Background: Informed consent in Indonesia is often treated as a legal and administrative requirement, yet patient autonomy remains ethically fragile when medical explanation is difficult to understand, insufficiently dialogic, or detached from health-literacy realities. Objective: This study examines how Indonesian consent-related discourse linguistically frames medical explanation, patient choice, refusal, clarification, relational support, and comprehension as conditions of meaningful autonomy. method: This study applies qualitative discourse analysis to 25 coded units drawn from 20 publicly accessible legal, institutional, patient-education, and scholarly documents, using a plain-language comprehension audit, patient autonomy and agency framework, and interactional access lens. Results: Consent discourse strongly recognizes explanation, approval, and patient rights, but explicit risk elaboration, alternative explanation, and refusal space appear less consistently. Results: Patient agency is more visible as rights vocabulary than as practical interactional design, especially because clarification prompts and understanding checks remain largely absent or unclear. Results: Health literacy is relevant across all coded units, while language accommodation, relational mediation, and digital or AI-supported explanation remain unevenly embedded. implication: These findings suggest that consent should be evaluated through comprehensibility, agency, and access, not merely procedural documentation. Novelty: This study offers an integrated medical-linguistic model for analyzing informed consent as a communicative threshold where legal validity, patient autonomy, and ethical understanding intersect.