Informed Consent

To the Editor: In their review article (March 2 issue), 1 Grady and colleagues suggest that technological advances could help to facilitate obtaining informed consent without an in-person meeting between participants and investigators. However, we believe that true informed consent needs to go beyond symbolic measures such as clicking blocks electronically or supplying a signature. Without an in-person meeting, participants may feel coerced into participating without the researcher being aware of it. In addition to securing the privacy and confidentiality of participants, mutual trust and confidence must be built while sharing the emotions regarding fear and anxiety about uncertainty and unpredictability . . .