Yeah, but these are rather theoretical practicalities. In the majority of cases, consent is coaxed out of the consumer. If you show up for a MRI, and you get a piece of paper with the comment "It is for data protection", almost nobody has the time or nerve to actually read the text, and even less people have the inclination to decline to sign. After all, they (sometimes desperately) need the service. Let alone that the accompanying comment is deliberately phrased such that some people will believe they need to sign in order for their data to be protected. Dark patterns all over the place. My bank implemented the consent (for a while) as a reoccuring pop-up after login. Yes, you get the popup as long as you decline to sign it, over and over again. I think they gave up on that practice, and it was partly a dark pattern (IOW, there were two buttons to decline to sign, and one would result in the popup reoccuring). Examples are all over the place if you walk an EU country with open eyes.