KIE: The chairman of the Patients Association, a British advocacy group, responds to Roger C. Sider and Colleen D. Clements' essay in this issue of the Journal of Medical Ethics on a patient's moral obligation to preserve his or her health. She rejects their implication that, because of this obligation to oneself, there also is an obligation to follow the advice of one's doctor. Agreeing that society would be healthier and public health expenditures would be lower if people took better care of themselves, Ackroyd nonetheless declines to view the latter as a moral obligation. She believes that a closer relationship between patients and doctors should be encouraged, but rejects Sider and Clements' assertion that the latter "are moral guides in the realm of health," and that patients who disregard their advice "risk violating fundamental ethical obligations and invite justifiable disapproval."