Informed consent has become biomedicine's universal ethical standard, the primary mechanism for respecting patient autonomy and preventing medical paternalism. As philosopher Heidi Hurd observes, consent possesses "talismanic" qualities: it performs a kind of moral magic, transforming potentially invasive interventions into legitimate medical acts through the ritual of signature. This enchantment, however, conceals a structural particularity: the model assumes patients as atomistic decision-makers, privileges deliberative rationality over other modes of moral reasoning, and conceives autonomy primarily as freedom from interference. This model faces twin challenges that expose its inadequacy: first, biomedical technologies and AI generate forms of complexity and opacity that undermine the very possibility of autonomous, informed choice; second, moral and religious pluralism reveals that the framework's claimed neutrality masks culturally specific commitments that cannot accommodate how diverse patients actually reason about consequential medical decisions. This paper examines how Judaism, Catholicism, and Islam approach medical decision-making through distinctive epistemologies that address precisely what informed consent lacks: engagement with substantive goods (embodiment, relationality, communal obligations, transcendent meaning) rather than procedural authorization that brackets values as private preferences. Drawing on Value-Sensitive Design methodology, it proposes translating these epistemologies into practical tools: stakeholder analysis including moral communities, value scenarios making commitments explicit, and iterative consent architectures structured as negotiation. The goal is moving beyond the false choice between universal proceduralism and fragmented relativism.