Django {% with %} tags within {% if %} {% else %} tags?

if you want to stay DRY, use an include.

{% if foo %}
  {% with a as b %}
    {% include "snipet.html" %}
  {% endwith %} 
{% else %}
  {% with bar as b %}
    {% include "snipet.html" %}
  {% endwith %} 
{% endif %}

or, even better would be to write a method on the model that encapsulates the core logic:

def Patient(models.Model):
    ....
    def get_legally_responsible_party(self):
       if self.age > 18:
          return self
       else:
          return self.parent

Then in the template:

{% with patient.get_legally_responsible_party as p %}
  Do html stuff
{% endwith %} 

Then in the future, if the logic for who is legally responsible changes you have a single place to change the logic — far more DRY than having to change if statements in a dozen templates.