman Act by "conducting an illegal boycott in restraint of the trade directed at chiropractors generally, and at the four plaintiffs in particular." This 1990 verdict against the AMA followed three other antitrust cases against the association in 1978, 1980 and 1986, all of which were settled. The fact that the AMA tried to eliminate the profession of chiropractic is fairly well known in the medical community. But there are other skeletons in the AMA's closet that aren't as well known. Have you ever heard of Morris Fishbein? The University of Chicago's Center for History of Science and Medicine is named after him. He was editor of the Journal of the American Medical Association (JAMA) from 1924-1949. Oh, and he was a racketeer, too. Fishbein apparently operated the AMA for the sole purpose of dominating medicine and discrediting anything he could not control. He also masterminded a scam where he determined what products were fit to carry the AMA's "seal of acceptance" and then accepted money from the manufacturers of those products in exchange for permission to use the AMA seal. But in reality, the association had no facilities in which to conduct tests of foods or drugs to evaluate their so-called "fitness." Gaining the seal was merely a matter of paying Fishbein shady advertising fees to feature the products in AMA publications. Those fees were in fact "protection" fees paid to keep AMA membership. As editor of JAMA, Fishbein had full control over what information reached the public and what did not. Thanks to Fishbein, you most likely haven't heard of the Rife Beam Ray. It is a holistic treatment for cancer and infectious diseases. Fishbein single-handedly stifled its research when he learned of the technology. "Sadly, the research was suppressed by medical authorities under the covert direction of Morris Fishbein … who sought to buy into and control the use of the Rife Beam Ray," writes Richard Gerber, author of Vibrational Medicine. "Fishbein (who was later convicted of racketeering charges) was spurned by Rife [creator of Beam Ray treatment] when he attempted to buy into his company. In response, Fishbein decided that if he could not control the therapy, he would suppress it." Although Fishbein's legacy is tainted with corruption and his misuse of an agency the public trusts, he is remembered by many as the AMA's spokesman for medical orthodoxy, which advocates sticking to what is commonly accepted, customary or traditional. Take the case of Hoxsey Cancer Clinic in Dallas, which was the world's largest private cancer center in the 1950s. Harry Hoxsey, the clinic's founder, was a self-taught healer who treated cancer patients with herbal folk remedies that proved amazingly effective. "A Dallas judge ruled in federal court that Hoxsey's therapy was 'comparable to surgery, radium and x-ray in its effectiveness, without the destructive side effects of those treatments'," writes Dr. John Heinerman in Natural Pet Cures. "[Hoxsey] faced unrelenting opposition and harassment from a hostile medical establishment. [But] even his archenemies, the American Medical Association and the Food and Drug Administration, admitted that his treatment could cure some forms of cancer." Despite the courts' approval of Hoxsey's treatment, the Dallas clinic was shut down in the 1950s at the end of the McCarthy Era. "The AMA, NCI (National Cancer Institute), and FDA organized a 'conspiracy' to 'suppress' a fair, unbiased assessment of Hoxsey's methods, according to a 1953 report to Congress," writes Heinerman. But that was all in the 50s. Surely the AMA has improved with time, right? Perhaps not. According to a 1998 article in The New York Times, the AMA paid Sunbeam Corp. $9.9 million to avoid a breach-of-contract trial with the company after pulling out of a five-year, multi-million-dollar endorsement deal. The AMA would have made millions of dollars in royalties by endorsing Sunbeam's blood pressure monitors, humidifiers and other products, but the association backed out of the deal after being criticized because it had no plans to test the products. The AMA had basically made a profit-making deal to endorse products they had no plans of testing beforehand. The AMA only pulled out once the public got wind of the deal. Does this situation sound familiar? It sounds a bit Fishbein-esque; although Fishbein's "seal of acceptance" program was abandoned in 1955 after a lawsuit was brought against the AMA. It was settled out of court – much like the Sunbeam suit. After the settlement with Sunbeam, the AMA said it was "now fully focused on its historic mission to serve America's patients and the quality of American medicine." What, then, had been its focus before the Sunbeam settlement? Was it making money? Was it controlling what medical information is "fit" to reach the American public? Despite the fact that the AMA is stated to be a nonprofit association, it nevertheless has a troublesome history of focusing on money and control. Even its longtime campaign against chiropractic medicine appears grounded in money-making motives, since the association was attempting to eliminate orthodox medicine's "competition." Today, the AMA boasts that its core purpose is "to promote the science and art of medicine and the betterment of public health." The AMA further claims "only the AMA has the national voice, the reputation and the stature to be a strong advocate for physicians and their patients." Reputation? For those inclined to place trust in the "reputation" and "stature" of the AMA, just take a look at the association's history. In doing so, you will find an organization operated with questionable ethics. Even today, the AMA continues to make decisions obviously designed to protect organized medicine, not patients. For example, the AMA is right now engaged in the following actions: Refusing to support the ban of direct-to-consumer drug advertising, a dangerous phenomenon that is partly responsible for the vast over-prescribing of prescription drugs that are right now killing 100,000 Americans each and every year. Continuing to accept tens of millions of dollars each year in advertising funds from drug companies whose products dominate the pages of the Journal of the American Medical Association. Many of the drugs advertised in JAMA are, in fact, the very same drugs that are right now killing tens of thousands of Americans each year, according to senior drug safety researchers at the FDA. This massive funding of the AMA by drug companies creates a clear conflict of interest. The experts speak on the AMA and Fishbein Cigarette manufacturer Philip Morris, the Journal's biggest single advertiser, also ran into some problems. Blitzing the AMA Journal and thirty-one state and regional medical journals, the start-up tobacco company was eager to publicize its innovative use of diethylene glycol as a hygroscopic agent (to retain moisture), in place of the glycerin used by other manufacturers. Philip Morris pegged its campaign on hyping the breakthrough that its cigarettes were consequently "less irritating to the throat." When the corporation approached the Journal with its ads, Dr. Fishbein courteously advised it how to go about conducting acceptable scientific testing to validate its unsubstantiated claims and thereby qualify. The cigarette manufacturer was eager to link its product with health benefits, and Dr. Fishbein saw a vast new opportunity for revenues from nonmedical products, despite the fact that by this time in the 1930s medical journals were already publishing studies associating smoking with lung cancer. The company completed its testing at the Columbia University College of Physicians and Surgeons with findings that the cigarettes with diethylene glycol caused three times less swelling than other brands. The company used these studies to launch its medical ad campaign, while supplying free smokes to doctors. One Journal ad read, "Patients with coughs were instructed to change to Philip Morris cigarettes. In three out of four cases, the coughs disappeared completely. When these patients changed back to cigarettes made by the ordinary method of manufacture, coughs had returned in one third of the cases. This Philip Morris superiority is due to the employment of diethylene glycol." (Note: this is what was substituted for glycerin in toothpastes, cough syrups, etc. recently by the Chinese and which killed hundreds of people and sickened many others). The AMA was also composed almost entirely of male doctors and there were many swipes at women in Fishbein's writing. It is interesting from a sociological point of view that nutrition and herbalism were opposed, in part, because they were associated with women. For example, Fishbein considered Eclecticism "the apotheosis of the old grandmother and witch-doctor systems of treatment." It arose out of "the medical practice of an old-woman herb doctor." Herbal remedies, built up over decades of careful observation, were mockingly derided as "veritable vegetable soups". Fishbein considered anything traditional in medicine to be abhorrent. He saw the botanical drugs of the late 19th century as "almost a replica of the herbals of the 17th and 18th century Europe." ...Of course, the vast majority of phytochemicals now known to reside in plants and herbs (many with unique physiological effects) were undreamed of in Fishbein's day. To put it colloquially, he was simply blowing smoke. While the AMA was successful in eliminating most competition, Fishbein became concerned, and then obsessed, by "the worst cancer quack of the century," Harry Hoxsey. One of the landmark days in the recent history of alternative medicine in the U.S. was August 27, 1987. On that day, District Judge Susan Getzendanner found the American Medical Association (AMA) and fourteen associated parties guilty of waging a conspiracy against chiropractors to contain and eliminate them entirely, in violation of the Sherman Antitrust law. …the fourteen litigators probably cost AMA at least $15 million. Fishbein's early success combating quackery revealed to him a gold mine of limitless possibilities. In rapid-fire succession he cranked out three books: Fads and Quackery, Medical Follies, and The New Medical Follies. "As one reads the rolls of fakirs down through the ages," Fishbein gleefully penned, "one becomes almost convinced of the doctrine of transmigration of souls." Dr. Fishbein also utilized the "Devil theory of history," as one observer put it, exemplified by his quackdown. In Medical Follies, he dubbed the profession of chiropractic a "malignant tumor" whose theory was "so simple that even farm-hands can grasp it. It has been said that osteopathy is essentially a method of entering the practice of medicine by the back door. Chiropractic, by contrast, is an attempt to arrive through the cellar. The man who applies at the back door at least makes himself presentable. The one who comes through the cellar is besmirched with dust and grime; he carries a crowbar and he may wear a mask." Under Dr. Fishbein's direction, the AMA Bureau of Investigation's quack files swelled to a prodigious 300,000 names. ...Even the American Medical Association (AMA) was complicit in suppressing results of tobacco research. In 1964, the Surgeon General's report condemned smoking, however the AMA refused to endorse it. … …. By the 1950s, the Hoxsey Cancer Clinic in Dallas was the world's largest private cancer center, -with branches in seventeen states. Born in Illinois, the charismatic practitioner of herbal folk medicine faced unrelenting opposition and harassment from a hostile medical establishment. Nevertheless, two federal courts upheld the 'therapeutic value' of Hoxsey's internal tonic. Even his archenemies, the American Medical Association and the Food and Drug Administration, admitted that his treatment could cure some forms of cancer. A Dallas judge ruled in federal court that Hoxsey's therapy was 'comparable to surgery, radium, and x-ray' in its effectiveness, without the destructive side effects of those treatments.' But in the 1950s, at the tail end of the McCarthy era, Hoxsey's clinics were shut down. The AMA, NCI [National Cancer Institute], and FDA organized a 'conspiracy' to 'suppress' a fair, unbiased assessment of Hoxsey's methods, according to a 1953 federal report to Congress." The campaign was wildly successful and established Philip Morris as a major tobacco player, until, in 1937, seventy-two people died as a result of using a drug called Sulfanalamide Massengill. With help from the AMA itself, the toxic agent was determined to be diethylene glycol. Dr. Fishbein hit the ground backpedaling. He defended his advertiser in an editorial by saying "There is no evidence that the ordinary use of diethylene glycol in industry, or as an ingredient in the manufacture of cigarettes, is harmful." The company was so grateful that it offered him a retainer for his services, which he refused, tipping his editor's public health hat. Other cigarette manufacturers quickly followed suit in their entry into the medical market using physician testimonials. More Doctors smoke Camels than any other cigarette was the slogan at Camel's exhibit at the 1947 AMA convention. Only in the 1950s, when overwhelming evidence of the causation of lung cancer by smoking reached the public, did the Journal stop accepting tobacco ads, though Dr. Fishbein was by then serving as a paid consultant to the Lorillard tobacco company. Through its Members' Retirement Fund, the AMA continued to own tobacco stock in the seven figures until the mid-1980s. Numerous physicians complained of other high-pressure tactics from Chicago. Dr. George Starr White, a respected physician who lectured extensively to doctors and reputedly had the largest private practice in the country, described how two doctors from AMA headquarters approached him with a proposition. The AMA could not survive on membership dues alone, and without the income secured by him, the Association would undoubtedly flounder. The key to financial solvency for the organization has been its monthly publication, the AMA Journal. It was begun in 1883 by Dr. Simmons as a last-ditch effort to save the infant association from bankruptcy. Its first press run was 3,500 copies and sold at a subscription rate of five dollars per year. But it was anticipated that the bulk of the revenue would be derived from advertisers. By 1973, under the tight control of Managing Editor Dr. Morris Fishbein, it had a print run of almost 200,000 copies each month and had extended its publication list to include twelve separate journals including the layman's monthly, Today's Health. Altogether the AMA now derives over ten million dollars per year in advertising, which is almost half of the Association's total income. Who advertises in the AMA Journal and related publications? The lion's share is derived from the Pharmaceutical Manufacturer's Association whose members make up ninety-five percent of the American drug industry. The National Council Against Health Fraud (NCAHF) is widely considered the unofficial propaganda arm of the American Medical Association. After a federal court ruling that found the AMA and other medical organizations had conspired to disseminate misinformation about chiropractic in an attempt to destroy its "competition," the NCAHF became the front man for the attack. When Dr. Fishbein took the stand under cross-examination, the digging done by Hoxsey's lawyers paid off. Under oath, Dr. Fishbein made shocking admissions. He failed anatomy in medical school. He never completed his internship before going to work at the Journal. He never practiced a day of medicine or treated a single patient in his entire career. Dr. Fishbein was sweating profusely by the time he left the stand. His definition of a quack as "one who pretends to medical skill he does not possess" now reflected back in an unseemly mirror. One may ask why no one has heard of the Rife Beam Ray if it had such a high success rate in treating cancer and infectious diseases. Sadly, the research was suppressed by medical authorities under the covert direction of Morris Fishbein, a powerful editor of JAMA (the Journal of the American Medical Association) who sought to buy into and control the use of the Rife Beam Ray. Fishbein (who was later convicted of racketeering charges) was spurned by Rife when he attempted to buy into his company. In response, Fishbein decided that if he could not control the therapy, he would suppress it. … The American Medical Association had just been convicted in federal court of a "conspiracy to destroy and eliminate" the chiropractic profession." The court judgment was unequivocal. "For over twelve years and with the full knowledge and support of their executive officers, the AMA paid the salaries and expenses for a team of more than a dozen medical doctors, lawyers, and support staff for the expressed purpose of conspiring (overtly and covertly) with others in medicine to first contain, and eventually, destroy the profession of chiropractic in the United States and elsewhere." Also convicted with the AMA were the American College of Surgeons and the American College of Radiologists. Historically, this was a period in which the AMA had recently established its hegemony over American medicine. It was headed by Morris Fishbein, a pugnacious physician who was to make himself infamous in the eyes of many advocates of unconventional cancer therapies for his attacks on Gerson, Hoxsey, and other pioneers of unconventional therapies. It is no surprise to me that Fishbein, faced with congressional hearings inimical to conventional cancer treatment and AMA hegemony, went on the attack. The details of the process by which the AMA destroyed Gerson's professional reputation have been described by Ward and others. Gerson lost his hospital affiliation and was denied malpractice insurance: The Journal, after all, solicits advertisers to pay top dollar for its pages, whose 750,000 circulation still commands the greatest market share of doctors (including fifteen international editions in 150 countries). The lure of advertising profits continues to compete with the impartiality of "scientific medicine." The AMA medical publicity machine Dr. Fishbein founded is running in perpetual overdrive today. The "JAMA Report," a video news release, goes out weekly on satellite to every TV network and local station in the United States, reaching between 25 and 110 million viewers. Most major newspapers routinely scan JAMA for breaking stories, as do wire services and radio. The AMA also floods about 2,500 press outlets worldwide with weekly e-mails and faxes. The credibility of the AMA's vaunted Code of Ethics, which ostensibly puts the profession of healing above business, is in tatters today. In 1998 the AMA once again was mired in negative publicity as the Seal of Acceptance experienced its latest devaluation. After the AMA granted the Sunbeam corporation an exclusive product endorsement for the manufacturer's medical devices without even testing them, the medical association was set to receive millions of dollars in licensing fees, which it planned to use to offset declining membership dues. Outrage from the medical community and other competing companies crashed the nakedly commercial transaction. The mass media roasted the AMA's signature cupidity. Historian Harris Coulter, PhD, has called Eclecticism "a more sophisticated system of practice drawing on the same intellectual and philosophical sources" as Thomsonianism (86). However, they had no systematic theory of diagnostics or pharmacology, and basically accepted allopathic medicine's systems, substituting their own vegetable cures. Regular and Eclectic physicians competed for the same clients and generally despised each other. JAMA editor Morris Fishbein, MD, called Eclecticism "the apotheosis of the old grandmother and witch-doctor systems of treatment" (132). He championed chemotherapy and denied any utility to herbs, whatsoever. In 1912, 1921 and 1936, the AMA issued three volumes called Nostrums and Quackery. These described the "evils" of patent medicines, which a few years before had been a mainstay of the Journal of the American Medical Associations revenue. In 1927, Morris Fishbein, MD, the editor of JAMA, issued a popular book that included an "Encyclopedia of Cults and Quackery." Fishbein saw "cults" everywhere. It is amusing that he even considered beauty parlors to be part of the medical cult phenomenon. And he filled page after page with descriptions of cults from Aero- to Zonotherapy. "The appeal of the bizarre is strong even to enlightened men," wrote the enlightened Fishbein. "To a public educated to a belief in the black art, magic, alchemy, and the miracles of the saints, the unusual necessarily has an absolute fascination. Medicine in this way became inordinately complex and chaotic". Fishbein and his colleagues set out to make medicine simple and well organized, by centralizing everything under the control of the AMA. They especially aimed at the destruction of Eclecticism and its heirs. This set the stage for the great battle of the 20th century concerning herbs and cancer, the Hoxsey saga. Throughout Hoxsey's era, organized medicine denied any link between diet and cancer. As Dr. Morris Fishbein contended, "There is no scientific evidence whatsoever to indicate that modification in the dietary intake of food or any other nutritional essentials are of any specific value in the control of cancer." Science has since contradicted him. In general terms, contemporary research has shown that the Hoxsey diet does directly serve important anticancer functions. Over the years Fishbein not only established himself as the gifted editor of the most widely read medical journal in the United States; he also learned how to extend his editorial position, how to project his opinions nationwide. He became, as the saying went in those years, a "personality." TIME referred to him as "the nation's most ubiquitous, the most widely maligned, and perhaps most influential medico." In addition to his development of JAMA as an editorial and personal voice, Fishbein also continually railed against "quackery." In a brief twenty years, the AMA came to dominate medical practice through brute financial force, political manipulation, and professional authority enhanced by rising public favor with "scientific" medicine. The AMA emerged as the supreme arbiter of medical practice, making binding pronouncements regulating even the most picayune details. American medicine surged forward as a profit-driven enterprise of matchless scope. By the time Dr. Morris Fishbein assumed the mantle of Dr. Simmons, who had himself started out as a homeopath, the AMA was at the helm of a strapping new industry flying the allopathic flag. The code word for competition was quackery. Rife's discovery was mysteriously burned to the ground. Rife was dragged through the California court system on trumped-up charges. So powerful were Fishbein's connections to major medical groups of the day that many doctors who were successfully using the Rife Beam Ray had to cease their use of it for fear of being blacklisted. Because the Rife Beam Ray was suppressed by greedy, unscrupulous people, this cure for cancer was buried and nearly forgotten. It turns out that Rife was not the only researcher experimenting with using an electromagnetic field device to treat cancer. Dr. Fishbein's crusade to eliminate the irregulars played no small part in the AMA's financial success by throttling economic competition. While member dues accounted for half the AMA's revenues, the balance flowed from the Journal, now the most profitable publication in the world. Flush with revenues, it soon became known as "the tail that wagged the dog." In addition, the Journal owned or controlled another half-dozen medical journals along with the thirty-five state society journals, with advertising revenues of over $2 million, a huge sum in those days. The AMA's core mission of preserving the power, privilege, and financial prosperity of doctors has established it as an organization "notorious for confrontation, ultimatums, and hardball politics".17 Its political action committee, AMPAC, has given over $100 million over the last twenty years to 83 percent of federal congressional representatives and senators. The AMA actually owns the very building in the nation's capital that the government leases for its federal political action committee monitoring program. Morris Fishbein became a lot more to the AMA than his title of Managing Editor would suggest. He was its chief executive and business manager. He brought in the money and he decided how it was spent. His investments on behalf of the Association were extremely profitable, so the grateful membership could not, or at least dared not, complain too bitterly. One of the reasons for this investment success was that over ten-million dollars of the organization's retirement fund had been put into leading drug companies. http://query.nytimes.com/gst/fullpage.html?res=9C0CEED81F3FF93AA35751C0A966958260 A Federal appeals court has upheld a 1987 ruling that the American Medical Association violated antitrust laws by trying to destroy the chiropractic profession. On Wednesday, the United States Circuit Court of Appeals for the Seventh Circuit affirmed the finding of Federal District Judge Susan Getzendanner, who barred the medical association from boycotting chiropractors, whose treatment is manipulation focusing on the spine. George McAndrews, a lawyer for the chiropractors, said the rights they want include ''fair treatment by tax-supported institutions, hospitals, insurance plans, H.M.O.'s and other groups that have burdened those patients with anticompetitive barriers.'' A.M.A. policy, the plaintiffs charge, has prevented doctors from referring patients to chiropractors or taking referrals from them. The doctors were accused of preventing chiropractors from treating patients at hospitals controlled by medical doctors. Association's Curbs Enjoined On Sept. 25, 1987, Judge Getzendanner, who has since retired, permanently enjoined the A.M.A. from ''restricting, regulating or impeding'' its 275,000 members or hospitals where they work from associating with chiropractors. Earlier she found a conspiracy ''to contain and eliminate the chiropractic profession.'' A three-judge appellate panel ruled that Judge Getzendanner had reached a ''reasonable'' decision. The panelists were Judges David Manion, Harlington Wood Jr. and Kenneth Ripple. She ''found a cognizable danger of recurrent violations, was unimpressed with the A.M.A.'s expressed intent to comply with antitrust laws, was unpersuaded by the effectiveness of the A.M.A.'s discontinuance of its boycott and properly considered the systematic and long-term nature of the boycott,'' the appeals panel said. Internal Amendment Is Directed Judge Getzendanner also directed the A.M.A. to publish a copy of her order in the Journal of the American Medical Association and mail all of its members and employees copies. She also required that the association amend its Current Opinions of the Council on Ethical and Judicial Affairs, guidelines on ethical behavior to reflect that it is ethical to associate with chiropractors. The lawsuit, filed in 1977 by four chiropractors, did not seek money damages but challenged the medical doctors' refusal to acknowledge chiropractors' professional abilities. http://www.chirobase.org/08Legal/AT/at00.html The Order of Permanent Injunction issued by the Court requires the AMA to send copies of the Order of Injunction to each of its 275,000 members, to modify the official AMA Judicial Council Opinions and Reports to reflect the AMA's representations to the Court that it is now "ethical for a medical physician to professionally associate with chiropractors provided the physician believes that such an association is in the best interest of its patient," and to publish the Injunction Order in the Journal of the American Medical Association. The AMA, which in 1963 commenced working aggressively, in the words of the Court, to "overtly and covertly" eliminate the profeseion of chiropractic.in the United States, found itself on the day the injunction was issued precisely where it was in 1963 - standing alone. In the lost three days prior to the issuance of the Court's injunction against the AMA, codefendants American College of Radiology and the American College of Surgeons reached settlement agreements with the four plaintiff chiropractors terminating the litigation as to them in return for policy statements of those organizations to their members affirming the right of their members to freely associate with doctors of chiropractic in hospitals, private practice, research, educational endeavors and any other legal setting. Both the ACS and the ACR made payments of $200,000.00 - the ACS payment being made to Kentuckiona Children's Center in Louisville, Kentucky, a home for mentally and physically retarded children, which, the evidence in the trial demonstrated, was the victim of a concerted effort by various medical associations to either close the Center or forbid medical physicians to cooperate with the Center's founder Dr. Lorraine Golden, a chiropractor, in the health care of the children. With the support of the City of Louisville, Kentuckiano has just launched an aggressive expansion program to build new facilities to care for up to 1,000 mentally and physically retarded children and the $200,000.00 gift by the American College of Surgeons is the first contributions to the fund drive for the expansion. The $200,000.00 payment by the American College of Radiology was to help defray the plaintiff chiropractors' legal expenses in bringing the suit. Chiropractic Antitrust Suit In a 101-page opinion, Judge Getzendanner ruled that the American Medical Association and its co-conspirators had violated the Sherman Antitrust Laws of the United States. Judge Getzendanner ruled that they had done this by organizing a national boycott of doctors of chiropractic by medical physicians and hospitals using an ethics ban on interprofessional cooperation. Evidence at the trial showed that the defendants took active steps, often covert, to undermine chiropractic educational institutions, conceal evidence of the usefulness of chiropractic care, undercut insurance programs for patients of chiropractors, subvert government inquiries into the efficacy of chiropractic, engage in a massive disinformation campaign to discredit and destabilize the chiropractic profession and engage in numerous other activities to maintain a medical physician monopoly over health care in this country. Judge Getzendanner ruled: I conclude that an injunction is necessary in this case. There ore lingering effects of the conspiracy; the AMA has never acknowledged the lawlessness of its post conduct and in fact to this day maintains that it has always been in compliance with the antitrust laws; there has never been an affirmative statement by the AMA that it is ethical to associate with chiropractors; there has never been a public statement to AMA members of the admission made in this court about the improved nature of chiropractic despite the fact that the AMA today claims that it made changes in its policy in recognition of the change and improvement in chiropractic; there has never been public retraction of articles such as "The Right and Duty of Hospitals to Deny Chiropractor Access to Hospitals"; a medical physician has to very carefully read the current AMA Judicial Council Opinions to realize that there has been a change in the treatment of chiropractors and the court cannot assume that members of the AMA pore over these opinions*, and finally, the systematic, long-term wrongdoing and the long-term intent to destroy a licensed profession suggests that an injunction is appropriate in this case. When all of these factors are considered in the context of this "private attorney general" antitrust suit, a proper exercise of the court's discretion permits, and in my judgment requires, an injunction. (Opinion pp. 11). Evidence in the case demonstrated that the AMA knew of scientific studies implying that chiropractic care was twice as effective cis medical care in relieving many painful conditions of the neck and back as well as related musculoskeletal problems. The court concluded: There also was some evidence before the Committee that chiropractic was effective - more effective than the medical profession in treating certain kinds of problems such as workmen's back injuries. The Committee on Quackery was also aware that some medical physicians believed chiropractic to be effective and that chiropractors were better trained to deal with musculoskeletal problems than most medical physicians. (Opinion pp. 7) The Opinion found: The AMA and its officials, including Dr. Sammons, instituted a boycott of chiropractors in the mid-1960s by informing AMA members that chiropractors were unscientific practitioners and that it was unethical for a medical physician to associate with chiropractors. The purpose of the boycott was to contain and eliminate the chiropractic profession. This conduct constituted a conspiracy among the AMA and its members and an unreasonable restraint of trade in violation of Section I of the Sherman Act. The AMA sought to spread the boycott to other medical societies. Other groups agreed to participate in the boycott by agreeing to induce their members to forego any form of professional, research, or educational association with chiropractors. The defendants which knowingly joined in the conspiracy were ACS, ACR, and AAOS. None of the defendants established the patient care defense. The plaintiffs are entitled to injunctive relief against the AMA, ACS, and ACR, but not against AAOS or Dr. Sammons. The court shall conduct further proceedings regarding the form of the injunction. The actions of the other defendants, JCAH and ACP, were taken independently of the AMA boycott and these defendants did not join the conspiracy. Accordingly, defendants JCAH, ACP, AAOS and Dr. Sammons are dismissed. (Opinion pp. 2) The Committee on Quackery disbanded in December 1974 and considered its activities a success: The AMA believed that chiropractic would hove achieved greater growth if it had not been for the Committee's activities. (opinion pp. 4) The Court of Appeals stated that enforcement of a code of ethics was not necessary to obtain compliance with the boycott: The anti-competitive effects of the boycott were generally conceded by the defendants' expert, William J. Lynk of Lexecon, Inc. Some of the anticompetitive effects acknowledged by Mr. Lynk include the following: it is anti-competitive and it raises costs to interfere with the consumer's free choice to take the product of his liking; it is anti-competitive to prevent medical physicians from referring patients to a chiropractor; it is anti-competitive to impose higher costs on chiropractors by forcing them to pay for their own x-ray equipment rather than obtaining x-rays from hospital radiology departments or radiologists in private practice; and it is anti-competitive to prevent chiropractors from improving their education in a professional setting by preventing medical physicians from teaching or lecturing to chiropractors. Mr. Lynk agreed that in an economic sense a boycott such as the one described by plaintiffs raises the costs of chiropractic services and creates inefficiencies and economic dislocations. (Opinion pp. 6) The anti -competitive effects of the AMA boycott were established by defendant's witnesses: The activities of the AMA undoubtedly have injured the reputation of chiropractors generally. This kind of injury more likely than not was sustained by the four plaintiffs. In my judgment, this injury continues to the present time and likely continues to adversely affect the plaintiffs. The AMA has never made any attempt to publicly repair the damage the boycott did to chiropractors' reputations. (Opinion pp. 10). ORDER Based on the findings of fact and conclusions of low set forth in this opinion, the case is dismissed against defendants JCAH, ACP, AAOS, and Dr. Sammons, and an injunction shall issue against defendants AMA, ACS, and ACR. The plaintiffs and the AMA, ACS, and ACR, are directed to confer on the form of injunction and to report to the court on the progress of those discussions. The case is set for an in-chambers conference on September 4, 1987 at 3:00 P.M. It is so ordered. August 27, 1987 Memorandum Opinion and Order: In 1964, the Committee's primary goal was to contain and eliminate chiropractic. Throughout the 1960s and early 1970s, H. Doyl Taylor, the chairman of the Department of Investigation, repeatedly described the Committee's prime mission to be the containment and elimination of chiropractic as a recognized health care service. I found his video deposition denials, and his explanation that at all times he and the Committee only meant to eliminate chiropractic as a health hazard, incredible and unworthy of belief. Mr. Taylor believed that chiropractic was based on a "single cause -- single cure" theory of disease and that given this baseless foundation, the entire profession should be "swept away." The Committee worked aggressively to achieve its goals in several areas. it conducted nationwide conferences on chiropractic; prepared and distributed numerous publications critical of chiropractic; assisted others in the preparation and distribution of anti-chiropractic literature; regularly communicated with medical boards and associations, warning that professional association between medical physicians and chiropractors was unethical; and attempted to discourage colleges, universities, and faculty members from cooperating with chiropractic schools. [The Committee worked to influence legislation on the state and federal levels and engaged in informational activities to inform the public on the nature of chiropractic. All of this activity is protected under the Noerr-Pennington doctrine, and I have not relied on any such conduct in reaching any conclusion in this case. The Wilk Court specifically approved the jury instruction used in the first trial that stated that defendants advocacy activity directed to legislative and administrative agencies, or bodies was protected if the "defendants undertook such efforts to influence governmental bodies with a sincere purpose to obtain the governmental actions that they sought." 719 F.2d at 229.] In 1966, the AMA adopted an anti-chiropractic resolution. This resolution, recommended by the AMA Board of Trustees and adopted by the House of Delegates, called chiropractic an unscientific cult. This label implicitly invoked Principle 3 of the AMA's Principles which made it unethical for a physician to associate with on unscientific practitioner. In 1967, the AMA Judicial Council issued an opinion under Principle 3 specifically holding that it was unethical for a physician to associate professionally with chiropractors. [The Judicial Council is now known as the Council on Judicial and Ethical Affairs, but I shall refer to it in this opinion by its original name.] "Associating professionally" would include making referrals of patients to chiropractors, accepting referrals from chiropractors, providing diagnostic, laboratory, or radiology services for chiropractors, teaching chiropractors, or practicing together in any form. This opinion was published in the 1969 Opinions and Reports of the Judicial Council of the AMA ("1969 opinions") which was widely circulated to members of the AMA. The opinion on chiropractic was also sent by the AMA to 56 medical specialty boards and associations. The AMA and the Committee on Quackery used the anti-chiropractic policy statement as a tool -- what the Committee called a necessary tool" -- to spread the boycott to other medical groups. The Committee's efforts were successful. Other groups, including some of the defendants, specifically adopted or approved the policy statement on the ethical prohibition against association with chiropractors. In 1971, the Committee made a report of its activities to the AMA Board of Trustees and described the policy statement as follows: This was the necessary tool with which your Committee has been able to widen the base of its chiropractic campaign. With it, other health-related groups were asked and did adopt the AMA policy statement or individually-phrased versions of it. These, in turn led to even wider acceptance of the AMA position. The hoped-for effect of this widened base of support was and is to minimize the chiropractic argument that the campaign is simply one of economics, dictated and manipulated by the AMA. The memorandum further stated: The Committee has not submitted such a report (earlier) because it believes that to make public some of its activities would have been and continues to be unwise. Thus this report is intended only for the information of the Board of Trustees. Principle 3 was widely viewed as proscribing association with chiropractors. The four defendants who issued the Status Report on Chiropractic Lawsuits in 1978 acknowledged in that Report that Principle 3 proscribed association with chiropractors. Any reasonable medical physician who read Principle 3 and either the AMA policy statement or any AMA reference to chiropractors as unscientific practitioners, would conclude that it was unethical for medical physicians to associate with chiropractors. In 1973, the AMA drafted Standard X, which incorporated the unscientific practitioners ethics bar into the JCAH hospital accrediting standards. The AMA urged JCAH to adopt Standard X, and JCAH complied. Keeping chiropractors out of hospitals was one of the goals of the boycott. When chiropractic was included under Medicare in 1973, the AMA become concerned that this would open the way for chiropractors to be on hospital staffs. Doyl Taylor caused the Office of General Counsel of the AMA to publish an article entitled "The Right and Duty of Hospitals to Exclude Chiropractors" in the Journal of the American Medical Association. This was intended to offer advice to hospital trustees across the country. it also told every hospital attorney that JCAH accreditation might be lost if hospitals dealt with chiropractors. [The JCAH accreditation standards prior to 1983 did not permit a hospital to allow chiropractors on the medical staff or to obtain hospital privileges, except to the extent allowed by state low. The legality of JCAH's actions prior to the 1983 revisions to the JCAH standards, and the responsibility of the member owners for such actions, will be discussed fully in the section of this opinion dealing with JCAH. I do not find that the AMA, or any other member of JCAH, is legally responsible for the pre-1983 accreditation standards.] The Committee on Quackery disbanded in December of 1974. By this time, chiropractic had achieved licensing in all fifty states, chiropractic services had become reimbursable through Medicare, Medicaid, and virtually every private health insurance pion, and the chiropractic educational system hod been given official sanction by the United States Office of Education. Nevertheless, the Committee pronounced itself a success. The AMA believed that chiropractic would have achieved greater growth if it had not been for the Committee's activities. In May of 1975 the AMA Department of Investigation was disbanded and Doyl Taylor left the employ of the AMA. This lawsuit was filed in 1976. In that year, the Judicial Council suspended distribution of the 1969 Opinions which contained the anti-chiropractic policy. Later that year the AMA Judicial Council adopted Opinion 3.50 and in March of 1977 Opinions 3.60, 3.70, and 3.71 were adopted. Under these opinions, a medical physician could refer a patient to a "limited licensed practitioner" for diagnostic or other health care services. Although there was no express reference to chiropractors, chiropractors would fall within the definition of "limited licensed practitioners." Next, a medical physician could choose to accept or decline patients sent to her or him by a licensed practitioner or by a layman. Finally, a medical physician could engage in any teaching permitted by low for which she or he is qualified. However, the relaxation of the right to refer patients was not without qualification. Opinion 3.60 specifically required that a medical physician should not refer a patient unless she or he is confident that the services provided on referral will be performed in accordance with accepted scientific standards. In addition, Opinion 3.01 provided that it is 11 wrong to engage in or aid and abet any treatment which has no scientific basis and is dangerous." Distribution of the revised opinions began in May of 1977. Principle 3 was still in effect. In July of 1979, the AMA House of Delegates adopted Report UU. Report UU was the AMA's new policy statement on chiropractic. It was a very begrudging change of position. Although it is now hailed by the AMA lawyers and Dr. Alan R. Nelson, present Chairman of AMA's Board of Trustees, as a recognition by the AMA of the growth and development of chiropractic as a valid health care service, the Report does not convey that change of heart. First, Report UU states that the AMA knows of no scientific evidence to support spinal manipulation and adjustment as appropriate treatment for such diseases as cancer, diabetes, and infections. It does not declare support for that which the AMA seemingly now approves -- manipulation for musculoskeletal problems. Next the Report condemns the single cause of disease theory and states that "chiropractors disagree on the extent to which they accept or reject traditional chiropractic doctrine." The Report does not state that the two major chiropractic associations had rejected the doctrine in 1969. But the Report continues: Describing chiropractic as an "unscientific cult" does not, however, necessarily mean that everything a chiropractor may do when acting within the scope of his or her license granted by the state is without therapeutic value, nor does it mean that all chiropractors should be equated with cultists. It is better to call attention to the limitations of chiropractic in the treatment of particular ailments than to label chiropractic an "unscientific cult." The Report then reaffirms that a physician should at all times practice a method of healing founded on a scientific basis. This again directly tied into Principle 3 which prohibited association with unscientific practitioners. Although the Report ends by stating that a medical physician may refer a patient to a limited licensed practitioner permitted by low to furnish such services, there is no particular reference to chiropractors. Report UU was obviously written by lawyers in an effort to bring the AMA into compliance with the antitrust laws, and not a bold change of position designed to reverse the attitudes of the AMA members formed, at least in port, by the then eleven-year-old boycott. In December of 1978, the AMA House of Delegates adopted Resolution 14 which provided that medical physicians "continue to exercise the duty to expose unscientific practices and practitioners while supporting and protecting the freedom of individuals to choose among physicians, other licensed practitioners or religious healers as part of the American tradition." It is hard to tell the purpose of this resolution, other than to suggest a similarity between chiropractors and Elmer Gantry, but it once again keyed into Principle 3 which condemned association with unscientific practitioners. In 1980 the AMA adopted a completely revised version of the principles of medical ethics. Principle 3 finally was eliminated. The new principles provided that a medical physician "shall be free to choose whom to serve, with whom to associate, and the environment in which to provide medical services." The revised principles theoretically do allow association with chiropractors but there is no explicit reference to chiropractors in the new code. The revised code received a fair amount of publicity in the medical and private press in 1980. The revision was interpreted as changing the AMA's position on chiropractic in response to various pressures, including the legal climate. And yet, two years later, when Dr. Daniel T. Cloud, who was then finishing his term as president of the AMA, was asked in a formal interview whether the 1980 ethics code changed the position of doctors with regard to chiropractors -- "Was there a change?" -- he stated, "No." This fairly bizarre answer (considering the nature of the publicity the ethics revision received) today is explained by the AMA's lawyers-as a technically accurate answer since, they assert, the change in position was accomplished in 1977 and 1979. Yet today the AMA relies on the revision of the ethical standards in 1980 as part of its change in position on chiropractic. The lawyers' argument is not persuasive. In 1982 the president of the AMA appears to be announcing that the AMA has not changed its position on chiropractic. In 1983 the AMA participated in the revision of the JCAH accreditation standards for hospitals. The revision process started in 1982 with recommendations from the JCAH staff and the JCAH Standards-Survey Procedures Committee that each hospital, through its governing body, be permitted to decide for itself, under applicable state low, which licensed health care providers would be allowed hospital privileges and membership on the medical staff. The AMA initially supported this approach but it was severely criticized by its members and other medical societies which wanted to ensure medical and osteopathic physician control of the medical staff and patient care in hospitals. As a result of this criticism, the AMA changed its position and supported revisions which would ensure such control. In February of 1983, the AMA voted to recommend revised standards that would require the medical staff of each hospital to have an "executive committee," the majority of which had to be medical or osteopathic physicians. The executive committee would make recommendations to the hospital's governing body for its approval of credentialing, membership on the medical staff, hospital privileges delineations, and structure of the medical staff. Any dispute between the medical staff and the governing body of the hospital would have to be resolved jointly by them. In late 1983, JCAH adopted the new standards which included the mandatory, medical physician dominated executive committee concept. The plaintiffs rely heavily on the 1983 accreditation standards to show that the conspiracy was ongoing. This issue is discussed generally in the section of this opinion dealing with JCAH, and, in short, I have rejected the argument. What is noteworthy with respect to the AMA, however, is that although it believed that the standards originally proposed by the JCAH Standards-Survey Procedures Committee were more in tune with the existing antitrust "legal climate," it was unable to sustain its position when faced with substantial criticism of its members and other medical groups. Through the date of the trial, the AMA continued to respond to requests for information on chiropractic which it received from AMA members and others by sending out anti -chiropractic literature. The old boycott language has been eliminated, but the AMA has not had anything positive to say about chiropractic. It was not until mid-way through the trial of this case that the AMA announced that chiropractic has improved and that at least some forms of chiropractic treatment and joint adjustments are scientific. The membership has never been informed of this position. The plaintiffs argue that the AMA boycott began in 1966 and continued until 1983 when the JCAH accreditation standards were revised. The AMA argues that Report UU and the 1977 opinions constituted a change in the AMA's policy on chiropractors. I reject both positions. Report UU and the 1977 opinions were clearly inadequate to announce a change in the AMA policy, and probably deliberately so. This is well demonstrated by the American College of Physicians' analysis of the 1977 revisions of the opinions. In a 1978 report to its members, the ACP stated: In 1977, as noted above, a revision of the Judicial Council interpretations of the AMA Principles of Medical Ethics appeared. The explicit language of 1966 was absent; there was no reference to chiropractic per se. In many places, the language used was unclear and ambiguous. Paragraph 1, Section 3.50, of the 1977 Judicial Council Opinions and Reports does, however, remain forthright: "A physician should not use unscientific methods of treatment, nor should he voluntarily associate professionally with anyone who does. it is wrong to engage in, or to aid and abet in treatment which has no scientific basis and is dangerous, is calculated to deceive the patient by giving him false hope, or which may cause the patient to delay in seeking proper care until his condition becomes irreversible." This interpretation supports the court's view that the 1977 opinions were ambiguous and that the use of the key phrase "unscientific methods" continued to signal the existence of the boycott. I conclude that the AMA and its members engaged in a group boycott or conspiracy against chiropractors from 1966 to 1980, when Principle 3 was first eliminated. [Dr. Sammons was a willing participant in the conspiracy. An AMA trustee, Dr. Sammons was on the Committee on Quackery Oversight Panel of the Board of Trustees of the AMA and recommended continued funding of the Committee with knowledge that its prime mission was to be to contain and eliminate chiropractic. Dr. Sammons presently is the Executive Vice President of the AMA.] Memorandum Opinion and Order: In 1966, Dr. David B. Stevens, a Kentucky orthopedic surgeon, sent a copy of the Kentucky Medical Society's anti -chiropractic resolution to Sam Youngerman, a lawyer with the AMA's Department of Investigation. Stevens also sent Youngerman a draft of a resolution to be proposed by Stevens to the AAOS. Youngerman proposed less "monopolistic" language which would have the 11 some intent." Stevens adopted Youngerman's proposed changes and deleted references to the "elimination" of chiropractic. Some argument could be made that at this point Stevens and the AMA are conspiring and that only they knew that the true intent of the resolution was to eliminate and contain chiropractic (which, according to Youngerman would indicate a monopolistic intent). On January 16, 1967, there was a meeting of the AAOS resolutions committee. Stevens and three others proposed affirmance of the AMA anti -chiropractic policy. Youngerman was an "official guest" at the meeting and "was able to offer the committee helpful advice and suggestions." The AMA's 1966 anti-chiropractic policy statement was presented. AAOS adopted a resolution affirming the AMA's policy statement that chiropractic was an unscientific cult and constituted a hazard to health. The resolution also requested the Executive Committee of AAOS to establish activities to alert the professional and lay public of the hazards of unscientific practice and to participate in the medical profession's program to reduce such dangers to the public health. Although there was no explicit reference to the prohibition of professional association with chiropractors, the reasonable inference is that AAOS knew that a significant part of the medical profession's program to reduce chiropractic dangers to the public health was the prohibition against association with chiropractors. This inference is based on Youngerman's participation at the meeting of the resolutions committee and it is also further supported by the admission made by AAOS in the Status Report on Chiropractic Lawsuits dated October 27, 1978. In this report AAOS acknowledged that Principle 3 proscribed all voluntary association with chiropractors and submitted to the belief that this interpretation of Principle 3 should not be changed. AAOS argues that the passing of the 1967 resolution was protected Noerr-Pennington activity because the AAOS resolution was obtained by the Committee on Quackery in connection with the Committee's legislative activities. In support of this argument, AAOS relies on a portion of Dr. Stevens' testimony (at pp. 2196-98) during which he is responding to a series of leading questions which assumed that at the time Stevens was presenting his resolution to AAOS he was also a member of the Committee on Quackery, and that his activity was on behalf of the Committee on Quackery. The evidence in this record does not support that assumption. Dr. Stevens testified that he joined the Committee in 1967, but he did not state it was as early as January. He frankly could not recall. The Court of Appeals in Wilk referred to the fact that Stevens joined the Committee on Quackery in 1968. During the first trial AAOS's counsel informed the court that Dr. Stevens joined the Committee on Quackery one and one-half years after the AAOS resolution was adopted. (See p. 866 of the first trial transcript.) AAOS cannot argue in one trial that Stevens joined the Committee on Quackery in 1968 and in this trial that he joined the Committee before January 17, 1967. There is no factual basis for the Noerr-Pennington argument made before this court. There is no evidence that AAOS was acting in furtherance of any political goals when it adopted its anti-chiropractic policy. In 1972, a member of the AAOS complained to the Academy about pro-chiropractic legislation in California and AAOS wrote to the AMA stating "we are aware of your stated position in this matter." This shows an awareness of the AMA's position but not of any particular activities. In 1974, there was some activity involving AAOS and the American College of Surgeons regarding the study of chiropractic being undertaken by the NINDS. I have already held, in connection with ACP, that attempts to influence NINDS, a governmental agency, was protected activity. Also in 1974, a neurosurgeon told the American College of Chiropractic Orthopedists that Principle 3 prevented him from speaking to the group and he canceled his commitment to speak. There is no evidence, however, that this doctor was acting this way because of his membership in the AMA or in AAOS. On February 23, 1986, AAOS formally rescinded its anti-chiropractic resolution. It included the resolution among several other obsolete" resolutions and the membership was asked to approve the deletion of these "obsolete" resolutions. There was no affirmative statement that the policy had been rescinded or was wrong. During the entire relevant period AAOS never attempted to enforce the AMA's Principles against any members. However, the bylaws did have discipline procedures. Dr. Freitag, an orthopedic surgeon who testified on behalf of the plaintiffs, regularly associates with chiropractors. He had some concerns about his association with chiropractors in connection with passing his specialty boards, but he in fact encountered no difficulty. Several of the plaintiffs have professionally associated with orthopedic surgeons, In a separate order dated October 25, 1983, the Court of Appeals affirmed the trial court's denial of AAOS's motion for directed verdict at the end of the first trial, holding as follows: However, the evidence permitted the jury to find: that there was communication between the AMA and AAOS on the subject of chiropractic; that this communication revealed acquiescence by AAOS in the AMA view that chiropractic is unscientific cultism; and that by adopting the essence of the 1966 AMA policy statement, in combination with AMA's Principle 3, AAOS endeavored to discourage medical doctors from professional association with chiropractors. On the basis of the evidence, I find that AAOS knowingly joined the conspiracy. Whether it adopted Principle 3 of the AMA's Principles intending to boycott chiropractors is not decisive. When AAOS adopted the 1966 AMA policy statement branding chiropractors as unscientific cultists, it knew that it was prohibiting association with chiropractors. This is clear from the 1978 Status Report. AAOS consciously participated in the conspiracy. The evidence clearly establishes that AAOS was not acting independently. AAOS relied on the same evidence as the AMA on the patient care defense. That evidence is inadequate to establish that defense. The question of whether an injunction should issue is not so easily answered. AAOS took no corrective action until 1986, many years after the corrective action taken by the AMA. Orthopedic surgeons are direct competitors of chiropractors and they directly benefited from the boycott. However, the actions of AAOS which tied it to the AMA conspiracy occurred in 1966. Apart from protected activity, it did not actively participate in the boycott after 1967. Most of the facts which led the court to enjoin the AMA simply are not present in the evidence against AAOS. I conclude that there is no likelihood that AAOS would renew any boycott or conspiracy against chiropractors. I find that an injunction should not issue against AAOS. http://www.chirobase.org/08Legal/AT/at04.html CHESTER A. WILK, et al., Plaintiffs, v. The court conducted a lengthy trial of this case in May and June of 1987 and on August 27, 1987, issued a 101-page opinion finding that the American Medical Association ("AMA") and its members participated in a conspiracy against chiropractors in violation of the nation's antitrust laws. Thereafter on opinion dated September 25, 1987 was substituted for the August 27, 1987 opinion. The question now before the court is the form of injunctive relief that the court wi I I order. As port of the injunctive relief to be ordered by the court against the AMA, the AMA shall be required to send a copy of this Permanent Injunction Order to each of its current members. The members of the AMA are bound by the terms of the Permanent Injunction Order if they act in concert with the AMA to violate the terms of the order. Accordingly, it is important that the AMA members understand the order and the reasons why the order has been entered. The AMA's Boycott and Conspiracy The AMA's purpose was to prevent medical physicians from referring patients to chiropractors and accepting referrals of patients from chiropractors, to prevent chiropractors from obtaining access to hospital diagnostic services and membership on hospital medical staffs, to prevent medical physicians from teaching at chiropractic colleges or engaging in any joint research, and to prevent any cooperation between the two groups in the delivery of health care services. The AMA believed that the boycott worked -- that chiropractic would have achieved greater gains in the absence of the boycott, Since no medical physician would want to be considered unethical by his peers, the success of the boycott is not surprising. However, chiropractic achieved licensing inall 50 states during the existence of the Committee on Quackery. The Committee on Quackery was disbanded in 1975 and some of the committee's activities become publicly known. Several lawsuits were filed by or on behalf of chiropractors and this case was filed in 1976. Change in AMA's Position on Chiropractic The AMA settleck three chiropractic lawsuits by stipulating and agreeing that under the current opinions of the Judicial Council a physician may, without fear of discipline or sanction by the AMA, refer a patient to a duly licensed chiropractor when he believes that referral may benefit the patient. The AMA confirmed that a physician may also choose to accept at to decline patients sent to hini by a duly licensed chiropractor. Finally, the AMA con. firmed that a physician may teach at a chiropractic college or seminar. These settlements were entered into in 1978, 1980, and 1986. The AMA's present position on chiropractic, as stated to the court, is that it is ethical for a medical physician to professionally associate with chiropractors provided the physician believes that such association is in the best interests of his patient. This position has not previously been communicated by the AMA to its members. Antitrust Laws In this case, however, the court allowed the defendants the opportunity to establish a "patient care defense" which has the following elements: (1) that they genuinely entertained a concern for what they perceive as scientific method in the care of each person with whom they have entered into a doctor-patient relationship; (2) that this concern is objectively reasonable; (3) that this concern has been the dominant motivating factor in defendants' promulgation of Principle 3 and in the conduct intended to implement it; and (4) that this concern for scientific method in patient care could not have been adequately satisfied in a manner less restrictive of competition. The court concluded that the AMA had a genuine concern for scientific methods in patient care, and that this concern was the dominant factor in motivating the AMA's conduct. However, the AMA failed to establish that throughout the entire period of the boycott, from 1966 to 1980, this concern was objectively reasonable. The court reached that conclusion on the basis of extensive testimony from both witnesses for the plaintiffs and the AMA that some forms of chiropractic treatment are effective and the fact that the AMA recognized that chiropractic began to change in the early 1970s. Since the boycott was not formally over until Principle 3 was eliminated in 1980, the court found that the AMA was unable to establish that during the entire period of the conspiracy its position was objectively reasonable. Finally, the court ruled that the AMA's concern for scientific method in patient care could have been adequately satisfied in a manner less restrictive of competition and that a nationwide conspiracy to eliminate a licensed profession was not justified by the concern for scientific method. On the basis of these findings, the court concluded that the AMA had failed to establish the patient care defense. None of the court's findings constituted a judicial endorsement of chiropractic. All of the parties to the case, including the plaintiffs, and the AMA, agreed that chiropractic treatment of diseases such as diabetes, high blood pressure, cancer, heart disease and infectious disease is not proper, and that the historic theory of chiropractic, that there is a single cause and cure of disease was wrong. There was disagreement between the parties as to whether chiropractors should engage in diagnosis. There was evidence that the chiropractic theory of subluxations was unscientific, and evidence that some chiropractors engaged in unscientific practices. The court did not reach the question of whether chiropractic theory was in fact scientific. However, the evidence in the case was that some forms of chiropractic manipulation of the spine and joints was therapeutic. AMA witnesses, including the present Chairman of the Board of Trustees of the AMA, testified that some forms of treatment by chiropractors, including manipulation, can be therapeutic in the treatment of conditions such as back pain syndrome. Need for Injunctive Relief Most importantly, the court believes that it is important that the AMA members be made aware of the present AMA position that it is ethical for a medical physician to professionally associate with a chiropractor if the physician believes it is in the best interests of his patient, so that the lingering effects of the illegal group boycott against chiropractors finally can be dissipated. Under the law, every medical physician, institution, and hospital has the right to make an individual decision as to whether or not that physician, institution, or hospital shall associate professionally with chiropractors. Individual choice by a medical physician voluntarily to associate professionally with chiropractors should be governed only by restrictions under state low, if any, and by the individual medical physician's personal judgment as to what is in the best interests of a patient or patients. Professional association includes referrals, consultations, group practice in partnerships, Health Maintenance Organizations, Preferred Provider Organizations, and other alternative health care delivery systems; the provision of treatment privileges and diagnostic services (including radiological and other laboratory facilities) in or through hospital facilities; association and cooperation in educational programs for students in chiropractic colleges; and cooperation in research, health care seminars, and continuing education programs. An injunction is necessary to assure that the AMA does not interfere with the right of a physician, hospital, or other institution to make an individual decision on the question of professional association. Form of Injunction 2. This Permanent Injunction does not and shall not be construed to restrict or otherwise interfere with the AMA's right to take positions on any issue, including chiropractic, and to express or publicize those positions, either alone or in conjunction with others. Nor does this Permanent Injunction restrict or otherwise interfere with the AMA's right to petition or testify before any public today on any legislative or regulatory measure or to join or cooperate with any other entity in so petitioning or testifying. The AMA's membership in a recognized accrediting association or society shall not constitute a violation of this Permanent Injunction. 3. The AMA is directed to send a copy of this order to each AMA member and employee, first class mail, postage prepaid, within thirty days of the entry of this order. In the alternative, the AMA shall provide the Clerk of the Court with mailing labels so that the court may send this order to AMA merpbers and employees. 4. The AMA shall cause the publication of this order in JAMA and the indexing of the order under "Chiropractic" so th |