When CFA actually did send aid to cancer parents, it was at least in some cases apparently a sham:

Carol Smith still gets angry when she remembers the box that arrived by mail for her dying husband. Cancer Fund of America sent it when he was diagnosed with lung cancer six years ago. Smith had called the charity for help. “It was filled with paper plates, cups, napkins and kids’ toys,” the 67-year-old Knoxville, Tenn., resident said. “My husband looked like somebody slapped him in the face. I just threw it in the trash.”

Among the defendants in the case are Reynolds’s son, James Reynolds II, and ex-wife, Rose Perkins, as well as Kyle Effler. Those three agreed to settle charges, with a proposed agreement that bans them from charity work and fundraising and closes CCFOA and BCS. While there are large monetary judgments involved, the money is mostly spent, and it’s unlikely much of it will be recovered. Reynolds Sr., meanwhile, is fighting the charges.

This isn’t the first time Reynolds-linked charities have come under scrutiny. In 2013, an investigation by The Tampa Bay Times and the Center for Investigative Reporting looked into bad charities across the board, concluding that even among the worst offenders, “None is more brazen and incestuous than the Reynolds network.”

The network’s programs are overstated at best. Some have been fabricated. “Urgent pain medication” supposedly provided to critically ill cancer patients amounted to nothing more than over-the-counter ibuprofen, regulators determined. A program to drive patients to chemotherapy, touted by the charity in mailings, didn’t exist. One Reynolds family charity, Breast Cancer Society, told the IRS it shipped $36 million worth of medical supplies overseas in 2011. But the two companies named as suppliers of the donated goods said they have no record of dealing with the group. Over the past 20 years, Cancer Fund has run afoul of regulators in at least six states, paying $525,000 to settle charges that include lying to donors. It hasn’t slowed the network.

Associated Community Services, listed in the complaint as CFA’s main telemarketer, settled a lawsuit from the Michigan Attorney General’s office in early 2014, and filed for bankruptcy soon after.

The FTC says this is one of the largest scam charity cases it has ever filed. But even if the scale is unusual, the way the Reynolds network operated is not. (The complaint refers to Reynolds II “learn[ing] the cancer business from his father,” offering some idea of how conventional it is.) Many of the worst charities hire fundraisers who eat up most of donations, and many of them use misleading names that fool would-be donors.

First, the fundraising: What is so pernicious about scams like this is that the very thing that makes them so outrageous is what makes them so effective. Anyone with a heart is likely to be outraged at the scheme—taking advantage of a horrific disease as a way to line an individual’s pockets. But it also makes it hard for people to turn down solicitations. Altruism, of course, makes people feel good, and helping out cancer victims seems like a no-brainer. The Tampa Bay Times/CIR investigation produced a list of charities that spend tiny amounts on direct cash aid while sending enormous sums to the fundraisers themselves.