Advance Care Planning (PZP) STU3
1.0.0 - release

Advance Care Planning (PZP) STU3 - Downloaded Version 1.0.0 See the Directory of published versions

## Resource Profile: ACP AdvanceDirective

Official URL: https://api.iknl.nl/docs/pzp/stu3/StructureDefinition/ACP-AdvanceDirective | Version: 1.0.0 | Highlight text changes?
Draft as of 2026-08-11 | Computable Name: ACPAdvanceDirective
Copyright/Legal: Copyright and related rights waived via CC0, https://creativecommons.org/publicdomain/zero/1.0/. This does not apply to information from third parties, for example a medical terminology system. The implementer alone is responsible for identifying and obtaining any necessary licenses or authorizations to utilize third party IP in connection with the specification or otherwise.

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: ACP TreatmentDirective
- Examples for this Profile: Consent/ACP-AdvanceDirective-DNR-2025-Pat1, Consent/ACP-AdvanceDirective-DNR-Pat1 and Consent/ACP-AdvanceDirective-DNR-Pat2

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description Differentials, Snapshots, and other representations.

- 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
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(ACP Patient(1.0.0)) | Who the consent applies to
dateTime | Σ | 1..1 | dateTime | LivingWillDate
consentingParty | Σ | 0..1 | Reference(nl-core-relatedperson(2.0.5)) | Representative
source[x] | Σ | 0..1 | Attachment | LivingWillDocument
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Consent.status | Base | required | ConsentState | 📍3.0.2 | FHIR Std.
Consent.category | Base | example | Consent Category Codes | 📍3.0.2 | FHIR Std.
Consent.category:livingWill | Base | example | Consent Category Codes | 📍3.0.2 | FHIR Std.
Consent.category:typeOfLivingWill | Base | required | WilsverklaringTypeCodelijst | 📍2017-12-31T00:00:00 | Nictiz FHIR NL STU3 Zib2017 v2.3

#### Constraints

Id | Grade | Path(s) | Description | Expression
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()`

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
Slices for category |  |  |  | Content/Rules for all slices
category:typeOfLivingWill |  | 1..1 | CodeableConcept | TypeOfLivingWill
patient |  | 1..1 | Reference(ACP Patient(1.0.0)) | Who the consent applies to
dateTime |  | 1..1 | dateTime | LivingWillDate
consentingParty |  | 0..1 | Reference(nl-core-relatedperson(2.0.5)) | Representative
source[x] |  | 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
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 Slice: Unordered, Open by value:url
coding | Σ | 0..* | 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 Slice: Unordered, Open by value:url
system | Σ | 0..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 0..1 | code | Symbol in syntax defined by the system Fixed Value: 11341000146107
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(ACP Patient(1.0.0)) | 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 | Σ C | 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
source[x] | 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 | Σ C | 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 | Σ C | 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 | Status | Usage | ValueSet | Version | Source
Consent.language | Base | extensible | Common Languages | 📍3.0.2 | FHIR Std.
Consent.status | Base | required | ConsentState | 📍3.0.2 | FHIR Std.
Consent.category | Base | example | Consent Category Codes | 📍3.0.2 | FHIR Std.
Consent.category:livingWill | Base | example | Consent Category Codes | 📍3.0.2 | FHIR Std.
Consent.category:typeOfLivingWill | Base | required | WilsverklaringTypeCodelijst | 📍2017-12-31T00:00:00 | Nictiz FHIR NL STU3 Zib2017 v2.3
Consent.actor.role | Base | extensible | SecurityRoleType | 📍1.8.0 | FHIR Std.
Consent.action | Base | example | Consent Action Codes | 📍3.0.2 | FHIR Std.
Consent.securityLabel | Base | extensible | All Security Labels | 📍3.0.2 | FHIR Std.
Consent.purpose | Base | extensible | PurposeOfUse | 📍2014-03-26 | FHIR Std.
Consent.data.meaning | Base | required | ConsentDataMeaning | 📍3.0.2 | FHIR Std.
Consent.except.type | Base | required | ConsentExceptType | 📍3.0.2 | FHIR Std.
Consent.except.actor.​role | Base | extensible | SecurityRoleType | 📍1.8.0 | FHIR Std.
Consent.except.action | Base | example | Consent Action Codes | 📍3.0.2 | FHIR Std.
Consent.except.securityLabel | Base | extensible | All Security Labels | 📍3.0.2 | FHIR Std.
Consent.except.purpose | Base | extensible | PurposeOfUse | 📍2014-03-26 | FHIR Std.
Consent.except.class | Base | extensible | Consent Content Class | 📍3.0.2 | FHIR Std.
Consent.except.code | Base | example | Consent Content Codes | 📍3.0.2 | FHIR Std.
Consent.except.data.​meaning | Base | required | ConsentDataMeaning | 📍3.0.2 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
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()`

Summary

Structures

This structure refers to these other structures:

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

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
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(ACP Patient(1.0.0)) | Who the consent applies to
dateTime | Σ | 1..1 | dateTime | LivingWillDate
consentingParty | Σ | 0..1 | Reference(nl-core-relatedperson(2.0.5)) | Representative
source[x] | Σ | 0..1 | Attachment | LivingWillDocument
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Consent.status | Base | required | ConsentState | 📍3.0.2 | FHIR Std.
Consent.category | Base | example | Consent Category Codes | 📍3.0.2 | FHIR Std.
Consent.category:livingWill | Base | example | Consent Category Codes | 📍3.0.2 | FHIR Std.
Consent.category:typeOfLivingWill | Base | required | WilsverklaringTypeCodelijst | 📍2017-12-31T00:00:00 | Nictiz FHIR NL STU3 Zib2017 v2.3

#### Constraints

Id | Grade | Path(s) | Description | Expression
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

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
Slices for category |  |  |  | Content/Rules for all slices
category:typeOfLivingWill |  | 1..1 | CodeableConcept | TypeOfLivingWill
patient |  | 1..1 | Reference(ACP Patient(1.0.0)) | Who the consent applies to
dateTime |  | 1..1 | dateTime | LivingWillDate
consentingParty |  | 0..1 | Reference(nl-core-relatedperson(2.0.5)) | Representative
source[x] |  | 0..1 | Attachment | LivingWillDocument
Documentation for this format

Snapshot ViewView

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
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 Slice: Unordered, Open by value:url
coding | Σ | 0..* | 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 Slice: Unordered, Open by value:url
system | Σ | 0..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 0..1 | code | Symbol in syntax defined by the system Fixed Value: 11341000146107
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(ACP Patient(1.0.0)) | 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 | Σ C | 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
source[x] | 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 | Σ C | 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 | Σ C | 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 | Status | Usage | ValueSet | Version | Source
Consent.language | Base | extensible | Common Languages | 📍3.0.2 | FHIR Std.
Consent.status | Base | required | ConsentState | 📍3.0.2 | FHIR Std.
Consent.category | Base | example | Consent Category Codes | 📍3.0.2 | FHIR Std.
Consent.category:livingWill | Base | example | Consent Category Codes | 📍3.0.2 | FHIR Std.
Consent.category:typeOfLivingWill | Base | required | WilsverklaringTypeCodelijst | 📍2017-12-31T00:00:00 | Nictiz FHIR NL STU3 Zib2017 v2.3
Consent.actor.role | Base | extensible | SecurityRoleType | 📍1.8.0 | FHIR Std.
Consent.action | Base | example | Consent Action Codes | 📍3.0.2 | FHIR Std.
Consent.securityLabel | Base | extensible | All Security Labels | 📍3.0.2 | FHIR Std.
Consent.purpose | Base | extensible | PurposeOfUse | 📍2014-03-26 | FHIR Std.
Consent.data.meaning | Base | required | ConsentDataMeaning | 📍3.0.2 | FHIR Std.
Consent.except.type | Base | required | ConsentExceptType | 📍3.0.2 | FHIR Std.
Consent.except.actor.​role | Base | extensible | SecurityRoleType | 📍1.8.0 | FHIR Std.
Consent.except.action | Base | example | Consent Action Codes | 📍3.0.2 | FHIR Std.
Consent.except.securityLabel | Base | extensible | All Security Labels | 📍3.0.2 | FHIR Std.
Consent.except.purpose | Base | extensible | PurposeOfUse | 📍2014-03-26 | FHIR Std.
Consent.except.class | Base | extensible | Consent Content Class | 📍3.0.2 | FHIR Std.
Consent.except.code | Base | example | Consent Content Codes | 📍3.0.2 | FHIR Std.
Consent.except.data.​meaning | Base | required | ConsentDataMeaning | 📍3.0.2 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
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()`

Summary

Structures

This structure refers to these other structures:

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

Other representations of profile: CSV, Excel, Schematron