CSPI
 Center for Science in the Public Interest
Publisher of Nutrition Action Healthletter November 5, 2001

Application To File Amicus Letter; Amicus Letter
Pertaining To Robert Sinaiko, M.D. v. Medical Board
of California, Sacramento Superior Court No. 99CS02275

Dear Judge Robie:

The Center for Science in the Public Interest applies for leave to file the accompanying amicus letter.

The Center for Science in the Public Interest (CSPI) is a nonprofit education and advocacy organization that focuses on improving the safety and nutritional quality of our food supply and on reducing the deleterious effects resulting from the consumption of alcohol. CSPI seeks to promote health through educating the public about nutrition and alcohol. It represents citizens' interests before legislative, regulatory, and judicial bodies; and it works to ensure that advances in science are used for the public good. CSPI is supported by the 800,000 member-subscribers to its Nutrition Action Healthletter, through foundation grants, and through ales of educational materials.

CSPI has participated in Federal court litigation, as both a party, and an amicus, in cases pending before the U.S. Supreme Court, the U.S. Court of Appeals for the 4th, 5t, 9th, and DC circuits, and the federal district courts.

"Amicus curiae presentations assist the court by broadening its perspective on the issues raised by the parties. Among other services, they facilitate informed judicial consideration of a wide variety of information and points of view that may bear upon important legal questions." Bily v. Arthur Young (1992) 3Cal. 4th 370, 405 n.14

From the time it learned of the accusation by the Medical Board ("Board") against Dr. Robert Sinaiko, CSPI has been concerned about the case. As discussed in more detail below, we believe the disciplinary proceedings, and the existing disciplinary order, appear to pose a substantial threat to the rational, science-based practice of medicine in California. Specifically, we are concerned that the Board, by sanctioning Dr. Sinaiko in part for his handling of the LTS case, has inappropriately attempted to resolve an ongoing debate in the medical community regarding the treatment of children who have been diagnosed with Attention Deficit and Hyperactivity Disorder (ADHD).

We have attached as Exhibit A to this amicus letter a document produced by CSPI entitled "Diet, ADHD & Behavior - a Quarter Century Review" ("Diet"). Diet, ADHD & Behavior was prepared by CSPI for the purpose of informing the public, the medical profession, and government, including courts around the United States, about the scientific literature published on the subject of dietary restriction an the treatment of ADHD and other pediatric behavior problems. Those treatments, usually undertaken by allergists as opposed to pediatricians or psychiatrists, are undertaken as alternatives or additions to Ritalin and other psychiatric drugs, for the medical management of childhood ADHD.

Should the Court permit filing of this amicus letter, CSPI urges the Court to consider the following in reviewing the Medical Board's disciplinary order against Dr. Robert Sinaiko:

  1. Some medical authors have misrepresented the results of the many published research reports regarding diet and ADHD. (Diet, ADHD & Behavior at 12-13). CSPI believes that a reasonable person familiar with the literature reviewed in Diet, ADHD & Behavior would conclude that a doctor who employs techniques of diet in response to a child who exhibits symptoms consistent with ADHD has behaved reasonably.

  2. The impression to be gained from a comprehensive review of the relevant literature is that diet can be extremely helpful in some patients with ADHD. CSPI believes that the use of diet by physicians treating ADHD should not be rejected or discouraged, and that any attempt to sanction a doctor for employing these techniques constitutes an unnecessary limitation on patient and doctor choice.

  3. CSPI is of the view that the Board should not, by means of a disciplinary order, settle an ongoing debate in the medical community regarding the appropriate treatment of children with ADHD.

  4. The existing disciplinary order appears to pose a serious threat to the innovation of medicine in California as it sanctions a physician who engaged in practice methods that have support from the medical literature.

Sincerely,

Michael F. Jacobson, PhD
Executive Director