Wheeler's comments1 relating to my Hunterian paper2 are welcome, highlighting persuasive arguments in favour of a request-based system of consent and allowing some clarifications. His suggestion of ‘special arrangements’ aiding non-English speakers is most welcome; indeed, the fact that procedures are not universally in place for these patients at present is a critical legal, ethical and clinical omission of the current process of written consent. It is just too easy to acquire simply a signature from any patient and proceed to surgery (without truly valid consent). The ‘all-you-need-is-a-signature’ process of current consent facilitates this negligent practice. Wheeler, therefore, puts into sharp focus how consent using RFT does not allow a patient to undergo treatment without first giving truly informed consent. Thus, the issue is not that RFT can in some circumstances be difficult to implement, it is that RFT will not allow a non-informed patient to proceed to surgery, which, after all, is the primary aim of a written document of consent. In any circumstance where a patient can sign a consent form but cannot accurately complete an RFT form, I would challenge the validity of that consent. Wheeler suggests that comparative data could help in seeing whether RFT might be better than standard written consent in the assessment of capacity. This is simple to answer: current written consent forms provide no evidence of capacity and were never designed to do so. In contrast, RFT uniquely provides documentary evidence of capacity. Wheeler concedes ‘providing evidence of a patient's consideration of information before deciding to consent...would be an improvement on the current evidential offering in a claim in negligence’.3 It is worth noting that ‘patient consideration of information’ to which he refers is pre-requisite in defining capacity under the Mental Capacity Act 2005. Wheeler also urges caution in completion of RFT forms, suggesting doctors could demonstrate liability if not completed properly. This, of course, is relevant for any process with medicolegal implications. If introduced, RFT must be undertaken correctly.2 Ultimately, however, I doubt that his note of caution is actually practically relevant: in the legal cases where consent was deemed negligent, the onus rests with the doctor to prove that the signature on the form reflected true patient understanding. Chester v Afshar3 changed the UK legal stance and highlighted the importance of risk disclosure and informed consent. Thus, ‘inability to prove informed consent’ and ‘proof that consent is inadequate’ are equally detrimental. Through harbouring excellent communication and better understanding of patient expectations, RFT will have a greater impact in reducing clinical negligence - a much bigger problem in terms of frequency and cost than negligent consenting practice. The ‘trap’ is, therefore, not in the RFT form, it is simply in operating on patients who have not been adequately consented, regardless of modality. Unlike the origins of written consent, RFT has been designed to improve patient care whilst simultaneously improving documentary evidence of consent (currently described as ‘window dressing’ by Lord Popwell4). We all yearn for evidence upon which to base our practice, despite the fact that much of what we do remains surprisingly lacking in that precious commodity. We currently consent patients using a non-evidence-based bureaucratically imposed system against which there exists a large body of evidence that it is not fit for purpose.2 Whilst there are many contexts in which further evidence for RFT would surely be welcomed, the specific evidence that Wheeler calls for is surely redundant and appears contradictory: A mere signature does not demonstrate valid consent. Evidence is needed that the use of an RFT form will improve the situation. (final paragraph, Wheeler1) Really? Try it.5