> How many people die every year because we don't dare risk any deaths from uncertain treatments like these? Sure, they aren't ever going to be perfect, but- what's the net?

The trials exist. Getting patients enrolled in the trials is the biggest problem. Navigating the bureaucracy is a huge problem ("Please be dying, but not too quickly, part 1: a clinical trial story" see: https://bessstillman.substack.com/p/please-be-dying-but-not-...).

Even worse--we know the net to this stuff. It's negative and large.

We just went through this. Desperate people are stupid. Look at all the snake oil about Covid cures before the vaccines and how much damage that snake oil did.

And it's worse than that. It encourages ethical problems among the doctors themselves. You're sure your treatment will work it just needs a couple more patients. What will you do to get those patients?

Finally, if you throw the system open, the people playing by the rules will get drowned by those not. Bad money drives out good and all that.

The system as we have it certainly isn't ideal, but throwing things open would be much, much worse.