This page is part of the Advance Care Planning (PZP) (v1.0.0-rc1: Release 1) based on FHIR (HL7® FHIR® Standard) R3. No current official version has been published yet. For a full list of available versions, see the Directory of published versions

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Resource Profile: AdvanceDirective

A living will is a verbal or written description of the patient’s wishes with regard to future medical action or end of their life. A living will is mainly used for situations in which the patient is no longer able to speak about these decisions with their healthcare provider.

Usages:

• Refer to this Profile: TreatmentDirective
• Examples for this Profile: Consent/P1-ACP-AdvanceDirective-DNR and Consent/P2-ACP-AdvanceDirective

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Consent	C	0..*	Zib AdvanceDirective(2.1.5)	LivingWill Constraints: ppc-1
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension				Content/Rules for all slices
extension:disorder		0..*	Reference(HCIM Problem)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/zib-AdvanceDirective-Disorder Constraints: ext-1
extension:comment		0..1	string	Comment URL: http://nictiz.nl/fhir/StructureDefinition/Comment Constraints: ext-1
extension:encounter		0..1	(Complex)	ext Encounter Reference URL: https://api.iknl.nl/docs/pzp/stu3/StructureDefinition/ext-EncounterReference
extension		0..0
url		1..1	uri	"https://api.iknl.nl/docs/pzp/stu3/StructureDefinition/ext-EncounterReference"
value[x]		0..1	Reference(Encounter(1.0.0-rc1))	Encounter
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!Σ	1..1	code	draft | proposed | active | rejected | inactive | entered-in-error Binding: ConsentState (required): Indicates the state of the consent
Slices for category	Σ	2..*	CodeableConcept	Classification of the consent statement - for indexing/retrieval Slice: Unordered, Open by value:$this Binding: Consent Category Codes (example): A classification of the type of consents found in a consent statement
category:livingWill	Σ	1..1	CodeableConcept	Living will and advance directive record Binding: Consent Category Codes (example): A classification of the type of consents found in a consent statement Required Pattern: At least the following
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 11341000146107
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
category:typeOfLivingWill	Σ	1..1	CodeableConcept	TypeOfLivingWill Binding: WilsverklaringTypeCodelijst (2017-12-31T00:00:00) (required): List of the different types of living wills.
coding	Σ	1..*	Coding	Code defined by a terminology system
system	Σ	1..1	uri	Identity of the terminology system
code	Σ	1..1	code	Symbol in syntax defined by the system
patient	Σ	1..1	Reference(Patient(1.0.0-rc1))	Who the consent applies to
dateTime	Σ	1..1	dateTime	LivingWillDate
consentingParty	Σ	0..1	Reference(nl-core-relatedperson(2.0.5))	Representative
Slices for source[x]	Σ	0..1		LivingWillDocument Slice: Unordered, Closed by type:$this
sourceAttachment			Attachment
sourceIdentifier			Identifier
sourceReference			Reference(Consent | DocumentReference | Contract | QuestionnaireResponse)
source[x]:sourceAttachment	Σ	0..1	Attachment	LivingWillDocument
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Consent.status	required	ConsentState http://hl7.org/fhir/ValueSet/consent-state-codes|3.0.2 From the FHIR Standard
Consent.category	example	Consent Category Codes http://hl7.org/fhir/ValueSet/consent-category|3.0.2 From the FHIR Standard
Consent.category:livingWill	example	Pattern Value: SNOMED-CT Code 11341000146107 http://hl7.org/fhir/ValueSet/consent-category|3.0.2 From the FHIR Standard
Consent.category:typeOfLivingWill	required	WilsverklaringTypeCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.7.15.1--20171231000000|2017-12-31T00:00:00

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-1	error	Consent	If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty()
dom-2	error	Consent	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Consent	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource : contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4	error	Consent	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	error	Consent.extension:disorder, Consent.extension:comment	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ppc-1	error	Consent	Either a Policy or PolicyRule : policy.exists() or policyRule.exists()

This structure is derived from Zib AdvanceDirective

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Consent		0..*	Zib AdvanceDirective(2.1.5)	LivingWill
Slices for extension				Content/Rules for all slices
extension:disorder		0..*	Zib AdvanceDirective Disorder(2.0.2)	Optional Extensions Element
extension:comment		0..1	Comment(1.0.3)	Comment
extension:encounter		0..1	(Complex)	ext Encounter Reference URL: https://api.iknl.nl/docs/pzp/stu3/StructureDefinition/ext-EncounterReference
value[x]		0..1	Reference(Encounter(1.0.0-rc1))	Encounter
Slices for category				Content/Rules for all slices
category:typeOfLivingWill		1..1	CodeableConcept	TypeOfLivingWill
patient		1..1	Reference(Patient(1.0.0-rc1))	Who the consent applies to
dateTime		1..1	dateTime	LivingWillDate
consentingParty		0..1	Reference(nl-core-relatedperson(2.0.5))	Representative
Slices for source[x]				Content/Rules for all slices
source[x]:sourceAttachment		0..1	Attachment	LivingWillDocument
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Consent	C	0..*	Zib AdvanceDirective(2.1.5)	LivingWill Constraints: ppc-1
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: Common Languages (extensible): A human language. Additional Bindings Purpose All Languages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
extension:disorder		0..*	Reference(HCIM Problem)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/zib-AdvanceDirective-Disorder Constraints: ext-1
extension:comment		0..1	string	Comment URL: http://nictiz.nl/fhir/StructureDefinition/Comment Constraints: ext-1
extension:encounter		0..1	(Complex)	ext Encounter Reference URL: https://api.iknl.nl/docs/pzp/stu3/StructureDefinition/ext-EncounterReference
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..0
url		1..1	uri	"https://api.iknl.nl/docs/pzp/stu3/StructureDefinition/ext-EncounterReference"
value[x]		0..1	Reference(Encounter(1.0.0-rc1))	Encounter
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..1	Identifier	Identifier for this record (external references) Example General: {"system":"urn:ietf:rfc:3986","value":"Local eCMS identifier"}
status	?!Σ	1..1	code	draft | proposed | active | rejected | inactive | entered-in-error Binding: ConsentState (required): Indicates the state of the consent
Slices for category	Σ	2..*	CodeableConcept	Classification of the consent statement - for indexing/retrieval Slice: Unordered, Open by value:$this Binding: Consent Category Codes (example): A classification of the type of consents found in a consent statement
category:livingWill	Σ	1..1	CodeableConcept	Living will and advance directive record Binding: Consent Category Codes (example): A classification of the type of consents found in a consent statement Required Pattern: At least the following
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 11341000146107
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	0..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
category:typeOfLivingWill	Σ	1..1	CodeableConcept	TypeOfLivingWill Binding: WilsverklaringTypeCodelijst (2017-12-31T00:00:00) (required): List of the different types of living wills.
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	1..*	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
patient	Σ	1..1	Reference(Patient(1.0.0-rc1))	Who the consent applies to
period	Σ	0..1	Period	Period that this consent applies
dateTime	Σ	1..1	dateTime	LivingWillDate
consentingParty	Σ	0..1	Reference(nl-core-relatedperson(2.0.5))	Representative
actor	Σ	0..*	BackboneElement	Who|what controlled by this consent (or group, by role)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
role		1..1	CodeableConcept	How the actor is involved Binding: SecurityRoleType (extensible): How an actor is involved in the consent considerations
reference		1..1	Reference(Device | Group | CareTeam | nl-core-organization(2.0.6) | nl-core-patient(2.2.5) | nl-core-practitioner(2.0.7) | nl-core-relatedperson(2.0.5))	Resource for the actor (or group, by role)
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
extension:practitionerRole		0..1	Reference(nl-core-practitionerrole)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference Constraints: ext-1
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
action	Σ	0..*	CodeableConcept	Actions controlled by this consent Binding: Consent Action Codes (example): Detailed codes for the consent action.
organization	Σ	0..*	Reference(nl-core-organization(2.0.6))	Custodian of the consent
Slices for source[x]	Σ	0..1		LivingWillDocument Slice: Unordered, Closed by type:$this
sourceAttachment			Attachment
sourceIdentifier			Identifier
sourceReference			Reference(Consent | DocumentReference | Contract | QuestionnaireResponse)
source[x]:sourceAttachment	Σ	0..1	Attachment	LivingWillDocument
policy		0..*	BackboneElement	Policies covered by this consent
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
authority	C	0..1	uri	Enforcement source for policy
uri	C	0..1	uri	Specific policy covered by this consent Example General Dutch Law: http://wetten.overheid.nl/
policyRule	ΣC	0..1	uri	Policy that this consents to
securityLabel	Σ	0..*	Coding	Security Labels that define affected resources Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
purpose	Σ	0..*	Coding	​Context of activities for which the agreement is made Binding: PurposeOfUse|2014-03-26 (extensible): What purposes of use are controlled by this exception. If more than one label is specified, operations must have all the specified labels
dataPeriod	Σ	0..1	Period	Timeframe for data controlled by this consent
data	Σ	0..*	BackboneElement	Data controlled by this consent
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
meaning	Σ	1..1	code	instance | related | dependents | authoredby Binding: ConsentDataMeaning (required): How a resource reference is interpreted when testing consent restrictions
reference	Σ	1..1	Reference(Resource)	The actual data reference
except	Σ	0..*	BackboneElement	Additional rule - addition or removal of permissions
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
type	Σ	1..1	code	deny | permit Binding: ConsentExceptType (required): How an exception statement is applied, such as adding additional consent or removing consent
period	Σ	0..1	Period	Timeframe for this exception
actor	Σ	0..*	BackboneElement	Who|what controlled by this exception (or group, by role)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
role		1..1	CodeableConcept	How the actor is involved Binding: SecurityRoleType (extensible): How an actor is involved in the consent considerations
reference		1..1	Reference(Device | Group | CareTeam | nl-core-organization(2.0.6) | nl-core-patient(2.2.5) | nl-core-practitioner(2.0.7) | nl-core-relatedperson(2.0.5))	Resource for the actor (or group, by role)
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
extension:practitionerRole		0..1	Reference(nl-core-practitionerrole)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference Constraints: ext-1
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
action	Σ	0..*	CodeableConcept	Actions controlled by this exception Binding: Consent Action Codes (example): Detailed codes for the consent action.
securityLabel	Σ	0..*	Coding	Security Labels that define affected resources Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
purpose	Σ	0..*	Coding	​Context of activities covered by this exception Binding: PurposeOfUse|2014-03-26 (extensible): What purposes of use are controlled by this exception. If more than one label is specified, operations must have all the specified labels
class	Σ	0..*	Coding	e.g. Resource Type, Profile, or CDA etc Binding: Consent Content Class (extensible): The class (type) of information a consent rule covers
code	Σ	0..*	Coding	e.g. LOINC or SNOMED CT code, etc in the content Binding: Consent Content Codes (example): If this code is found in an instance, then the exception applies
dataPeriod	Σ	0..1	Period	Timeframe for data controlled by this exception
data	Σ	0..*	BackboneElement	Data controlled by this exception
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
meaning	Σ	1..1	code	instance | related | dependents | authoredby Binding: ConsentDataMeaning (required): How a resource reference is interpreted when testing consent restrictions
reference	Σ	1..1	Reference(Resource)	The actual data reference
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Consent.language	extensible	Common Languages http://hl7.org/fhir/ValueSet/languages|3.0.2 From the FHIR Standard Additional Bindings Purpose All Languages Max Binding
Consent.status	required	ConsentState http://hl7.org/fhir/ValueSet/consent-state-codes|3.0.2 From the FHIR Standard
Consent.category	example	Consent Category Codes http://hl7.org/fhir/ValueSet/consent-category|3.0.2 From the FHIR Standard
Consent.category:livingWill	example	Pattern Value: SNOMED-CT Code 11341000146107 http://hl7.org/fhir/ValueSet/consent-category|3.0.2 From the FHIR Standard
Consent.category:typeOfLivingWill	required	WilsverklaringTypeCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.7.15.1--20171231000000|2017-12-31T00:00:00
Consent.actor.role	extensible	SecurityRoleType http://hl7.org/fhir/ValueSet/security-role-type|1.8.0 From the FHIR Standard
Consent.action	example	Consent Action Codes http://hl7.org/fhir/ValueSet/consent-action|3.0.2 From the FHIR Standard
Consent.securityLabel	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels|3.0.2 From the FHIR Standard
Consent.purpose	extensible	PurposeOfUse http://hl7.org/fhir/ValueSet/v3-PurposeOfUse|2014-03-26 From the FHIR Standard
Consent.data.meaning	required	ConsentDataMeaning http://hl7.org/fhir/ValueSet/consent-data-meaning|3.0.2 From the FHIR Standard
Consent.except.type	required	ConsentExceptType http://hl7.org/fhir/ValueSet/consent-except-type|3.0.2 From the FHIR Standard
Consent.except.actor.role	extensible	SecurityRoleType http://hl7.org/fhir/ValueSet/security-role-type|1.8.0 From the FHIR Standard
Consent.except.action	example	Consent Action Codes http://hl7.org/fhir/ValueSet/consent-action|3.0.2 From the FHIR Standard
Consent.except.securityLabel	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels|3.0.2 From the FHIR Standard
Consent.except.purpose	extensible	PurposeOfUse http://hl7.org/fhir/ValueSet/v3-PurposeOfUse|2014-03-26 From the FHIR Standard
Consent.except.class	extensible	Consent Content Class http://hl7.org/fhir/ValueSet/consent-content-class|3.0.2 From the FHIR Standard
Consent.except.code	example	Consent Content Codes(a valid code from LOINC) http://hl7.org/fhir/ValueSet/consent-content-code|3.0.2 From the FHIR Standard
Consent.except.data.meaning	required	ConsentDataMeaning http://hl7.org/fhir/ValueSet/consent-data-meaning|3.0.2 From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-1	error	Consent	If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty()
dom-2	error	Consent	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Consent	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource : contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4	error	Consent	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	error	Consent.extension:disorder, Consent.extension:comment, Consent.actor.reference.extension:practitionerRole, Consent.except.actor.reference.extension:practitionerRole	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ppc-1	error	Consent	Either a Policy or PolicyRule : policy.exists() or policyRule.exists()

This structure is derived from Zib AdvanceDirective

Summary

Structures

This structure refers to these other structures:

• Encounter (https://api.iknl.nl/docs/pzp/stu3/StructureDefinition/ACP-Encounter|1.0.0-rc1)
• Patient (https://api.iknl.nl/docs/pzp/stu3/StructureDefinition/ACP-Patient|1.0.0-rc1)

Extensions

This structure refers to these extensions:

• https://api.iknl.nl/docs/pzp/stu3/StructureDefinition/ext-EncounterReference|1.0.0-rc1

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Consent	C	0..*	Zib AdvanceDirective(2.1.5)	LivingWill Constraints: ppc-1
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension				Content/Rules for all slices
extension:disorder		0..*	Reference(HCIM Problem)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/zib-AdvanceDirective-Disorder Constraints: ext-1
extension:comment		0..1	string	Comment URL: http://nictiz.nl/fhir/StructureDefinition/Comment Constraints: ext-1
extension:encounter		0..1	(Complex)	ext Encounter Reference URL: https://api.iknl.nl/docs/pzp/stu3/StructureDefinition/ext-EncounterReference
extension		0..0
url		1..1	uri	"https://api.iknl.nl/docs/pzp/stu3/StructureDefinition/ext-EncounterReference"
value[x]		0..1	Reference(Encounter(1.0.0-rc1))	Encounter
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!Σ	1..1	code	draft | proposed | active | rejected | inactive | entered-in-error Binding: ConsentState (required): Indicates the state of the consent
Slices for category	Σ	2..*	CodeableConcept	Classification of the consent statement - for indexing/retrieval Slice: Unordered, Open by value:$this Binding: Consent Category Codes (example): A classification of the type of consents found in a consent statement
category:livingWill	Σ	1..1	CodeableConcept	Living will and advance directive record Binding: Consent Category Codes (example): A classification of the type of consents found in a consent statement Required Pattern: At least the following
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 11341000146107
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
category:typeOfLivingWill	Σ	1..1	CodeableConcept	TypeOfLivingWill Binding: WilsverklaringTypeCodelijst (2017-12-31T00:00:00) (required): List of the different types of living wills.
coding	Σ	1..*	Coding	Code defined by a terminology system
system	Σ	1..1	uri	Identity of the terminology system
code	Σ	1..1	code	Symbol in syntax defined by the system
patient	Σ	1..1	Reference(Patient(1.0.0-rc1))	Who the consent applies to
dateTime	Σ	1..1	dateTime	LivingWillDate
consentingParty	Σ	0..1	Reference(nl-core-relatedperson(2.0.5))	Representative
Slices for source[x]	Σ	0..1		LivingWillDocument Slice: Unordered, Closed by type:$this
sourceAttachment			Attachment
sourceIdentifier			Identifier
sourceReference			Reference(Consent | DocumentReference | Contract | QuestionnaireResponse)
source[x]:sourceAttachment	Σ	0..1	Attachment	LivingWillDocument
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Consent.status	required	ConsentState http://hl7.org/fhir/ValueSet/consent-state-codes|3.0.2 From the FHIR Standard
Consent.category	example	Consent Category Codes http://hl7.org/fhir/ValueSet/consent-category|3.0.2 From the FHIR Standard
Consent.category:livingWill	example	Pattern Value: SNOMED-CT Code 11341000146107 http://hl7.org/fhir/ValueSet/consent-category|3.0.2 From the FHIR Standard
Consent.category:typeOfLivingWill	required	WilsverklaringTypeCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.7.15.1--20171231000000|2017-12-31T00:00:00

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-1	error	Consent	If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty()
dom-2	error	Consent	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Consent	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource : contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4	error	Consent	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	error	Consent.extension:disorder, Consent.extension:comment	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ppc-1	error	Consent	Either a Policy or PolicyRule : policy.exists() or policyRule.exists()

Differential View

This structure is derived from Zib AdvanceDirective

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Consent		0..*	Zib AdvanceDirective(2.1.5)	LivingWill
Slices for extension				Content/Rules for all slices
extension:disorder		0..*	Zib AdvanceDirective Disorder(2.0.2)	Optional Extensions Element
extension:comment		0..1	Comment(1.0.3)	Comment
extension:encounter		0..1	(Complex)	ext Encounter Reference URL: https://api.iknl.nl/docs/pzp/stu3/StructureDefinition/ext-EncounterReference
value[x]		0..1	Reference(Encounter(1.0.0-rc1))	Encounter
Slices for category				Content/Rules for all slices
category:typeOfLivingWill		1..1	CodeableConcept	TypeOfLivingWill
patient		1..1	Reference(Patient(1.0.0-rc1))	Who the consent applies to
dateTime		1..1	dateTime	LivingWillDate
consentingParty		0..1	Reference(nl-core-relatedperson(2.0.5))	Representative
Slices for source[x]				Content/Rules for all slices
source[x]:sourceAttachment		0..1	Attachment	LivingWillDocument
Documentation for this format

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Consent	C	0..*	Zib AdvanceDirective(2.1.5)	LivingWill Constraints: ppc-1
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: Common Languages (extensible): A human language. Additional Bindings Purpose All Languages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
extension:disorder		0..*	Reference(HCIM Problem)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/zib-AdvanceDirective-Disorder Constraints: ext-1
extension:comment		0..1	string	Comment URL: http://nictiz.nl/fhir/StructureDefinition/Comment Constraints: ext-1
extension:encounter		0..1	(Complex)	ext Encounter Reference URL: https://api.iknl.nl/docs/pzp/stu3/StructureDefinition/ext-EncounterReference
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..0
url		1..1	uri	"https://api.iknl.nl/docs/pzp/stu3/StructureDefinition/ext-EncounterReference"
value[x]		0..1	Reference(Encounter(1.0.0-rc1))	Encounter
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..1	Identifier	Identifier for this record (external references) Example General: {"system":"urn:ietf:rfc:3986","value":"Local eCMS identifier"}
status	?!Σ	1..1	code	draft | proposed | active | rejected | inactive | entered-in-error Binding: ConsentState (required): Indicates the state of the consent
Slices for category	Σ	2..*	CodeableConcept	Classification of the consent statement - for indexing/retrieval Slice: Unordered, Open by value:$this Binding: Consent Category Codes (example): A classification of the type of consents found in a consent statement
category:livingWill	Σ	1..1	CodeableConcept	Living will and advance directive record Binding: Consent Category Codes (example): A classification of the type of consents found in a consent statement Required Pattern: At least the following
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 11341000146107
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	0..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
category:typeOfLivingWill	Σ	1..1	CodeableConcept	TypeOfLivingWill Binding: WilsverklaringTypeCodelijst (2017-12-31T00:00:00) (required): List of the different types of living wills.
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	1..*	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
patient	Σ	1..1	Reference(Patient(1.0.0-rc1))	Who the consent applies to
period	Σ	0..1	Period	Period that this consent applies
dateTime	Σ	1..1	dateTime	LivingWillDate
consentingParty	Σ	0..1	Reference(nl-core-relatedperson(2.0.5))	Representative
actor	Σ	0..*	BackboneElement	Who|what controlled by this consent (or group, by role)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
role		1..1	CodeableConcept	How the actor is involved Binding: SecurityRoleType (extensible): How an actor is involved in the consent considerations
reference		1..1	Reference(Device | Group | CareTeam | nl-core-organization(2.0.6) | nl-core-patient(2.2.5) | nl-core-practitioner(2.0.7) | nl-core-relatedperson(2.0.5))	Resource for the actor (or group, by role)
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
extension:practitionerRole		0..1	Reference(nl-core-practitionerrole)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference Constraints: ext-1
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
action	Σ	0..*	CodeableConcept	Actions controlled by this consent Binding: Consent Action Codes (example): Detailed codes for the consent action.
organization	Σ	0..*	Reference(nl-core-organization(2.0.6))	Custodian of the consent
Slices for source[x]	Σ	0..1		LivingWillDocument Slice: Unordered, Closed by type:$this
sourceAttachment			Attachment
sourceIdentifier			Identifier
sourceReference			Reference(Consent | DocumentReference | Contract | QuestionnaireResponse)
source[x]:sourceAttachment	Σ	0..1	Attachment	LivingWillDocument
policy		0..*	BackboneElement	Policies covered by this consent
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
authority	C	0..1	uri	Enforcement source for policy
uri	C	0..1	uri	Specific policy covered by this consent Example General Dutch Law: http://wetten.overheid.nl/
policyRule	ΣC	0..1	uri	Policy that this consents to
securityLabel	Σ	0..*	Coding	Security Labels that define affected resources Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
purpose	Σ	0..*	Coding	​Context of activities for which the agreement is made Binding: PurposeOfUse|2014-03-26 (extensible): What purposes of use are controlled by this exception. If more than one label is specified, operations must have all the specified labels
dataPeriod	Σ	0..1	Period	Timeframe for data controlled by this consent
data	Σ	0..*	BackboneElement	Data controlled by this consent
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
meaning	Σ	1..1	code	instance | related | dependents | authoredby Binding: ConsentDataMeaning (required): How a resource reference is interpreted when testing consent restrictions
reference	Σ	1..1	Reference(Resource)	The actual data reference
except	Σ	0..*	BackboneElement	Additional rule - addition or removal of permissions
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
type	Σ	1..1	code	deny | permit Binding: ConsentExceptType (required): How an exception statement is applied, such as adding additional consent or removing consent
period	Σ	0..1	Period	Timeframe for this exception
actor	Σ	0..*	BackboneElement	Who|what controlled by this exception (or group, by role)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
role		1..1	CodeableConcept	How the actor is involved Binding: SecurityRoleType (extensible): How an actor is involved in the consent considerations
reference		1..1	Reference(Device | Group | CareTeam | nl-core-organization(2.0.6) | nl-core-patient(2.2.5) | nl-core-practitioner(2.0.7) | nl-core-relatedperson(2.0.5))	Resource for the actor (or group, by role)
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
extension:practitionerRole		0..1	Reference(nl-core-practitionerrole)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference Constraints: ext-1
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
action	Σ	0..*	CodeableConcept	Actions controlled by this exception Binding: Consent Action Codes (example): Detailed codes for the consent action.
securityLabel	Σ	0..*	Coding	Security Labels that define affected resources Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
purpose	Σ	0..*	Coding	​Context of activities covered by this exception Binding: PurposeOfUse|2014-03-26 (extensible): What purposes of use are controlled by this exception. If more than one label is specified, operations must have all the specified labels
class	Σ	0..*	Coding	e.g. Resource Type, Profile, or CDA etc Binding: Consent Content Class (extensible): The class (type) of information a consent rule covers
code	Σ	0..*	Coding	e.g. LOINC or SNOMED CT code, etc in the content Binding: Consent Content Codes (example): If this code is found in an instance, then the exception applies
dataPeriod	Σ	0..1	Period	Timeframe for data controlled by this exception
data	Σ	0..*	BackboneElement	Data controlled by this exception
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
meaning	Σ	1..1	code	instance | related | dependents | authoredby Binding: ConsentDataMeaning (required): How a resource reference is interpreted when testing consent restrictions
reference	Σ	1..1	Reference(Resource)	The actual data reference
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Consent.language	extensible	Common Languages http://hl7.org/fhir/ValueSet/languages|3.0.2 From the FHIR Standard Additional Bindings Purpose All Languages Max Binding
Consent.status	required	ConsentState http://hl7.org/fhir/ValueSet/consent-state-codes|3.0.2 From the FHIR Standard
Consent.category	example	Consent Category Codes http://hl7.org/fhir/ValueSet/consent-category|3.0.2 From the FHIR Standard
Consent.category:livingWill	example	Pattern Value: SNOMED-CT Code 11341000146107 http://hl7.org/fhir/ValueSet/consent-category|3.0.2 From the FHIR Standard
Consent.category:typeOfLivingWill	required	WilsverklaringTypeCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.7.15.1--20171231000000|2017-12-31T00:00:00
Consent.actor.role	extensible	SecurityRoleType http://hl7.org/fhir/ValueSet/security-role-type|1.8.0 From the FHIR Standard
Consent.action	example	Consent Action Codes http://hl7.org/fhir/ValueSet/consent-action|3.0.2 From the FHIR Standard
Consent.securityLabel	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels|3.0.2 From the FHIR Standard
Consent.purpose	extensible	PurposeOfUse http://hl7.org/fhir/ValueSet/v3-PurposeOfUse|2014-03-26 From the FHIR Standard
Consent.data.meaning	required	ConsentDataMeaning http://hl7.org/fhir/ValueSet/consent-data-meaning|3.0.2 From the FHIR Standard
Consent.except.type	required	ConsentExceptType http://hl7.org/fhir/ValueSet/consent-except-type|3.0.2 From the FHIR Standard
Consent.except.actor.role	extensible	SecurityRoleType http://hl7.org/fhir/ValueSet/security-role-type|1.8.0 From the FHIR Standard
Consent.except.action	example	Consent Action Codes http://hl7.org/fhir/ValueSet/consent-action|3.0.2 From the FHIR Standard
Consent.except.securityLabel	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels|3.0.2 From the FHIR Standard
Consent.except.purpose	extensible	PurposeOfUse http://hl7.org/fhir/ValueSet/v3-PurposeOfUse|2014-03-26 From the FHIR Standard
Consent.except.class	extensible	Consent Content Class http://hl7.org/fhir/ValueSet/consent-content-class|3.0.2 From the FHIR Standard
Consent.except.code	example	Consent Content Codes(a valid code from LOINC) http://hl7.org/fhir/ValueSet/consent-content-code|3.0.2 From the FHIR Standard
Consent.except.data.meaning	required	ConsentDataMeaning http://hl7.org/fhir/ValueSet/consent-data-meaning|3.0.2 From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-1	error	Consent	If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty()
dom-2	error	Consent	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Consent	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource : contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4	error	Consent	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	error	Consent.extension:disorder, Consent.extension:comment, Consent.actor.reference.extension:practitionerRole, Consent.except.actor.reference.extension:practitionerRole	Must have either extensions or value[x], not both : extension.exists() != value.exists()
ppc-1	error	Consent	Either a Policy or PolicyRule : policy.exists() or policyRule.exists()

This structure is derived from Zib AdvanceDirective

Summary

Structures

This structure refers to these other structures:

• Encounter (https://api.iknl.nl/docs/pzp/stu3/StructureDefinition/ACP-Encounter|1.0.0-rc1)
• Patient (https://api.iknl.nl/docs/pzp/stu3/StructureDefinition/ACP-Patient|1.0.0-rc1)

Extensions

This structure refers to these extensions:

• https://api.iknl.nl/docs/pzp/stu3/StructureDefinition/ext-EncounterReference|1.0.0-rc1

Other representations of profile: CSV, Excel, Schematron