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Anyone who has been a scientist for more than 20 years will realize that there has been a progressive decline in the honesty of communications between scientists, between scientists and their institutions and between scientists and their institutions and the outside world.’ These are the words of Bruce Charlton, Professor of Theoretical medicine. This sad stated of affairs is reinforced by Marcia Agnell who was the editor of the New England Journal of Medicine for twenty years. The highest impact medical journal in the world. ‘It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines.’ Dr Kendrick will explain how we have traveled to this crisis point.