Explicit documentation of consent for (each and every) administration of medications and routine radiographs is excessively onerous and not routine practice, even in the VA system. The use of the admission “blanket consent” for “routine and low-risk” diagnostic and therapeutic interventions seems reasonable. However, many routinely administered medications have potentially life-threatening side effects. Should practitioners be required to discuss risks, benefits, and alternatives of every new medication with their hospitalized patients and document each discussion? If so physicians could spend half of each day pursuing and documenting informed consent. Irrespective of its shortcomings, the VA policy has strengths that could serve as the foundation for a more uniform code of conduct in this area. We noted in casual conversations with our peers around the state and country that our local (rigid) practice of consent differed from that of many institutions. Our study simply documented this heterogeneity. The practice of informed consent, which is fundamental to patient autonomy, varies within states and even within hospitals.2 We suspect that this heterogeneity of practice resulted from lack of a single, explicit (and enforced) national standard.