[Melas]

It is about a question being asked and the answer recorded in what is a permanent file which follows you everywhere.

So long as answering the question is voluntary, there is no problem. None at all.

[Smokin' Joe]

If you refuse to answer, and the doctor records that as a "yes", then you have participated. (Otherwise, why refuse? Not answering is an answer.) There is no voluntary participation once you are asked.