Consent you can take back

Most systems treat consent as a checkbox at the start. Agree once, on signup, to a paragraph nobody reads, and the system is free thereafter. For ordinary software that is sloppy. For health data in Bangladesh it is dangerous, because the cost of the wrong person seeing the wrong record is measured in firings, evictions, and cancelled work permits.

So consent here is not a checkbox. It is specific, per provider and per category. It is revocable, and revoking it actually stops the next use rather than logging a preference. And it is enforced by the architecture rather than by a promise, because a promise is only as good as the company that made it, and infrastructure a country relies on cannot rest on a company's good behavior.

Specific means the consent the patient gives to share a blood-pressure reading with her doctor is not consent to share her early-pregnancy consultation with a factory. Different categories, different grants, different keys. The system cannot quietly widen a narrow consent, because the thing standing between a record and a reader is not a rule in the software. It is whether the reader holds the key, and the patient decides who holds the key.

Revocable means the grant runs in one direction and can be pulled back. The daughter abroad who watches her father's readings sees them because he allowed it, and stops seeing them the moment he withdraws it. Withdrawal is not a request the system may honor later. It is the removal of access, and the next attempt to read fails.

Enforced by cryptography means the guarantee does not depend on KhaM Health being honest or even being alive. A shielded consultation is invisible to a factory-owned device because the factory does not hold the key, not because an app agreed to hide it. This matters most for the people the system exists to protect, because their safety cannot be left resting on a policy that a future owner, or a court order, or a breach could quietly set aside.

The Personal Data Protection Ordinance of 2025 says, in law, that the citizen owns her personal data, that health data is specially protected, and that consent must be explicit. The law arrives with force around 2027. This architecture is that law rendered in cryptography instead of policy, built before the enforcement date, so that compliance is not a feature added under deadline but the shape of the thing from the start. A patient who can grant narrowly, revoke completely, and rely on the keys rather than the company is a patient the ordinance describes and the architecture already serves.