Abstract

Traditional accounts of informed consent treat it as an episodic, individual act, but this model struggles in contexts of sustained dependency, fluctuating capacity, or long-term relational care. This paper introduces collaborative consent, in which agency and decision-making are distributed across people and institutions over time. Caregivers, clinicians, and patients co-construct understanding and authorisation, preserving autonomy while clarifying responsibility. By viewing consent as relational and processual rather than momentary, collaborative consent better captures the ethics of paediatric care, developmental disability, and neurodegenerative illness, without collapsing into paternalism or proxy decision-making.