BE TRUSTED: A Blueprint for the Future of Consent in Tech

Katherine Ortiz’s project began after she noticed a sign taped to the wall at a routine doctor’s appointment. “Doctor uses SCRIBE who takes their notes. Please let them know if you are not comfortable with this.” After Ortiz inquired about the sign, the doctor took a cell phone out of her lab pocket and proceeded to tell Ortiz how a person in a different location was listening and transcribing her entire appointment. 

“From my vantage point, this completely changed the dynamic of our engagement,” Ortiz shared. “There was now a human in the room that I didn't know about. I didn't know who they were. They were essentially using some type of surveillance app to record very personal information, [and] there was no governance around this new dynamic.” This interaction bolstered Ortiz’s interest in how consent is addressed more broadly when technology is involved. Ortiz explored the ethical dimensions of consent in technology more deeply as a 2025 Ethics and Technology Practitioner Fellow at Stanford’s McCoy Family Center for Ethics in Society. Outside of the Ethics Center, Ortiz is a technical program manager at Google working in Cloud enterprise data governance. She is also a Lieutenant Colonel in the United States Army Reserve, having served as an intelligence officer and an information operations planner for over 19 years. 

Ortiz’s work is centered on the premise that as digital technology becomes more ubiquitous in our daily lives, the standard notice-and-consent frameworks we are used to —where we are simply presented with terms or privacy policies to “agree”—is proving itself fundamentally flawed as a mechanism for genuine consent. Digital technology is now playing a key role in defining the dynamics and outcomes of so many of our daily interactions and yet, the ways in which we engage in decision making and choice in these interactions, namely how our consent is sought, established and recorded, hasn’t evolved as quickly as the technology we are surrounded by.

Ortiz’s fellowship explored consent in tech in a number of different scenarios with healthcare being most prominent. Given the proliferation of emerging technology in the healthcare industry such as ambient surveillance tech, AI and robotics, Ortiz wanted to dig into human perspectives of emerging consent considerations in this space, since this technology is evolving faster than laws can be put in place, creating higher chances of weakening patient privacy and trust in the healthcare system.

Ortiz has discussed her research with a number of different industry professionals about the state of consent, including healthcare professionals and legal researchers. They all acknowledge the limitations of informed consent guidelines, which fail to keep up with individual needs. “I had one person in the healthcare industry say that consent in healthcare is fiction,” Ortiz said. She explained how current consent frameworks in health spaces fail to adequately inform and ease patients' concerns about new technology, research, or programs being implemented. This leaves patients agreeing to processes and/or procedures without fully grasping or feeling in control of what’s actually occurring.

During her fellowship at the Ethics Center, Ortiz has aimed to rework this dynamic, creating a framework that makes consent more human-centered. “We need to rethink it, reimagine it, and make sure that it's grounded in actual human norms,” Ortiz explained, “because if we don't, we run the risk of eroding our human power in digital spaces and degrading our own human autonomy.”

'Typically, the way you see a critical user journey written is it's a user task or user goal,' Ortiz explained. 'If you just expand that a bit to account for values, expectations, and norms, then you get a much richer understanding of the context through which the user wants to engage in decision making.'

Ortiz’s new framework serves as a blueprint for building meaningful consent into situations involving technology. The framework includes a set of principles and tools to guide designers, executives, technologists and community organizers into advocating for and building meaningful consent moments. Through over 60 one-on-one interviews, 150 surveys and nine group workshops that explored real-life consent scenarios with participants, Ortiz learned how personal values, expectations and norms differ depending on different types of interactions involving digital technology. Ortiz then synthesized the feedback from these engagements and developed a toolkit that takes into account the fundamental contextual factors that impact people’s needs for meaningful consent. Ortiz also developed some concrete ways to apply her framework into existing industry tools used in technology design and user experience, such as through the extension of critical user journeys. 

“Typically, the way you see a critical user journey written is it's a user task or user goal,” Ortiz explained. “If you just expand that a bit to account for values, expectations, and norms, then you get a much richer understanding of the context through which the user wants to engage in decision making.

Through her fellowship project, Ortiz developed a series of considerations that need to be taken into account that boil down to the acronym BE TRUSTED: Background (knowledge of individuals), Expectations (from individuals), Transparency, Risks, Understanding, Strategy, Type (of consent), Efficacy, and Dynamics. By considering these parameters, Ortiz hopes to empower people to design and demand consent frameworks that place individuals at the forefront.

Ortiz shared her findings in November at the closing “2025 Ethics and Technology Practitioner Fellows Project Showcase”. Her research, toolkit, and deliverables are available on her website. As for next steps, Ortiz is looking to implement this framework into everyday interactions and to help industry leaders and designers particularly in healthcare to improve their approach to consent. With the tech space evolving so rapidly, Ortiz is hoping to help build ways to create laws and guidelines that are enduring and resilient to the rapid pace of technological development and keep human autonomy and control top of mind.  

“I’m excited about some potential ways to apply this in my work,” Ortiz said. “The rise of [tech] agents, the rise of robotics, provides a really compelling reason to start reevaluating how we think about consent at large with technology.”