Legal Issues in Caring for the Adolescent Student—Consent and Privacy

Book Chapter

Kristen Reilly, Ashley Ebersole

Clinical Considerations in School-based Health, 24 May 2025 [Springer]

Abstract

For patients who are minors (younger than 18), laws governing their care may be different than those for adults. The legal issues that most commonly arise concern consent (who can provide consent and for what care?) and confidentiality (what information can be shared and with whom?). This chapter will summarize the legal framework within the United States, discuss considerations for a school-based provider, and review relevant patient cases.

The Issue of Informed Consent of the Surrogate Mother in Context of Surrogacy Arrangements – Autonomy and Dignity

Zsófia Nagy, Andrea Erdősová

STUDIA IURIDICA Cassoviensia, 27 March 2025

Abstract

Since assisted reproductive techniques have widespread in medical science, bioethical principles and legal implications surrounding commercial surrogacy arrangements, particularly focusing on the position of surrogate mothers have emerged. With the rise of in vitro fertilization and the growing prevalence of surrogacy in the latter half of the 20th century, the contractual nature of these arrangements has sparked significant ethical and human rights concerns. The article delves into the complexities of parental filiation, the potential exploitation of surrogate mothers, and the critical importance of informed consent and patient autonomy in this context. The analysis of these issues could shed light on the ethical and legal discourse surrounding commercial surrogacy and collaborate to the discourse of the relevancy of the informed consent of the surrogate mother in surrogacy arrangements.

Editor’s note:  STUDIA IURIDICA Cassoviensia is published by Jozef Safarik University [Slovakia] Faculty of Law

Regulatory Frameworks, Compliance and Healthcare Responsibilities on Informed Consent in Nigeria

Chukwunye Augusta Ojeih, Olumide Ogidan, Adetutu Adewole

African Journal of Law, Ethics and Education, 2025

Abstract

Informed consent is a cornerstone of healthcare ethics and law in Nigeria. However, ensuring regulatory compliance and healthcare provider accountability remains a challenge. This paper examines the tripartite relationship between regulatory frameworks, institutional compliance, and healthcare provider responsibilities in obtaining informed consent; it analyzes existing laws, policies, and guidelines to identify gaps. It further scrutinizes the role of healthcare institutions and providers in ensuring effective informed consent practices, highlighting the challenges and opportunities for promoting patient autonomy and dignity in Nigeria’s healthcare system. This study ultimately argues that a multifaceted approach, incorporating regulatory reform, institutional accountability, and provider responsibility is essential for ensuring the integrity and efficacy of informed consent in Nigeria’s healthcare sector.

Expectations for meaningful free, prior, and informed consent: an exploration by the Little Salmon/Carmacks First Nation
Original Article
Emily Martin, The Little Salmon Carmacks First Nation, Ben Bradshaw
The Extractive Industries and Society, September 2025
Abstract
Indigenous self-determination plays an increasingly prominent role in lands and resources development decisions. One way of operationalizing self-determination is through the realization of free, prior, and informed consent (FPIC) for development impacting Indigenous Peoples and their lands, as recognized in the United Nations Declaration on the Rights of Indigenous peoples (UNDRIP). In the Yukon, Canada, where some consent and consent-like rights are held by First Nations, few First Nations have formally articulated their expectations for the meaningful expression of their consent. This paper begins to address this gap based on a case study by the Little Salmon/Carmacks First Nation (LS/CFN), a self-governing, Northern Tutchone Yukon First Nation located proximate to past, present, and potentially future mineral development. Though LS/CFN’s expectations of FPIC are not formalized today, this exploratory research presents that LS/CFN participants expect: early engagement; to be fully informed; space for self-defined internal processes; ongoing engagement with proponents and the Crown; mitigation of resource barriers; enforceability of commitments; contextually relevant processes; appropriate representation; agreed upon definitions of terminology; mitigation of power imbalances; and mutual agreement on the consent process itself. More broadly this article makes a case for a covenantal, rather than a solely contractual, approach to make FPIC meaningful.

Beyond Consent: Ensuring Meaningful Protection of Genetic Data Under India’s Digital Personal Data Protection Act, 2023
Review Article
RK Singh, Vini Singh
Journal of Indian Academy of Forensic Medicine, 10 April 2025
Open Access
Abstract
   India’s Digital Personal Data Protection Act (DPDPA) adopts a notice-and-consent-based framework for data protection; it treats all personal data, including genetic data, as a singular category without accounting for its unique characteristics. Unlike ordinary personal data, genetic data is inherently relational; it reveals information not just about an individual but also their biological relatives. Moreover, the risks associated with the processing of genetic data extend beyond identifiability, such as the potential for its misuse in law enforcement or to discriminate in matters of employment or insurance. Despite these concerns, the DPDPA fails to offer a nuanced regulatory approach, lacks a clear definition of genetic data, and does not impose heightened safeguards for its processing.
This article identifies the limitations of the DPDPA’s notice-and-consent-based model in regulating genetic data processing and argues for a shift toward a harm-based framework. It proposes key reforms, such as the classification of genetic data into categories based on sensitivity, an expanded definition of the data principal to include affected blood relatives, and risk-based processing guidelines that categorize genetic data processing into prohibited, high-risk, medium-risk, and low-risk processing. Additionally, this article advocates for stronger privacy by design and by default requirements, mandatory data protection impact assessments (DPIAs), and the introduction of rights such as data portability and right to restrict processing.
Further, to ensure effective enforcement, it recommends strengthening grievance redressal mechanisms, introducing compensation for privacy harms, and imposing proportionate criminal liability for negligent handling of sensitive genetic data.
By addressing these gaps, this article underscores the need for a strong legal framework that moves beyond notice and consent to provide meaningful privacy protections for genetic data in India’s evolving digital landscape.

Patient’s Right to Consent to Medical Procedures from the Perspective of Health Law, Bioethics, and Human Rights
Ni Putu Parvathi Priyadarshini, Gusti Ayu Putri Kartika
Journal of Law Politic and Humanities, March 2025
Abstract
The patient’s right to consent to medical procedures is a vital element in the relationship between patients and healthcare providers, connected to health law, bioethics, and human rights, all focusing on the protection of patient autonomy. This study analyzes the patient’s right to consent from the perspectives of health law, bioethics, and human rights, and identifies challenges in its implementation in Indonesia. A normative method is employed with legislative, conceptual, and comparative approaches. Data is gathered by analyzing national regulations, bioethical principles, and literature on human rights. Descriptive-analytical analysis was used to explore the synergy between these three perspectives in medical consent implementation. Findings reveal that the patient’s right to consent is regulated by Law No. 17 of 2023 and other relevant regulations. Bioethics stresses respecting patient autonomy, while human rights ensure access to information and the freedom to consent. Challenges include paternalistic cultural attitudes, low public awareness, and inadequate healthcare facilities. Recommendations include strengthening regulations, providing bioethics training for healthcare professionals, and educating the public to safeguard patient rights in medical procedures in accordance with health law, bioethics, and human rights.

On the Legal Dilemma and the Way Out of Revocation of Consent by Living Organ Transplant Donors
Jie Xi, Lei Feng
Open Access Library Journal, March 2025
Abstract
This paper’s purpose is to discuss the legal dilemma arising from the revocation of consent by donors in living organ transplantation, analyze its jurisprudential basis and practical impact, and propose a solution to balance the rights and interests of donors and recipients, so as to promote the healthy development of the organ transplantation cause. Through the analysis of typical cases, it reveals the real harm of revocation of consent; combined with the legislative status of China’s Human Organ Transplantation Regulations, it points out the deficiencies of the current law in the definition of conditions, procedures and consequences of the exercise of the right of revocation; from the perspective of jurisprudence, it demonstrates the legitimacy of the revocation of consent, and emphasizes that it is in line with the principle of voluntariness, personal autonomy, and social adaptability of the law; through the comparative study, it compiles the legal difficulties in the protection of donor autonomy, information and notification mechanism, and psychological and social impacts in the US and Germany. Through comparative legal research, the practical experience of the United States and Germany in protecting the autonomy of donors, the information mechanism and the psychological counseling system is examined; specific conditions limiting the exercise of the right of revocation are proposed, including time, form and force majeure factors, and a framework of legislative proposals is constructed based on them.

Editor’s Note: The revocation of consent referred to in this article occurs prior to surgery taking place.

Updating Winterwerp with Rooman to add a requirement for ‘Real therapeutic measures’ to legal criteria for admission without consent in psychiatry
Brendan D. Kelly
International Journal of Law and Psychiatry, July–August 2025
Open Access
Abstract
Admission without consent and treatment without consent are topics of prolonged discussion throughout the history of psychiatry. These practices raise significant issues pertaining to human rights to liberty, bodily integrity, and treatment. Balancing rights is always challenging, especially when people lack decision-making capacity owing to the impact of mental illness. In 1979, the European Court of Human Rights outlined criteria required to justify lawful admission without consent owing to mental disorder in Winterwerp v. the Netherlands. These criteria were: (a) a competent national authority needs to demonstrate the existence of a true mental disorder based on objective medical expertise; (b) the extent of the mental disorder needs to warrant compulsory confinement, and (c) continued detention needs to be validated by the persistence of the disorder. Since then, the Court has delivered multiple judgements relating to psychiatric committal and detention in various facilities, but the most significant potential addition to the Winterwerp criteria occurred in 2019, in Rooman v. Belgium. In this case, the Court stated, “that there exists a close link between the ‘lawfulness’ of the detention of persons suffering from mental disorders and the appropriateness of the treatment provided for their mental condition”. The Court stressed ‘that, irrespective of the facility in which those persons are placed, they are entitled to be provided with a suitable medical environment accompanied by real therapeutic measures’. On this basis, this paper proposes adding a fourth requirement to the Winterwerp criteria to justify lawful admission without consent owing to mental disorder: ‘(d) real therapeutic measures must be provided’. The absence of ‘real therapeutic measures’ should undermine the legal basis of admission without consent on the basis of mental disorder. This would mean that there could be no involuntary admission owing to mental disorder without treatment being appropriate and available. Such an addition to criteria for involuntary admission in national mental health legislation would protect, rather than erode, human rights, and would more accurately reflect the core purpose of psychiatry: the treatment of mental illness and the consequent alleviation of suffering.

Waiver of informed consent in clinical research: a summary of contemporary guidelines and a resource for researchers
Amanda Siriwardana, Brendan Smyth, Meg Jardine
BMJ Open, 18 March 2025
Abstract
Objective
Low-risk pragmatic clinical research such as learning health system research, quality assurance activities and comparative effectiveness studies are approaches to embedding clinical research within routine practice to generate generalisable evidence. Individual written informed consent may present a barrier to the feasibility and inclusiveness of such low-risk clinical research. Within an overarching moral and ethical framework, the form and requirements of consent vary in both clinical practice and research settings according to the context and level of risk. Within some low-risk research settings, waiver of consent may be appropriate.
Analysis
We sought to describe contemporary national and international English-language guidelines pertaining to the use and oversight of waiver of consent in clinical research. We identify 14 guidelines including 1 international, 1 regional and 12 national statements, and summarise the principles in each for circumstances in which a waiver of consent is appropriate.
Conclusion
While complete international harmonisation of policy may be neither realistic nor necessary, there are numerous unifying concordances suggesting a broad consensus on the approach to waiver of consent research.

Unconsented Educational Pelvic Exams on Anesthetized Patients: The Collapse of Legal and Ethical Safeguards for Patient Consent
Rachel Beth Cohen
Maine Law Review, 10 March 2025
Abstract
It is a troubling reality that medical students in some U.S. teaching hospitals perform pelvic examinations on anesthetized surgical patients without their explicit knowledge or consent. These unconsented educational pelvic examinations raise serious ethical and legal concerns. Although professional medical societies agree that specific and voluntary consent is a fundamental ethical prerequisite for conducting such examinations, this standard has been frequently disregarded in practice. The law offers little practical deterrence to this violation of patient autonomy. Tort law provisions on battery and informed consent are ineffective in addressing the issue, while state legislatures have largely failed, or outright refused, to pass enforceable prohibitions on the practice. Criminal prosecution is problematic for multiple reasons. Even the United States Department of Health and Human Services, which has the authority to regulate procedures performed on anesthetized patients, has issued guidance that stops short of providing an enforceable solution. Given the inability to reliably ensure patient consent, this Article argues that educational pelvic examinations on anesthetized patients must be categorically prohibited. Ethical and legally sound alternatives exist to train medical students in pelvic examination techniques without compromising patients’ autonomy.