“YOU LET PEOPLE SIGN CONSENT FORMS IN PENCIL, HOW CAN YOU JUSTIFY THAT?!” The funny thing is, contracts are legally binding agreements, whether they are ve

“YOU LET PEOPLE SIGN CONSENT FORMS IN PENCIL, HOW CAN YOU JUSTIFY THAT?!” The funny thing is, contracts are legally binding agreements, whether they are verbal, scribbled on a napkin, signed in pencil, pen or blood, and whether the signature is an easily forged 'X' or elaborate calligraphy. Consent forms are a slightly different use-case, but I think the premise is the same: to show a meeting of the minds. Knowing this, the pencil signature actually protects the patient more than the institution, since the patient could theoretically forge a revocation of consent by erasing their mark. Meanwhile, ink isn't as binding, without some sort of objective third-party official (e.g. a notary public, beholden neither to patient nor to institution) serving as formal witness, further validating a non-forgery, in the case of a simple 'X' or erasure thereof. In practical terms, one solution to render the pencil signature binding would be to create a tamper-evident photocopy, with fraud-marks like a UUID moire pattern sprayed by an ordinary desktop printer, for each serialized document, readily detectable in the photocopy but permanently printed into the background of the form (e.g. yes, this is a photocopy of the same piece of paper, and the forger failed to notice the lightly tinted pattern, when erasing their signature), and retain the pencil copy, to ensure a match. In the event of an erasure, the paper might show an abrasion, and the photocopy would act as a snapshot/backup. Meanwhile, it should be possible to access existing, archived, historical questionnaires and actual clinical diagnoses from normal records, in a de-identified fashion, and compare results, no? Am I misunderstanding the goal of the study? Didn't he want to compare the assessment of the survey, with actual patient dispositions, and leave the rest of all treatment untouched, undisturbed and otherwise normal? Ask the questions, do the rest, same as ever, but analyze the opinion formed by the score of the answers to the questions, with the opinion of the professional caregiver beyond the scope of the simple Q&A exam?