Repeal the Cancer Act 1939 completely - repeal Clause 4.
The Cancer Act 1939 was an Act that originally made it the duty of all councils to secure facilities for the diagnosis and treatment of cancer and to pay for travelling expenses for patients to these facilities where necessary. It lays out how the government will pay local councils to provide such treatments. And it also banned the discussion of alternative treatments, making it an offence to even suggest that something other than radioactivity and ionising radiation could possibly cure cancer. The first couple of readings of the bill in 1938-39 even forgot to include exemptions for further research into cancer.
All of the good clauses that makes it a duty for cancer to be caught early and treated have been removed in the last 70 years - replaced by the NHS acts and other acts.
ALL that is left in the act now is Section 4 which continues to turn citizens into criminals for even mentioning cancer and cure in the same sentence... forget racial abuse in twitter... just saying turmeric (there is much scientific research into this and phase I and II trials in other countries - but it is a crime for me to suggest anyone takes part in the trial), vitamin C or baking soda... in the same sentence can get you a fine or a 3 months prison sentence.
It is our human right to free speech ... to free discussion about current research that can complement current treatments. Open discussion about other treatments available around the world.
We need the final Section of this Act and remove it entirely - thus promoting the open discussion by survivors of cancer, non-medical individuals with a good track record of alleviation of suffering and the public about methods that we can implement to prevent or alleviate the pain and suffering caused by cancer.
The Cancer Act as it stands (the original can be read in PDF format linked from the page below)
http://www.legislation.gov.uk/ukpga/Geo6/2-3/13
Oliver Slay
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22 comments
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Oliver Slay
commented
However Celgene will pay for your treatment beyond your 26th cycle... so .. once you've forked out a bit of over $350,000 for the first 2 yrs...
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Oliver Slay
commented
No-one says that it prevents new research into treatments. Aggressive patents by large pharmaceuticals do that well enough on their own.
It prevents gatherings of people who wish to discuss treatments that are offered...
The CA might prevent people from selling 'cures' as in America or elsewhere .. but it is the job of the MHRA to do that. So the CA should be obsolete. No?
http://www.mhra.gov.uk/Safetyinformation/index.htm
Finally I don't know what you are comparing Burzynski's treatment with... This is what I managed to dig up...
Burzynski's treatment is 'antineoplastin' the active ingredient found to be 3-phenylacetylamino-2,6-piperidinedione - which is pictured here:
http://www.chemicalregister.com/3-Phenylacetylamino-2_6-piperidinedione/Suppliers/pid116826.htm
That formula is only one or two reductions away from Thalidomide (pictured via link below) which is being re-targeted to treating cancers:
http://en.wikipedia.org/wiki/Thalidomide
Or Lenalidomide (http://en.wikipedia.org/wiki/Lenalidomide) or Pomalidomide (http://en.wikipedia.org/wiki/Pomalidomide) which Pharmaceutical company Celgene received FDA approval for in 2005 and 2013 respectively for treating cancers.
All of these are somewhat toxic to the human body, so no-one should think that Burzynski's won't be either... they are all chemotherapy and chemotherapy is necessarily toxic as it is targeting fast growing cells - in the hope that it kills off cancer cells. Like napalming a village to catch a crook...
Cost of treatment...
Burzysnki manufacturers, produces and pays for clinical trials - like any other pharmaceutical except probably has to pay for it with little subsidisation. The cost of treatment is
"Treatment can cost from $7,000 to $9,500 per month or more, depending on the type of treatment, number of consultations, and the need for surgery to implant a catheter for drug delivery."
[http://www.cancer.org/treatment/treatmentsandsideeffects/complementaryandalternativemedicine/pharmacologicalandbiologicaltreatment/antineoplaston-therapy]Is that expensive? let's compare with the newly FDA-approved pomalidomide - sold as Pomalyst by Celgene:
"Celgene has said it expects to launch Pomalyst in the US within the next couple of weeks, and has set a price of $10,450 per 28-day treatment cycle, with patients expected to receive between five and eight cycles."
[http://www.pmlive.com/pharma_news/celgene_gets_us_green_light_for_blockbuster_candidate_pomalyst_463187]and Lenalidomide:
"Lenalidomide has significantly improved overall survival in myeloma (which generally carries a poor prognosis), although toxicity remains an issue for users. It costs $163,381 per year for the average patient." [ from Wikipedia]I don't see much difference between Burzynski's treatment and these other drugs... although it appears to be cheaper.
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Guinea Piglet
commented
ignore the idiots claiming that the Cancer Act prevents new research into treatments, that's a lie. Clinical trials of new treatments and off-label therapies are ongoing constantly.
What the CA does is prevent UK patients ending up like their American compatriots, being bombarded by "cures" like Gerson, Rife, Burzynski's toxic nonsense etc., whose peddlers prey on the hopes and bank accounts of the desperately ill.
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Oliver Slay
commented
Well Rhys... I think highlighting one contentious point out of a long discussion and then shouting "quack" at the top of your voice... is just as un-scientific as the suggestion that Baking Soda will cure cancer. I guess you might be expecting a group mentality to all follow suit and shout "quack" along with you, rather than think for themselves. (which the Baking Soda story caused too on the other side of the fence from you.)
To join 'Baking Soda' and 'quackery' without scientific question is misleading. Because there are specific points at which sodium bicarbonate is important in the biological pathways of cell metabolism. Why should one have to justify researching an important biological reactant such as bicarbonate ions just because a group of people shout 'quack'? : one example where bicarbonate ions are researched in respect to tumour cells ...
http://onlinelibrary.wiley.com/doi/10.1002/cmdc.201200335/abstractThat is but one example of respected science.. investigating the actual mechanisms of cancer... It is, of course, incorrect to infer from this that Baking Soda is curing cancer... but it is certainly involved in the cell pathways...
The MHRA was given powers under new laws to deal with people selling fake medicines and potions for various diseases. They can perfectly well take over from the Cancer Act. I do not see how repealing the act suddenly makes unscrupulous people think there's a green light... most people do not even know there is a Cancer Act but they do not act in the way you suggest without that knowledge. (well some do.. but they get caught, because I see it happening in the HPA Alerts for Drug misuse.
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Anonymous
commented
Repealing the Cancer Act would be a green light for quacks to prey on desperate people.
This kind of thing brings 38 degrees into disrepute.
Strengthen the Cancer Act - keep quacks away from the pockets of vulnerable people
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Rhys
commented
Baking soda? Really? The Cancer Act exists to protect the public from precisely this kind of dangerous, exploitative & lucrative quackery.
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Oliver Slay
commented
This is also a strong case : http://sallyrobertsourstory.wordpress.com/sally-roberts-story/
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Oliver Slay
commented
Hi anon
There is a slow and steady movement to begin to talk... but to be able to talk about cancer without being a doctor you have to have a LOT of money like the Imperial Cancer Research fund did back in 1939 when the law came out.. They ignored the law because they put enough money into research that no one could touch them. They combined with the other large cancer charity, Cancer Research Campaign in 2002 and are now Cancer Research UK.The other way is to simply ignore the rules ..
www.icancer.org.uk - recently set up in the new Health/Medicine 2.0 (a play on Web 2.0) to crowd-source on healthcare and treatments... where the public can pitch into cancer research where it is needed... on treatments that won't make big pharma any big profits. The main one for now being Anti-cancer viruses - see the previous website about it or http://www.guardian.co.uk/commentisfree/2013/jan/04/2013-new-approach-fighting-cancer
Then there's the story of Salvatore Iaconesi who was diagnosed with brain cancer at the age of 39. He hacked his records and released them to the internet - open source - and requested that anyone could look at them and send him comments - the 200,000+ answers ranged from orthodox medicine through to art and poetry - http://artisopensource.net/cure/ (in Italy, not the UK)
And there's always many interesting ideas on TED.com as well as hundreds of other websites...
Given all that... it's crazy that such a law could still exist - but mostly it should be ignored (with care). And a lot of Health 2.0 will end up being a USA/European thing.
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Anonymous
commented
What a pity this has such a small number of people voting for it, little do people know just what this means to them, until it is too late.
It hampers research into far better and proven effective methods that are on offer in other countries and what we have isn't working but it won't allow anything else. It prevents Dr's from trying other things or suggesting other methods also.
It started off protecting the radiologists but now the drug industry benefits from it very nicely and there's a bill we can't keep affording. yet many other methods are so much cheaper.
If chemo raises your chances of survival by 5% greater than doing nothing, then surely we can investigate other methods
The continual barracking of both sides, is ridiculous. There are many reasons why cancer develops and we need many ways to treat it. This term quackery is so offensive to people who very often are as well trained and educated in their field of medicine as Dr's are. In fact many started as medics.
This is a big health problem that will not be solved by closed minds, nor does it benefit the patients to be fear driven in their route and be given no choice and often no hope -
Philip Hackett
commented
Cancer is very lucrative. The cure for all Cancer is Physics not drugs or Doctors hence it is suppressed. Read The Cancer Cure that worked available from Amazon.
The cure for cancer has been known for decades but is suppressed by the http://www.legislation.gov.uk/ukpga/Geo6/2-3/13
Royal Rife cured terminal disease in 1934 https://www.youtube.com/watch?v=gEt5zd3YYHw
Rife treatment is available in Europe at www.ngcenergyhealing.com
Eating 100 Apricot Kernels daily cures cancer with natural cyanide. A Dutchman recently cured himself of Liver Cancer in eight weeks with Apricot Kernels.
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Oliver Slay
commented
So I see, David Briggs, that you have worked on research around the tes protein... something to do with cell adhesion... I skimmed over the paper.
I have no idea what you mean about my comment on the Totnes page on ANH. If I talk in a room full of Christians does it make me a theist? I merely suggest that people look into the science that is currently being commissioned. I say 'perhaps Simoncini is on the right path' .. unfortunately was not worded brilliantly... He was definitely not on the right path to refuse to treat people at all with radiation and chemotherapy even though those modalities have only a small positive outcome... He's not the first to come across alkali as a treatment of tumours... the suggestion goes back to Egyptian times.. he is a one of a string of people over the last 3-400 years to suggest a link.. but it's only since the Cancer Act 1939 that doctors have been castrated for talking about any other treatment than the politically mandated version .. another proponent was also an Italian in the 1700s who was commended for his work... a stark opposition... What one cannot ascertain from my response on that site... is what I would say if I was able to be in the same room with Simoncini... I have several critical questions about his assertions ... if cancer is a fungus then why are nearly 1/5 of all cancers caused by viruses? should there be a high chitin content of tumours.. to think of a couple.. personally I stand on a fence and I'll pick holes in both sides... I don't like non-scientific mambypamby as much as the next person... science is meant to reveal those things we thought to be true as untrue... or so the saying goes .. (from "zen and art of motorcycle maintenance" quoted in "Testing Treatments" - actually seems quite a good read...)
"Baking soda as a treatment is not very plausible. I don't understand how or why it might work "
ok.. so let me suggest a pathway that involves bicarbonate based in scientific research... and add to that the role of bicarcbonate in the Warburg hypothesis. (the alteration of the metabolism of pyruvate) - just a couple of bits that have stood out... i'll note here that I understand this suggests one small part in a pathway ... (for me that means I'm not going to throw the theory out the window... but it does not mean I embrace the theory as fact... )
Postmitochondrial regulation of apoptosis by bicarbonate.
http://www.ncbi.nlm.nih.gov/pubmed/12915121http://en.wikipedia.org/wiki/Warburg_hypothesis
Anon... there are several drugs that have been derived from plants that are used by traditional healers around the world... aspirin (now suggested as a prophylactic by scientists against cancer)... prostratins (from a bark), bryostatins (from a kind of moss like organism) to suggest a couple... unfortunately they have a more general effect on the body and there are too many side effects... and interesting characters is Paul Alan Cox, an ethnobotanist expert who spent the 80s in Samoa with traditional healers ... he was working with the National Cancer Institute in the US .. and sent samples of plants back to the US... if any were found to be active chemicals they would be patented - luckily for the Samoan government, Cox included them in on royalties for the treatments... and thus this was a small small part of the cataloguing of plant chemicals by institutions in the US which is often searched for analogs of chemicals / or their derivatives that might be the next big cure for this or that...
http://en.wikipedia.org/wiki/Paul_Alan_Cox
So on the one hand big pharma is embracing the world's heritage of traditional healing in order to find cures for disease... on the other misinformed scientists berate natural medicines such as herbalism as rooted in mythology...
Are we ready to talk about aspirin for cancer prevention? no?
http://www.sciencedirect.com/science/article/pii/S0140673611616541Oliver
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Anonymous
commented
The Cancer Act, like much legislation, is there to protect big business, not to serve the public.
There are several natural cures for cancer. Big Pharma dont want us to use nature to cure ourselves as there is no money it that for them. Research "Codex Alimentarius" if you want to know more.
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WakeUp
commented
Cannabis OIl Cures Cancer
http://www.youtube.com/watch?v=0psJhQHk_GIThe 1939 Cancer act has murdered more Brits than the 6 million Jews killed by Hitler in the 2nd world war.
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Anonymous
commented
The Cancer Act, like so much legislation, does not appear to have moved with the times.
I read regularly, both online, and in books and magazines of research which indicates how lifestyle helps to prevent cancer and other health conditions. Having read some of the comments below it appears that retailers are being treatened or prosecuted for alluding to 5-a-day etc.
This is ridiculous!
This act should certainly be repealed!
It appears to try to suppress all constructive discussion.
It appears to support an orthodox elite, trained in a particular way who make their living by advising and treating patients.
Note that was correct treatment 50 years ago is probably condemned now. How will advances happen?
Bearing in mind that most medical practitioners do not even learn nutrition (7 days in 7 years is not much instruction- and how up to date is the information that they are taught).
Smoking is mentioned- it took 20-30 years for most doctors to stop this dreadful habit, even after the research conclusions were quite clear.
Unfortunately most research is undertaken by the pharmaceutical industry, because that is what makes their high profits. Various studies have shown that, when a study starts to show negative results, they freqently stop the study, it is suppressed, and never published. No wonder they achieve positive results!
Most pharmaceutical drugs produce severe side effects.If you don't get the side effects that others do, it's probably that part of your body's protection system is dealing with it . Such drugs clearly put all sorts of strains on our bodies. Looked at dispassionately, such treatments are really very primitive.
When it comes to cancer, surgery, the traditional method, is possibly the safest, as our bodies are very clever at healing themselves after surgery, as long as it's not too drastic.
Chemotherapy and radiation have very drastic effects on healthy tissue, meaning that most such treatments constitute a fine balancing act. With chemotherapy the treatment seems to kill as often as the uncured cancer.
Under the Cancer Act, these treatments can be publicised freely, apparently.
Yet many 'alternative' treatments, practised over many years in some cases, seem to be disallowed from discussion.
The Hunzas, Japanese, Chinese and Indians, and possibly many others, appear to have lifestyles or diet that prevents cancer. Surely these should be fully discussed and investigated. Apparently this diabollical Act prevents such discussion.
I've recently read books which I've downloaded from the internet. Many of them refer to research, but I'd like to see some real trials carried out. Apparently discussiong and promoting this idea is itself against the Cancer Act. Is that really so?
In Germany and other countries cancer can be treated by less violent means than in the UK. Should we not be free to choose such options in the event of 'getting' cancer.
Apparently our bodies are daily killing off cancer cells with their own natural defences. Surely this system should be investigated and supported, rather than introducing chemicals etc. that purely destroy healthy and cancerous cells at the same time.
This Act should be repealed. -
David Briggs
commented
Hi Oliver,
No am not that David Briggs, rather I am a David Briggs who hails from the University of Manchester, formerly of Cancer Research UK. I am familiar with the field of cancer biology and also what might or might not be plausible causes and treatments of cancer.
Cancer being a fungus, for example, is not plausible. Baking soda as a treatment is not very plausible. I don't understand how or why it might work . But that is not the nub of this particular matter.
I was very uneasy when I read of your account of the Totnes conference which was banned under this legislation - and if the conference was indeed banned under the cancer act, I might have supported you.
However, I have found several accounts of this conference, indicating that whilst Trading Standard (the body tasked with enforcing the Cancer act) had advised on what could and could not be said, the conference did in fact go ahead.
http://www.quackometer.net/blog/2012/03/quack-totnes-cancer-conference-ends-in-farce.html
http://josephinejones.wordpress.com/2012/03/23/totnes-cancer-conference-forced-underground-by-trading-standards/
http://anh-europe.org/news/trials-of-the-totnes-cancer-health-care-conferenceThis last one indeed, appears to have been commented on by someone with your exact same name (!) - so you must have been aware that the conference was not banned. The organiser appears to have chosen to 'cancel' it loudly and publicly, perhaps as a protest, and the went ahead anyway. It was even streamed live on paradigm shift tv (apparently).
So, unless I am very much mistaken, you seem to be grossly misrepresenting one event in order to get 38 degrees to mount a campaign about a piece of legislation which exist to protect patients from predatory and profiteering quacks.
I cannot see why anyone would support your campaign to repeal the cancer act.
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Oliver Slay
commented
Vince:
Further reading:
Marty Pagel, PhD, awarded $2 million NIH grant to study impact of baking soda on breast cancer
http://www.azcc.arizona.edu/node/4187
http://engr.arizona.edu/news/story.php?id=429 -
Vince
commented
No. This clause presents false and misleading advertising & medical fraud. It doesn't stifle discussion, discussion takes place in the clinical research. There is no cure for cancer. Vitamin C and baking soda sold as cures are medical fraud. Anti-oxident supplements are useless as a treatment for cancer and the totnes cancer committee event was pure quackery. Fictional ideas, that all completely and absolutely disagreed with each other and yet all were being promoted as 'The One True Cure For Cancer'. The discussion about whether or not these treatments were legitimate has already taken place, it has been published in the peer-reviewed literature - it says that these are not useful, nor valid treatments for cancer, let alone cures. What has been stopped then, is the promotion of worthless, disproven therapies - it is in the publics interest that they do not fail victim to clever advertising and lose time, money and suffer damages to health due to harmful or useless treatments. That is why this clause still remains, that is why this clause should still remain. Without evidence that a product successfully, reliably cures cancer in a good amount of patients, with more benefit than harm from side effects then no-one should be advertising a cure for cancer. Note, that the clause also means that big pharma companies cannot advertise their products as cures for cancer either. There appears to be no exemption for radiation. The exemptions appear to be only if the advert is aimed at health professionals or health/med students, a person took part but didn't know, or if the advert is made by a local authority or by the governing body of a voluntary hospital or by any person acting with the sanction of the Minister.
Freedom of speech doesn't come into it. Adverts promoting cancer cures breach British Codes of advertising in the BCAP codes - any claims (in any advert, for anything, especially health products) need substantial and objective evidence to be held by the company making the claim, made freely available to the ASA upon request, failure to do so leads to the advert being judged misleading, rightly so. The freedom to not be the victim of fraud is a pretty compelling reason to keep this legislation in place. -
Oliver Slay
commented
a quick note on False hopes:
This is the claim made by Dr Leslie Hefferman, president of the Medical Practitioners' Union in Jun 1939 (as reported in the Guardian Jun 12 1939 - "Doctors Attack the Cancer Act") as part of the MPU's Resolution condemning the Cancer Act 1939 for "holding out mistaken hopes to the public" :-
-"... revealed disagreement with other medical opinion about the efficacy of radium and x-ray treatment."
-" there was no public benefit to be gained; only political exigencies determined it."
-"no need or occasion for the Act, with its sudden interference with the steady progress of cancer treatment and research."
- "The advocates had deliberately created an impression that treatment by radium and x-rays had only to be made more readily available and the cancer death-rate would be greatly reduced. This was a delusion and obviously a cruel suggestion." (and the death rate increased...)
-"Radium and X-ray were still largely in the experimental stage."So here we have government making it policy on heresay of a great new theory for treating cancer.. and holding it out as a public service... whilst the union of practitioners object.
And now... the GPs toe this once purely political line of radiotherapy and chemotherapy ... How have the attitudes of GPs changed between pre-1940s and post-1940s regarding scientific enquiry?
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Oliver Slay
commented
Hi David
(are you perhaps Prof Briggs of Imperial? whose book on GIS and Epidemiology Techniques I have just been window shopping on Amazon? -- Since I develop software using GIS and I am also studying Health Sciences - I was hoping to bring the two together.. )I do not have cancer. I am not a doctor nor a nurse nor MP (but I am studying Health Sciences). If someone is giving a discussion about certain topics that some people find controversial then I would actually like to listen to what they have to say. I have a strong interest in cancer, its aetiology, pathogenesis etc...
I have reviewed all of the cases that have reached the media due to Cancer Act 1939 since 1999. In many of the cases I think the decision was fair. ASDA in 2004 hired a good lawyer and the charge was dropped. I am sure there are many more cases that do not reach the media.
During a discussion about training general practitioners in detecting the early signs of cancer, In the House of Commons in 1945, Colonel Stoddart-Scott, of Pudsey, asked "Will the right hon. Gentleman also take steps to instruct the general public with regard to the early signs and symptoms of cancer, as very often when a patient goes to his general practitioner it is then too late for specialist treatment?"
Only Mr Aneurin Bevin, of Ebbw Vale, responded with "Speaking on the impulse of the moment, it would, I think, be extremely dangerous to try to instruct the general public, because you may have a nation of hypochondriacs." - and no other comment.a better attitude is seen in 1948 with the Secretary to the Minister of Health, John Edwards: "So I think we shall in a certain sense be helping to educate the public to take a more critical attitude towards claims which are made. Certainly, in so far as these medicines are costly in relation to the cost of the ingredients, then it is for the public to be educated, to weigh carefully the advantages of what they get against the cost, and in these particular instances to weigh the service that is freely and comprehensively available under the National Health Service against the doubtful virtues of self-medication—not that for one moment do I want to suggest that there is no place for simple household remedies, for clearly most of us have our pet remedies and I think none of us is the worse for having used them." (I wonder what pet remedies he is thinking about)
It's not that I feel the Cancer Act 1939 is the incorrect legislature - it is outdated legistature. Since the NHS was brought in ~1946 we have had a local GP - we know that if something is wrong we should go and visit the GP. Still we all probably would self-medicate in the first instance if we could... as John Edwards professes too.
Rather, now we have the Medicines and Healthcare Products Regulatory Authority (MHRA) guidelines and their Disease Awareness Campaign guidelines... the National Cancer Action Network, National Cancer Intelligence Network, the Peer Review Network, Quality in Service, Outcomes, Cancer charities, and Trading Standards can enforce the claims made by sellers of products making claims and selling cheap herbs at extortionate prices.
The objection I have... is that in Totnes, Dr Simoncini is invited to speak. And the whole conference was banned under the Cancer Act 1939, because he has made a claim about baking soda therapy (which is not his idea - you can find a book by William Beckett, FRS (on openlibrary.com) with a chapter "New discoveries concerning cancer" which he wrote to the Chief Surgeon to Queen Anne on July 12th 1711 in which Beckett suggests the tumour is the cause of the Acidity of the Blood.. which he coincidentally attributes to an Italian Surgeon, Fulchius. Fulchius in contrast to Simoncini was commended for his discovery.)
Also why is someone discussing baking soda therapy in the UK banned (and the whole conference banned under the Cancer Act 1939) from speaking about his 'wild' ideas, whilst in the same moment the National Institute of Health in America grants $2 million for research into baking soda as a therapy for breast cancer? or as an adjuvant to chemotherapy...?
What in effect is this ban? It simply means most people will go back to Youtube, Dr Weil, WDDTY, Patrick Holford and buying books from the local bookshops called "Foods to Fight Cancer", "Anticancer and new way of life", but now armed with something new they had not heard about before the whole dispute... so how about Mark Sircus' "Bicarbonate of Soda: Full medical review" for the Kindle...? (People however, do need to know that if they self-medicate with sodium bicarbonate they risk alkalosis and even potentially organ failure...)
Thus the Cancer Act 1939 merely stands in a doorway being a nuisance and hitting a few people on the head as they go in and out.
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David Briggs
commented
Is medical advice really a freedom of speech issue?
When advising people about healthcare we need to be extremely careful that the correct advice is given, advice that is supported by the best medical evidence and current understanding.
By all means those conducting the research and developing new techniques absolutely must be allowed to discuss whatever they wish, but until such time that a treatment is proven (beyond reasonable doubt) to be effective, these should not be offered to patients for two reasons:1) The risk of giving incorrect advice & treatment - if an unproven (and ineffective) treatment is offered in the place of a proven treatment, the patient will suffer as a result of this.
2) False hope - if a patient is told that an unproven treatment can help with their disease, and it doesn’t - that can be a profoundly depressing realisation for a patient.
Whether or not the cancer act is the correct legislative tool for the job is open to debate, but I do think that something similar this is needed on the statue books, and maybe not just for cancer. Giving the various quacks and charlatans that lurk in the shadows around the fringes of healthcare license to claim to be able to cure whatever they want with whatever they want would not be a positive step forwards IMO.
Ultimately, healthcare should be about putting the needs of the patient first, and patients need to have confidence that they are given the correct healthcare advice so that they can make correctly informed choices about their own health. People who abuse that confidence in order to make a profit should certainly face some sort of penalty
