|A majority of doctors want to ban chiropractic neck manipulation because they believe the small risk of death is not worth the benefits of its "placebo effect" on patients, a neurologist has told an inquest into the death of an Etobicoke woman.Dr. John Norris of Sunnybrook hospital told an inquest jury examining the 1996 death of Lana Dale Lewis yesterday that he disagrees with an outright ban and believes instead neck manipulations should be studied for why they can lead to fatal strokes.Although doctors know there is some relationship between neck manipulation and such tragedies, "we don't know what that relationship is," he said, under cross-examination by Tim Danson, lawyer for the Canadian Chiropractic Association and the Canadian Memorial Chiropractic College.A third alternative may be to ban chiropractic neck manipulations except within the confines of a study, he said. Lewis, 45, died in September, 1996, after suffering two strokes, 17 days after she had a chiropractic neck manipulation. On Sept. 1, she went to Etobicoke's Queensway hospital, complaining about dizziness and difficulty seeing. She was released from hospital Sept. 6 but collapsed four days later and died Sept. 12. An autopsy attributed her death to a stroke.Norris testified that one in 100,000 patients who receive chiropractic neck manipulation will, for some reason, suffer a stroke. He agreed with Danson that about 250 million a year are performed in Canada and the United States.Danson said if society were to ban chiropractic neck manipulations based on suspicions that they can cause damage in very rare cases, by the same logic it should ban many prescription drugs and "all kinds of medical procedures." Norris agreed.Norris testified that an angiogram done on Lewis — a procedure involving injecting a special dye through her arteries and tracking it by x-ray — was "highly suggestive" of her having a split in her vertebral artery at the top of the spine, which is where a neck manipulation occurs. Such a split, called a dissection, can lead to a stroke, and usually causes severe pain.Danson asked him if he agreed it was significant that Lewis attended work and did not visit a doctor or hospital the week after her Aug. 26, 1996 neck adjustment.Norris replied that a surprisingly large number of people continue on with daily activities despite such neck pain. "Patients vary a lot," he said. "Pain's a very subjective thing."The inquest continues.