A lot of people new to the use of magic are very interested in the ethics of what is and is not allowed. It seems to me, though, that these questions are often a way of glossing over other, more important, issues.
Someone asked me the other day, “Under what circumstances is it ethical to do a healing spell without permission?” A question like that envisions a universe in which there are XYZ allowed circumstances, and ABC disallowed circumstances. A rulebook.
Now, I could say “there is no rulebook,” or I could approximate the rulebook, and give you an extensive list of hypotheticals, but all of that is beside the point. There are other, more important questions to ask before we even get into a bunch of ethical what-ifs.
Why don’t you have permission? If it’s someone you aren’t comfortable communicating with, why are you doing magic for them? Is your magical connection going to be effective if you can’t even have a conversation with them? How much can you even know about the illness if you haven’t discussed healing it? If you don’t have permission because they disapprove of magic, isn’t that something of a barrier to your work? Won’t you be thinking about that disapproval while you work?
Under most circumstances, in the absence of other information, it is ethical to assume that people want to be well. Absent a DNR (Do Not Resucitate order), medical professionals assume that an unconscious patient would wish to be resucitated. In other words, you don’t need a Do Resucitate order, because that’s the default.
But chances are, you’re not talking about doing magic in an Emergency Room. You’re probably talking about a chronic or active but non-emergent condition. And in that case, your question shouldn’t be ethical at all; it should be practical and interpersonal.
Before healing, what you want to know is, who is this person? What is our connection? What is this illness? Securing permission is one way to answer all these questions. A problem securing permission could indicate a problem in knowing what needs to be known in order to be an effective healer.