An Extended Consent-Based Access Control Framework: Pre-Commit Validation and Emergency Access

2026-03-07

AI Summary

This work addresses the limitations of traditional consent-based access control, which relies on lazy evaluation and only reveals policy conflicts at runtime, leading to misalignment between patient intent and system behavior as well as increased decision overhead. To overcome this, the authors propose an extended framework that integrates a pre-commit validation workflow and a Consent Conflict Analysis Module (CCAM) during consent creation, ensuring baseline permissions through formally specified system invariants. Additionally, they design a context-aware Emergency Disclosure Control Function (EDCF) that leverages real-time physiological evidence to enable precise, minimally necessary data disclosure. Experimental evaluation based on an XACML extension demonstrates that the approach significantly reduces and stabilizes runtime decision latency—even as policy scale grows—and outperforms baseline methods, while the emergency mechanism effectively filters irrelevant records without compromising critical clinical information.

Technology Category

• Constraint Satisfaction and Optimization: Constraint Learning and Acquisition
• Cognitive Modeling & Cognitive Systems: Conceptual Inference and Reasoning
• Knowledge Representation and Reasoning: Preferences

Application Category

• Responsible Web: Consent frameworks and practices on the web
• Security and Privacy: Data transparency and provenance
• User Modeling, Personalization and Recommendation: User privacy protection in personalized systems

Abstract

Consent-Based Access Control (CBAC) is a foundational mechanism for enforcing patient autonomy in modern healthcare information systems. Many CBAC frameworks are built on the eXtensible Access Control Markup Language (XACML) and inherit its \emph{lazy evaluation} model, in which policy interactions are resolved only at request time. This design allows contradictory consent directives to accumulate within the repository, creating a semantic gap between patient intent and system behavior while burdening high-frequency runtime decisions with complex conflict resolution. This paper presents an extended CBAC framework that enforces semantic correctness at consent creation time rather than during access evaluation. The framework introduces a pre-commit validation workflow centered on a Consent Conflict Analysis Module (CCAM), which proactively detects modality conflicts and redundancies before directives become active. In addition, immutable system invariants are formalized to guarantee baseline access for record authors and patients, preserving clinical continuity and professional accountability. Finally, the framework incorporates a context-aware emergency mediation mechanism that enables controlled \emph{break-the-glass} access driven by real-time physiological evidence, with disclosure strictly bounded by an Emergency Disclosure Control Function (EDCF). Simulation-based evaluation using controlled synthetic workloads demonstrates that pre-commit conflict resolution yields low and stable runtime decision latency and consistently outperforms standard XACML-based baselines as policy repositories scale. Emergency access experiments further demonstrate strong restrictions on data access, pruning the majority of non-relevant record elements while preserving clinically essential information.

Problem

• Consent-Based Access Control
• Policy Conflict
• Runtime Decision Latency
• Emergency Access
• Semantic Gap

Innovation

• pre-commit validation
• Consent Conflict Analysis Module (CCAM)
• system invariants
• context-aware emergency access
• Emergency Disclosure Control Function (EDCF)