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.

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/