Who Controls the Proxy? Authorization Burden, Delegated Digital Health Work, and Meaningful Patient Control during the European Health Data Space Transition

This working paper examines ethical and practical questions surrounding adult proxy access, delegated digital health work, and meaningful patient control in the context of the European Health Data Space (EHDS) transition. It considers how authorization and delegation arrangements may affect patient autonomy, accessibility, accountability, digital equity, and administrative burden. The full manuscript and supporting research materials are maintained under restricted access. Detailed methodological procedures, analytical instruments, comparative evidence, and reproducibility materials are not included in the public metadata record and may be made available through controlled access.