Understanding how bureaucracy develops

I'm pretty torn about this, because I am also deeply skeptical of exactly the sort of situations an IRB is set up to prevent. Things like requiring documents to be signed in pen are an important part of a secure audit trail. And an appropriate audit trail with proper safe guards is absolutely essential especially given the way personal health related things are conducted in the inherent darkness of confidentiality. The privacy protections of personal health records also happens to be just as effective at keeping evidence of corrupt conduct within the system private as well.

Maybe the real problem is that there is (at least to a degree) a trilemma between effective, safe from research misconduct, and respectful of individual privacy.

Where does the perception that signing a physical piece of paper with pen is an important part of a secure audit trail?

If a signature is meant to represent both intent and identity, what is it about the physical medium which makes it more ideal than a digital signature where you're prompted to enter in your login password or something similar?

Is it the belief that its less forgable, that electronic audit trails are more easily duped and spoofed while signature blocks and paper/pen is somehow immutable (despite the decades of forged signatures easily traced from other sources)?

Never understood this idea whatsoever, it just strikes me as a form of pearl-clutching over some nebulous hackers that could easily destroy our well-oiled pen/paper/document machines.

As per the article, the alternative was pencil not digital. For whatever reason the rule of the mental ward was there could only be access to pencils. Pencil marks are indeed more mutable and thus more vulnerable than pen.

Electronic signatures are an entirely different (and interesting) thing to consider.

According to the original account, the pencil/pen thing wasn't about an audit trail, and both the IRB and hospital admin were equally silly.

> IRREGULARITY #3: Signatures are traditionally in pen. But we said our patients would sign in pencil. Why?

> Well, because psychiatric patients aren’t allowed to have pens in case they stab themselves with them. I don’t get why stabbing yourself with a pencil is any less of a problem, but the rules are the rules. We asked the hospital administration for a one-time exemption, to let our patients have pens just long enough to sign the consent form. Hospital administration said absolutely not, and they didn’t care if this sabotaged our entire study, it was pencil or nothing.

https://slatestarcodex.com/2017/08/29/my-irb-nightmare/