<p>Recent concerns about meditation-related adverse effects (MRAEs) have led to calls for more rigorous informed consent in mindfulness-based interventions (MBIs). This paper examines whether consent procedures are warranted, and under what circumstances, and of what kind, across the diverse settings in which mindfulness is delivered. Drawing on bioethics and the informed consent literature, we argue that although MBIs may involve some risks, the evidence justifying the case for written, formalized informed consent is weak. In clinical medicine and psychotherapeutic practice, consent practices vary according to risk, permanence, invasiveness, and patient control, often relying on informal processes where risk is minimal. We propose a dose-sensitive model of informed consent that functions on a sliding scale, calibrating the intensity of mindfulness practices to the probability of risk, potential harm, and severity of adverse events. Our proportional approach avoids the harms of over-disclosure—including inefficiency, nocebo effects, and autonomy infringement—while still respecting individuals’ rights and mitigating risk. A context-sensitive, proportional consent model better aligns with ethical norms, individual autonomy, and the empirical evidence on risks of adverse effects from mindfulness practices.</p>