What do you mean in secret? The person explicitly talks about providing the hospital with alternative agreement. It is their responsebility to read everything they sign, just like it is the patient's
It is absolutely not your responsibility to check for the case that you give someone papers to sign and they give you back something different unless they tell you so.
Correct. Sending a new draft along with a message saying "here are our revisions," is standard contract negotiation. You would have no case that the new terms were consented to.
It's amazing that you people are still arguing this in earnest so far down the thread. Can you think for a second what the implications of this would mean for society, if it were an acceptable form of "negotiation"? It would be even worse for the ordinary little people.
If you explicitly tell the other side that there are changes, sure.
But the comment I was referring to talked about "swapping" the papers and said "I doubt anyone would catch it". That does not sound like negotiating in good faith to me.
The most honest behavior would probably be to mark additions or changes on the form they give you, if they'll fit.