***** Pamphlet from the National Council against Health Fraud *****

                     AVOIDING LEGAL PROBLEMS
                     -----------------------

Combatting health fraud, quackery, and misinformation
understandably exposes activists to an increased risk of threats
of lawsuits or actual suits.  Quickness to sue opponents is a
common characteristic of quacks.  Quacks usually sue to harass or
gain a public forum, not because they expect to succeed.  However,
these guidelines are not intended to take the place of consultation
with legal counsel, nor can following them prevent legal action.
These guidelines will familiarize you with some of the common
pitfalls in free expression. Familiarity with these pitfalls should
signal when you need to consult with a lawyer on a prophylactic
basis in order to diminish the chance of a successful lawsuit
against you.

          TYPES OF CHARGES USED TO INTIMIDATE ACTIVISTS

According to one legal expert, there are five typical charges that
are pursued, usually without legal merit or success, against
citizens and organizations who have simply exercised their First
Amendment rights of free speech in opposition to someone believed
to be acting contrary to the public interest.
     1.   Defamation.
     2.   Business wrongs (i.e., interference with business, with 
          contract, with economic advantage.
     3.   Judicial wrongs (i.e., abuse of process, malicious     
          prosecution). 
     4.   Civil rights violations.
     5.   Conspiracy.
This pamphlet deals only with one of these:  defamation.  However,
some general advice is applicable to any critical public
expressions.

                  IMPORTANT TERMS AND CONCEPTS

DEFAMATION:  A statement or other communication to the mind of
another is defamatory of a person if it:  (a) holds him up to
hatred, contempt, disgrace, or ridicule; or (b) tends to injure him
in his office, business, trade, or profession.
SLANDER:  Slander generally refers to defamation conveyed to
another person orally, by gestures, mocking imitation, and so
forth. 
LIBEL:  Libel generally refers to defamation communicated in a
permanent form (it need not be immediately conveyed to another
person) such as writing, painting, caricature, effigy, emblem, and
so forth. 
BAD FAITH:  (see "fraud" in GLOSSARY)
GOOD FAITH:  A false statement mistakenly made by someone who
believed it to be true is said to have been made in "good faith".
MALICE:  Something, in a jury's judgement, done with ill will or
spite.
INVASION OF PRIVACY:  Some matters of a personal nature are nobody
else's business even if they happen to be true.
GENERAL DAMAGES:  Awarded by juries on the basis of their opinion
of fair compensation for a wrongful act.
PUNITIVE DAMAGES:  Extra compensation awarded an injured party in
order to set an example for others.  Usually based upon the ability
to pay.
SPECIAL DAMAGES:  These are damages to the plaintiff that are
extraordinary and not the usual consequences of the wrongful act. 
In slander (but not libel), these must be specified by the
plaintiff in the pleadings or they cannot be recovered.

              REQUIREMENTS OF ACTIONABLE DEFAMATION

1. ENTITY.  A specific entity or "entity under the law" such as a
person, organization, or class of persons recognized by law must
be involved.  For example, the statement "all medical doctors are
quacks" would not be actionable because it does not involve an
entity that is specific enough, since no single organization can
purport to represent "all medical doctors", and the statement is
too general to be applied to any individual medical doctor.

2.  THIRD PARTY.  Someone other than the entity that is the object
of the communication must hear or see it.  With SLANDER, the
witness must be capable of understanding the communication; LIBEL
doesn't require a direct third party witness, because
communications in a permanent form have a life of their own and 
may be seen by others in the future.

3.  DEFAMATION.  It is defamatory to accuse someone of impotence,
unchastity, having a loathsome disease, criminal acts, or
incompetence in his/her trade, business, office, or profession.

4.  INTENT.  Defamation need not be intentional.  For example, if
a personal defamatory letter not marked "private" or "personal" is
opened and read by a secretary, the secretary constitutes a third
party.

5.  MISTAKE.  If a third party reads a private communication by
mistake, the defendant cannot be held responsible if it was not
caused by him/her (e.g., letter opened by mistake).  However, if
the defendant caused the reading, even by mistake (e.g., a
secretary regularly opens and reads any mail not marked "personal"
or "private", he/she is deemed to be responsible.


                   DEFENSES AGAINST DEFAMATION

TRUTH.  In a civil action for slander or libel, it is always a
complete defense that the defamatory charge IS TRUE.  It is
immaterial whether or not the defendant believed it was true at the
time he/she made it or what the motive was for making it.  In
criminal cases, the defendant must have believed the charge was
untrue.  The defendant has the burden of proof for the truth of the
charge.

REPETITION OF ANOTHER'S STATEMENT.  Repetition of a defamation with
sufficient exactness and citation may be used as a defense, but
because great injury may accrue from the wrongful repetition of
defamation, the person repeating the charge can be held liable. 
Therefore, potentially defamatory information should be checked out
before it is repeated.

FAIR COMMENT OF CRITICISM.  Anything placed before the public, such
as a book or play, and the conduct of public persons, may be
commented upon and criticized provided such comment is fair,
without malice, and not an invasion of privacy.

LEAVE AND LICENSE.  If the plaintiff consented to the publication
of a defamation, he/she cannot afterwards make a complaint of it.

ABSOLUTE PRIVILEGE.  Under certain circumstances, specified
individuals are exempted from charges of defamation.  Included are
the President of the United States, federal and state legislators
acting in their official capacities, judges, juries, counselors,
witnesses in the course of judicial proceedings*, and reports by
naval and military officers in the course of their legal duty.

*Beware of the fact that privilege does not follow you from the
hearing room.  It is not unusual for the press to quote you after
a hearing.  If your statement is made outside of the hearing room,
you are not protected by privilege.

QUALIFIED PRIVILEGE.  The rule as to privileged reports is based
upon fairness and motivation.  The report should be a substantially
accurate account of the proceedings as a whole, not taken out of
context.  Government and scientific documents are often the source
of privileged reports.


                GENERAL GUIDELINES ON COMBATTING 
           HEALTH FRAUD, QUACKERY, AND MISINFORMATION

We believe that activists who understand the law and use common
sense have little to fear.  It is not libelous to attack an idea,
list the characteristic signs of quackery, or say that something
is "questionable".  One cannot libel a large group of individuals
or an entire industry.  One can libel an individual or organization
by name-calling.  It is legal to mention adverse facts about
someone who places himself in the public spotlight by claiming to
have expert knowledge.  Avoid statements about motivation (such as
"he's in it only for the money"), because they may be impossible
to prove.  During sensitive interviews, it is wise to have your own
tape recorder operating.

AVOID DEFAMATION.  This may be done by not aiming remarks at a
specific entity.  Don't single out specific individuals,
organizations, products, companies, and the like.  Be more general. 
Concentrate on generic formulas, types of practitioners, methods
of practice, and so forth.  If asked to label someone a "quack" or
something "quackery", be sure you offer a clear definition of what
you mean, and preface your remarks with "in my opinion" or an
equivalent statement.

YOUR OPINION IS ALWAYS TRUTH.  If you preface your remarks with a
clear statement that what you say is your opinion, it automatically
becomes a true statement.  However, even though "In my opinion,
John Doe is a dangerous quack" is a true statement of your opinion,
it is not necessarily a true description of John Doe.  Such a
statement would be ill-advised, because it is inflammatory and apt
to invite a lawsuit by John Doe that could cost you time and money
to defend.

BE SMART.  It is not a good idea to call an individual a quack,
unless you are willing to defend it in court.  It is better to call
a practice "quackery" without directing charges at individuals.

BE INFORMED.  Don't go off half-cocked.  Be sure that you know a
great deal about the topic you are dealing with.  Assume nothing. 
Be sure!

BE AWARE.  When criticizing or accusing an entity, be aware of the
nature of your charge.  Know whether you are making accusations of
criminal behavior, incompetence, or something else that will injure
him/her in business, trade, or profession.  Be sure your evidence
will support such a charge.

USE THE RIGHT TERMS.  When describing the actions of people, be
accurate.  Get a clear picture of what they are doing, and describe
it in proper terms.  The rule is to use standard terminology from
recognized, authoritative sources.  See the glossary provided at
the end of this pamphlet.

DESCRIBE AS THOROUGHLY AND ACCURATELY AS POSSIBLE.  The best rule
on being informed is to concentrate primarily upon obtaining a
clear, accurate, and thorough description of the product, service,
book, practitioner(s), company, organization, theory, belief, or
whatever it is you are dealing with.  Get it in writing, and be
sure you understand it in detail.  If you are unclear on a point,
obtain clarification.

POINT OUT ADVERSE TRUTHS.  It is not necessary or advisable to
exaggerate or embellish the facts.  It is only necessary to point
out the adverse truths about the entity in question.  If a quack's
doctorate is from an unaccredited school or "degree mill", simply
point it out.  If he/she has a criminal record, cite it accurately. 
If a claim is outrageous, merely provide accurate counter
information and sometimes some aid in logic or insight.

UNDERSTATEMENT IS BETTER.  It is tempting to attack the problems
of health fraud, quackery, and misinformation as strongly (in an
emotional sense) as possible at each opportunity.  Strident
approaches to public issues can attract attention, but often fail
in the long run (i.e. the "Chicken Little" phenomenon).  The war
against these social evils is on-going.  Credibility and
persistence are our most-effective weapons.  Objective,
unemotional, well-informed understatement offered with tolerance
and understanding (quacks are often victims themselves who
unwittingly victimize others in their misguided attempts to help) -
- with some humor when appropriate -- is a better way.

DO NOT ASSUME THAT QUACKS ACT IN BAD FAITH.  While it is true that
some quacks are greedy con men, others may be insane, incompetent,
or zealots who sincerely believe in their nostrums and are
motivated by altruism.  In the final analysis, from the consumer's
point of view, motivation doesn't matter.

FOCUS ON IMPORTANT ISSUES.  The important issues are (1) is the
health-related product or service accurately labeled or described,
(2) truthfully advertised, (3) safe to use as recommended, or (4)
valid (if diagnostic) or effective (if a preventative, medication,
or treatment) for the condition for which it is offered?

IDENTIFY THE HARM BEING DONE.  Opponents of health fraud, quackery,
and misinformation must compete with such crimes as robbery, child
abuse, maiming, and murder as dangers in the public mind.  In
reality, these problems may lead to any of these harmful outcomes. 
However, when pointing out such possibilities to the press,
legislators, or an audience, have specific examples in mind that
will hold up to close scrutiny and critical analysis as reasonable
and valid.

Categories in which harm may fall include
(1)  Economic harm.
(2)  Direct harm by commission (i.e., poisoning, maiming,
     malnutrition, injury).
(3)  Indirect harm by omission (i.e., avoiding or delaying proper
     care, which allows a disease to progress causing unnecessary
     damage or death).
(4)  Psychological harm (e.g., causing mental anguish by leading
     someone to wrongly believe he has cancer, creating false hope
     that will be dashed, creating unwarranted fear of drugs or
     surgery, creating distrust of scientifically-based health
     care, etc.).
(5)  Harm to society (e.g., widespread misbeliefs can lead to
     misguided policy, undermine sound consumer protection laws,
     waste resources, deflect research appropriation from sound
     pursuits, etc.).

BE FIRM.  Once you have your evidence in hand, know what you are
doing and have made your charge, stick to your guns.  Don't allow
threats of lawsuits and lawsuits filed against you to cause panic. 
Most threats do not materialize, and even lawsuits that have been
filed are not pursued when it becomes clear that you know what you
are doing and have a good case for your statements.

                            GLOSSARY

FRAUD.  The word "fraud" is legally defined as "a generic term
embracing all multifarious means that human ingenuity can devise,
and that are resorted to by one individual to get advantage over
another by false suggestions or by suppression of truth" (1).  A
shorter definition is "intentional perversion of truth in order to
induce another to part with something of value or surrender a legal
right" (2).  The quality of deliberate intent to deceive is the key
feature in fraud.  If intent to deceive cannot be proved, avoid
this term.

QUACK/QUACKERY.  An example of how confused attempts to define
quackery have been can be found in an FDA Consumer Memo, which
states "Broadly speaking, quackery is misinformation about health"
(5).  Certainly, quackery involves the use or exploitation of
misinformation about health, but the statement makes no sense as
presented.  The public understands this term to apply to health
promotions they should avoid.  However, it is a difficult term for
activists to employ, because of its loaded implication of fraud. 
A major medical dictionary defines a quack as "one who fraudulently
misrepresents his ability and experience in the diagnosis and
treatment of disease, or the effects to be achieved by the
treatment he offers" (3).  The word's origin simply was "...a
clipped form of KWAKSALVER, which is one who `quacks' like a duck
about his salves and remedies" (4), which does not require that
fraud be involved.  In some states, a quack is legally defined as
"someone who promotes medicine without a license", meaning that
neither fraud nor promoting worthless remedies is essential.

Congress has provided a functional definition of a quack in the
1984 hearings chaired by Claude Pepper.  In Pepper's report (10),
a quack was defined as "...anyone who promotes medical schemes or
remedies known to be false, or that are unproven, for a profit".
("...for a profit" is understood to refer to any type of money-
making scheme such as donations, loans, or alleged non-profit
organizations; it was meant to distinguish self-applied folk
medicine from commercial promotions.)  This definition is probably
the best to use presently, because it doesn't state or imply
deliberate fraudulent intent, and is from a recognized
authoritative source.  In any case, it is important that one make
clear what definition is being used when applying the term "quack".

MISINFORMATION.  Misinformation is what it is.  Misinformation
differs from ignorance (i.e., not knowing), and, if deeply-held,
may extend to misbelief.  There are no implications of fraud or
quackery.  Misinformation mainly needs identification and
correction.


                 DESCRIBING BEHAVIOR ASSOCIATED
         WITH HEALTH FRAUD, QUACKERY, AND MISINFORMATION

Many terms are available to describe behavior offensive to people
in consumer protection.  Select and use only those terms that
accurately apply.  Use standard or recognized reference sources for
definitions you choose.  Following are some useful examples:

CHARLATAN:     A pretender to medical knowledge, faker, or fraud
               (2).
CRANK:         An eccentric person (2) (who believes his offbeat
               theories).
CULT:          A system for the cure of disease, based upon dogma
               set forth by it promulgator (2).
DEGREE MILL:   An organization that awards degrees without
               requiring its students to meet educational standards
               for such degrees established and traditionally
               followed by reputable institutions (6).
FOOD FADDISM:  The is no standard definition for this term.  It is
               usually used as a generic term to describe
               nutritional nonsense of all kinds.  Food faddists
               are characterized by their exaggerated belief in the
               value of nutrition in health and disease.
FRINGE 
PRACTITIONER:  One with marginal or extremist views (2).
HUCKSTER:      One who acts primarily from mercenary motives (7);
               to promote by showmanship (2,7).
MAVERICK:      An independent individual who refuses to conform to
               his group (2).
MOUNTEBANK:    One who sells medicines from a platform (2).
PSEUDOSCIENCE: A system of theories, assumptions, and methods
               erroneously regarded as scientific (2,7).
SALESMAN:      A relatively benign term, which can be applied to
               promoters of health products & services for the
               purposes of warning consumers.


                    REFERENCES AND RESOURCES

1.   "Black's Legal Dictionary".
2.   "Webster's Seventh New Collegiate Dictionary".  Springfield,
     MA:  G. & C. Merriam Company, 1972.
3.   "Dorland's Illustrated Medical Dictionary, 25th Edition". 
     Philadelphia:  W. B. Saunders Co., 1974.
4.   Funk, W., "Word Origins".  New York:  Bell Publishing Co.,
     1978.
5.   "Quackery:  Paying for Miracles that Never Happen". HEW
     Publication No. (FDA) 79-1017, July, 1979.
6.   U.S. Office of Education, "Pollution in Higher Educational 
     Efforts of the U.S. Office of Education in Relation to Degree
     Mills", March, 1974.
7.   "Webster's Third New International Dictionary".  Chicago: 
     Encyclopedia Britannica, Inc., 1976.
8.   "American Law and Procedure, Volume Two:  Torts, Domestic
     Relations, and Persons".  Chicago:  LaSalle Extension
     University, 1962.
9.   Barretts, Herbert V., "Vitamins and `Health Foods':  The Great
     American Hustle", chapter "Nutrition and the Media",
     Philadelphia:  Stickley, 1982.
10.  Pepper, C., "Quackery: A $10 Billion Scandal", report by the
     chairman of the Subcommittee on Health and Long-Term Care of
     the Select Committee on Aging, House of Representatives, 98th
     Congress, Second Session, May 31, 1984.  Committee publication
     no. 98-435.


NOTE:     "Avoiding Legal Problems" is intended for educational
          purposes only.  It is not intended as legal advice.

Approved by the NCAHF Board of Directors on June 25, 1986.
----------------------------------------------------------
For more information, write to

The National Council against Health Fraud, Inc.
Post Office Box 1276
Loma Linda, CA 92354

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