
Informed consent is traditionally understood as an ethical and legal obligation in medical practice. This paper demonstrates that consent is also a physical constraint: a necessary permeability condition for the transmission of medical intervention through biological and social systems with memory. Building on Zero Leap Theory (ZLT), we show that consent functions as the permeability gate (𝒞) in intervention systems—when closed, no increase in intervention intensity can substitute for its absence without triggering structural resistance mechanisms. We validate the UNESCO Universal Declaration on Bioethics and Human Rights (2005) by translating its core principles into ZLT's formal framework, demonstrating that the Declaration implicitly encodes a thermodynamically coherent constraint structure. Critically, we analyze Article 27's emergency clause, which permits temporary suspension of consent requirements "in the interests of public safety" or "public health." ZLT predicts that such suspensions create a predictable failure mode: emergency measures intended as temporary become permanent, structurally closing the consent gate and transforming medical intervention into structural coercion. Version 2.3 introduces Exit Coercion Index (ECI) analysis for bioethical contexts, distinguishing between legal consent permission and viable consent. When patients can technically refuse treatment but face severe consequences (employment loss, service denial, social exclusion), effective consent approaches zero regardless of formal opt-out provisions. This constitutes manufactured consent, not genuine informed consent. The paper provides the IAS-BIO (Informed Consent Audit Standard for Bioethics) protocol with explicit criteria for emergency regime entry/exit, sunset clause requirements, and ECI assessment. The juridical framework establishes Structural Negligence as the accountability standard for consent infrastructure violations. Core principle: Consent is not a "nice-to-have" ethical ideal. It is a physical constraint. When 𝒞 → 0, escalating enforcement does not restore cooperation—it amplifies resistance.
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