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 TreatmentDirective

Official URL: https://api.iknl.nl/docs/pzp/stu3/StructureDefinition/ACP-TreatmentDirective | Version: 1.0.0 | Highlight text changes?
Draft as of 2026-08-11 | Computable Name: ACPTreatmentDirective
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.

This profile specifies verified treatment directives. A treatment directive contains a joint decision between a health professional (for example a general practitioner) and a patient or his representative(s) about the desirability of performing a certain treatment, such as resuscitation, before this treatment becomes (acute) necessary.

Usages:

- Examples for this Profile: Consent/ACP-TreatmentDirective-AdministrationOfBloodProduct-2025-Pat1, Consent/ACP-TreatmentDirective-AdministrationOfBloodProduct-Pat1, Consent/ACP-TreatmentDirective-AdmissionToICU-1-Pat1, Consent/ACP-TreatmentDirective-AdmissionToICU-2-Pat1... Show 20 more, Consent/ACP-TreatmentDirective-AdmissionToICU-2025-Pat1, Consent/ACP-TreatmentDirective-AdmissionToICU-Pat2, Consent/ACP-TreatmentDirective-AntibioticTherapy-2025-Pat1, Consent/ACP-TreatmentDirective-AntibioticTherapy-Pat1, Consent/ACP-TreatmentDirective-AntibioticTherapy-Pat2, Consent/ACP-TreatmentDirective-ArtificialRespiration-1-Pat2, Consent/ACP-TreatmentDirective-ArtificialRespiration-2-Pat2, Consent/ACP-TreatmentDirective-ArtificialRespiration-2025-Pat1, Consent/ACP-TreatmentDirective-ArtificialRespiration-Pat1, Consent/ACP-TreatmentDirective-CardiopulmonaryResuscitaion-Pat2, Consent/ACP-TreatmentDirective-CardiopulmonaryResuscitation-2025-Pat1, Consent/ACP-TreatmentDirective-CardiopulmonaryResuscitation-Pat1, Consent/ACP-TreatmentDirective-HospitalAdmission-2025-Pat1, Consent/ACP-TreatmentDirective-HospitalAdmission-Pat1, Consent/ACP-TreatmentDirective-HospitalAdmission-Pat2, Consent/ACP-TreatmentDirective-Other-Pat1, Consent/ACP-TreatmentDirective-Other-Pat2, Consent/ACP-TreatmentDirective-SwitchOffICD-2025-Pat1, Consent/ACP-TreatmentDirective-SwitchOffICD-Pat1 and Consent/ACP-TreatmentDirective-SwitchOffICD-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 TreatmentDirective(2.2.3) | TreatmentDirective Constraints: ppc-1, hcim-treatmentdirective-1
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:verification |  | 1..* | (Complex) | Verification URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Verification Constraints: ext-1
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
Slices for extension |  |  |  | Content/Rules for all slices
extension:Verified |  | 1..1 | Extension | Extension
extension |  | 0..0 |  | Additional Content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "Verified"
Slices for valueBoolean |  |  |  | Content/Rules for all slices
valueBoolean:valueBoolean |  | 1..1 | boolean | Verified Fixed Value: true
extension:VerifiedWith |  | 0..* | Extension | Extension
extension |  | 0..0 |  | Additional Content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "VerifiedWith"
Slices for valueCodeableConcept |  |  |  | Content/Rules for all slices
valueCodeableConcept:valueCodeableConcept |  | 0..1 | CodeableConcept | Value of extension Binding: GeverifieerdBijCodelijst (2017-12-31T00:00:00) (extensible): The person with whom the treatment instruction was discussed and verified.
extension:VerificationDate |  | 0..1 | Extension | Extension
extension |  | 0..0 |  | Additional Content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "VerificationDate"
Slices for valueDateTime |  |  |  | Content/Rules for all slices
valueDateTime:valueDateTime |  | 0..1 | dateTime | VerificationDate
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Verification"
extension:comment |  | 0..1 | string | Comment URL: http://nictiz.nl/fhir/StructureDefinition/Comment Constraints: ext-1
extension:treatment |  | 0..* | (Complex) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Treatment Constraints: ext-1
extension |  | 0..0 |  | Additional Content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Treatment"
Slices for value[x] |  |  |  | Content/Rules for all slices
value[x]:valueCodeableConcept |  | 0..1 | CodeableConcept | Treatment Binding: BehandelingCodelijst (2017-12-31T00:00:00) (extensible): The medical treatment to which the treatment instruction applies.
extension:additionalSources |  | 0..* | (Complex) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources Constraints: ext-1
extension |  | 0..0 |  | Additional Content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources"
Slices for modifierExtension | ?! | 1..* | Extension | Extension Slice: Unordered, Open by value:url
modifierExtension:treatmentPermitted | ?! | 1..1 | (Complex) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-TreatmentPermitted Constraints: ext-1
extension |  | 0..0 |  | Additional Content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-TreatmentPermitted"
Slices for value[x] |  |  |  | Content/Rules for all slices
value[x]:valueCodeableConcept |  | 0..1 | CodeableConcept | TreatmentPermitted Binding: ACPYesNoYesWithRestrictionsUnknownVS (1.0.0) (extensible)
status | ?!Σ | 1..1 | code | draft | proposed | active | rejected | inactive | entered-in-error Binding: ConsentState (required): Indicates the state of the consent
category | Σ | 1..* | CodeableConcept | Classification of the consent statement - for indexing/retrieval Binding: Consent Category Codes (example): A classification of the type of consents found in a consent statement
Slices for coding | Σ | 1..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:code
coding:treatmentDirective | Σ | 1..1 | Coding | Code defined by a terminology system
system | Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct
code | Σ | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 11291000146105
patient | Σ | 1..1 | Reference(ACP Patient(1.0.0)) | Who the consent applies to
source[x] | Σ | 0..1 | Reference(ACP AdvanceDirective(1.0.0)) | AdvanceDirective
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Consent.extension:verification.​extension:VerifiedWith.​valueCodeableConcept:valueCodeableConcept | Base | extensible | GeverifieerdBijCodelijst | 📍2017-12-31T00:00:00 | Nictiz FHIR NL STU3 Zib2017 v2.3
Consent.extension:treatment.​value[x]:valueCodeableConcept | Base | extensible | BehandelingCodelijst | 📍2017-12-31T00:00:00 | Nictiz FHIR NL STU3 Zib2017 v2.3
Consent.modifierExtension:treatmentPermitted.​value[x]:valueCodeableConcept | Base | extensible | ACP Yes, No, Yes with restrictions, Unknown Codes | 📍1.0.0 | This IG
Consent.status | Base | required | ConsentState | 📍3.0.2 | FHIR Std.
Consent.category | Base | example | Consent Category Codes | 📍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:verification, Consent.extension:comment, Consent.extension:treatment, Consent.extension:additionalSources, Consent.modifierExtension:treatmentPermitted | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
hcim-treatmentdirective-1 | error | Consent | extension.additionalSources may only be used for AdvanceDirective references in addition to first reference in .source[x] | `extension.where(url = 'http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources').empty() or source.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 TreatmentDirective(2.2.3) | TreatmentDirective
extension |  | 1..* | Extension | Extension
Slices for extension |  |  |  | Content/Rules for all slices
extension:verification |  | 1..* | Zib TreatmentDirective Verification(1.0.5) | Verification
extension |  | 1..* | Extension | Extension
Slices for extension |  |  |  | Content/Rules for all slices
extension:Verified |  | 1..1 | Extension | Extension
​ value[x] |  | 1..1 | boolean | Verified Fixed Value: true
extension:VerifiedWith |  | 0..* | Extension | Extension
extension:VerificationDate |  | 0..1 | Extension | Extension
extension:comment |  | 0..1 | Comment(1.0.3) | Comment
extension:treatment |  | 0..* | Zib TreatmentDirective Treatment(1.0.2) | Optional Extensions Element
extension:additionalSources |  | 0..* | Consent additionalSources(1.0.3) | Optional Extensions Element
modifierExtension |  | 1..* | Extension | Extension
Slices for modifierExtension |  |  |  | Content/Rules for all slices
modifierExtension:treatmentPermitted |  | 1..1 | Zib TreatmentDirective TreatmentPermitted(1.0.3) | Optional Extensions Element
value[x] |  | 0..1 | CodeableConcept | TreatmentPermitted Binding: ACPYesNoYesWithRestrictionsUnknownVS (1.0.0) (extensible)
patient |  | 1..1 | Reference(ACP Patient(1.0.0)) | Who the consent applies to
period |  |  |  |
start |  | 0..1 | dateTime | StartDate
end |  | 0..1 | dateTime | EndDate
source[x] |  | 0..1 | Reference(ACP AdvanceDirective(1.0.0)) | AdvanceDirective
except |  |  |  |
Slices for extension |  |  |  | Content/Rules for all slices
extension:restrictions |  | 0..* | Zib TreatmentDirective Restrictions(2.0.2) | Optional Extensions Element
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Consent.modifierExtension:treatmentPermitted.​value[x] | Base | extensible | ACP Yes, No, Yes with restrictions, Unknown Codes | 📍1.0.0 | This IG

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Consent | C | 0..* | Zib TreatmentDirective(2.2.3) | TreatmentDirective Constraints: ppc-1, hcim-treatmentdirective-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 |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:verification |  | 1..* | (Complex) | Verification URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Verification Constraints: ext-1
id |  | 0..1 | string | xml:id (or equivalent in JSON)
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
Slices for extension |  |  |  | Content/Rules for all slices
extension:Verified |  | 1..1 | Extension | Extension
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..0 |  | Additional Content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "Verified"
Slices for valueBoolean |  |  |  | Content/Rules for all slices
valueBoolean:valueBoolean |  | 1..1 | boolean | Verified Fixed Value: true
extension:VerifiedWith |  | 0..* | Extension | Extension
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..0 |  | Additional Content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "VerifiedWith"
Slices for valueCodeableConcept |  |  |  | Content/Rules for all slices
valueCodeableConcept:valueCodeableConcept |  | 0..1 | CodeableConcept | Value of extension Binding: GeverifieerdBijCodelijst (2017-12-31T00:00:00) (extensible): The person with whom the treatment instruction was discussed and verified.
extension:VerificationDate |  | 0..1 | Extension | Extension
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..0 |  | Additional Content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "VerificationDate"
Slices for valueDateTime |  |  |  | Content/Rules for all slices
valueDateTime:valueDateTime |  | 0..1 | dateTime | VerificationDate
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Verification"
extension:comment |  | 0..1 | string | Comment URL: http://nictiz.nl/fhir/StructureDefinition/Comment Constraints: ext-1
extension:treatment |  | 0..* | (Complex) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Treatment Constraints: ext-1
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..0 |  | Additional Content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Treatment"
Slices for value[x] |  |  |  | Content/Rules for all slices
value[x]:valueCodeableConcept |  | 0..1 | CodeableConcept | Treatment Binding: BehandelingCodelijst (2017-12-31T00:00:00) (extensible): The medical treatment to which the treatment instruction applies.
extension:additionalSources |  | 0..* | (Complex) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources Constraints: ext-1
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..0 |  | Additional Content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources"
value[x] |  | 0..1 |  | AdvanceDirective
valueAttachment |  |  | Attachment |
valueIdentifier |  |  | Identifier |
valueReference |  |  | Reference(HCIM AdvanceDirective(2.1.5) | DocumentReference | Contract | QuestionnaireResponse) |
Slices for modifierExtension | ?! | 1..* | Extension | Extension Slice: Unordered, Open by value:url
modifierExtension:treatmentPermitted | ?! | 1..1 | (Complex) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-TreatmentPermitted Constraints: ext-1
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..0 |  | Additional Content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-TreatmentPermitted"
Slices for value[x] |  |  |  | Content/Rules for all slices
value[x]:valueCodeableConcept |  | 0..1 | CodeableConcept | TreatmentPermitted Binding: ACPYesNoYesWithRestrictionsUnknownVS (1.0.0) (extensible)
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
category | Σ | 1..* | CodeableConcept | Classification of the consent statement - for indexing/retrieval Binding: Consent Category Codes (example): A classification of the type of consents found in a consent statement
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
Slices for coding | Σ | 1..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:code
coding:treatmentDirective | Σ | 1..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 Fixed Value: http://snomed.info/sct
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 11291000146105
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
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
start | Σ C | 0..1 | dateTime | StartDate
end | Σ C | 0..1 | dateTime | EndDate
dateTime | Σ | 0..1 | dateTime | When this Consent was created or indexed
consentingParty | Σ | 0..* | Reference(nl-core-relatedperson(2.0.5) | nl-core-organization(2.0.6) | nl-core-patient(2.2.5) | nl-core-practitioner(2.0.7)) | Who is agreeing to the policy and exceptions
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
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 | Reference(ACP AdvanceDirective(1.0.0)) | AdvanceDirective
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)
Slices for extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
extension:restrictions |  | 0..* | string | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Restrictions Constraints: ext-1
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.extension:verification.​extension:VerifiedWith.​valueCodeableConcept:valueCodeableConcept | Base | extensible | GeverifieerdBijCodelijst | 📍2017-12-31T00:00:00 | Nictiz FHIR NL STU3 Zib2017 v2.3
Consent.extension:treatment.​value[x]:valueCodeableConcept | Base | extensible | BehandelingCodelijst | 📍2017-12-31T00:00:00 | Nictiz FHIR NL STU3 Zib2017 v2.3
Consent.modifierExtension:treatmentPermitted.​value[x]:valueCodeableConcept | Base | extensible | ACP Yes, No, Yes with restrictions, Unknown Codes | 📍1.0.0 | This IG
Consent.status | Base | required | ConsentState | 📍3.0.2 | FHIR Std.
Consent.category | Base | example | Consent Category Codes | 📍3.0.2 | FHIR Std.
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:verification, Consent.extension:comment, Consent.extension:treatment, Consent.extension:additionalSources, Consent.modifierExtension:treatmentPermitted, Consent.consentingParty.extension:practitionerRole, Consent.actor.reference.extension:practitionerRole, Consent.except.extension:restrictions, Consent.except.actor.reference.extension:practitionerRole | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
hcim-treatmentdirective-1 | error | Consent | extension.additionalSources may only be used for AdvanceDirective references in addition to first reference in .source[x] | `extension.where(url = 'http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources').empty() or source.exists()`
ppc-1 | error | Consent | Either a Policy or PolicyRule | `policy.exists() or policyRule.exists()`

Summary

Mandatory: 5 elements
Fixed: 1 element

Structures

This structure refers to these other structures:

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

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Consent | C | 0..* | Zib TreatmentDirective(2.2.3) | TreatmentDirective Constraints: ppc-1, hcim-treatmentdirective-1
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:verification |  | 1..* | (Complex) | Verification URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Verification Constraints: ext-1
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
Slices for extension |  |  |  | Content/Rules for all slices
extension:Verified |  | 1..1 | Extension | Extension
extension |  | 0..0 |  | Additional Content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "Verified"
Slices for valueBoolean |  |  |  | Content/Rules for all slices
valueBoolean:valueBoolean |  | 1..1 | boolean | Verified Fixed Value: true
extension:VerifiedWith |  | 0..* | Extension | Extension
extension |  | 0..0 |  | Additional Content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "VerifiedWith"
Slices for valueCodeableConcept |  |  |  | Content/Rules for all slices
valueCodeableConcept:valueCodeableConcept |  | 0..1 | CodeableConcept | Value of extension Binding: GeverifieerdBijCodelijst (2017-12-31T00:00:00) (extensible): The person with whom the treatment instruction was discussed and verified.
extension:VerificationDate |  | 0..1 | Extension | Extension
extension |  | 0..0 |  | Additional Content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "VerificationDate"
Slices for valueDateTime |  |  |  | Content/Rules for all slices
valueDateTime:valueDateTime |  | 0..1 | dateTime | VerificationDate
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Verification"
extension:comment |  | 0..1 | string | Comment URL: http://nictiz.nl/fhir/StructureDefinition/Comment Constraints: ext-1
extension:treatment |  | 0..* | (Complex) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Treatment Constraints: ext-1
extension |  | 0..0 |  | Additional Content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Treatment"
Slices for value[x] |  |  |  | Content/Rules for all slices
value[x]:valueCodeableConcept |  | 0..1 | CodeableConcept | Treatment Binding: BehandelingCodelijst (2017-12-31T00:00:00) (extensible): The medical treatment to which the treatment instruction applies.
extension:additionalSources |  | 0..* | (Complex) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources Constraints: ext-1
extension |  | 0..0 |  | Additional Content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources"
Slices for modifierExtension | ?! | 1..* | Extension | Extension Slice: Unordered, Open by value:url
modifierExtension:treatmentPermitted | ?! | 1..1 | (Complex) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-TreatmentPermitted Constraints: ext-1
extension |  | 0..0 |  | Additional Content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-TreatmentPermitted"
Slices for value[x] |  |  |  | Content/Rules for all slices
value[x]:valueCodeableConcept |  | 0..1 | CodeableConcept | TreatmentPermitted Binding: ACPYesNoYesWithRestrictionsUnknownVS (1.0.0) (extensible)
status | ?!Σ | 1..1 | code | draft | proposed | active | rejected | inactive | entered-in-error Binding: ConsentState (required): Indicates the state of the consent
category | Σ | 1..* | CodeableConcept | Classification of the consent statement - for indexing/retrieval Binding: Consent Category Codes (example): A classification of the type of consents found in a consent statement
Slices for coding | Σ | 1..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:code
coding:treatmentDirective | Σ | 1..1 | Coding | Code defined by a terminology system
system | Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct
code | Σ | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 11291000146105
patient | Σ | 1..1 | Reference(ACP Patient(1.0.0)) | Who the consent applies to
source[x] | Σ | 0..1 | Reference(ACP AdvanceDirective(1.0.0)) | AdvanceDirective
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Consent.extension:verification.​extension:VerifiedWith.​valueCodeableConcept:valueCodeableConcept | Base | extensible | GeverifieerdBijCodelijst | 📍2017-12-31T00:00:00 | Nictiz FHIR NL STU3 Zib2017 v2.3
Consent.extension:treatment.​value[x]:valueCodeableConcept | Base | extensible | BehandelingCodelijst | 📍2017-12-31T00:00:00 | Nictiz FHIR NL STU3 Zib2017 v2.3
Consent.modifierExtension:treatmentPermitted.​value[x]:valueCodeableConcept | Base | extensible | ACP Yes, No, Yes with restrictions, Unknown Codes | 📍1.0.0 | This IG
Consent.status | Base | required | ConsentState | 📍3.0.2 | FHIR Std.
Consent.category | Base | example | Consent Category Codes | 📍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:verification, Consent.extension:comment, Consent.extension:treatment, Consent.extension:additionalSources, Consent.modifierExtension:treatmentPermitted | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
hcim-treatmentdirective-1 | error | Consent | extension.additionalSources may only be used for AdvanceDirective references in addition to first reference in .source[x] | `extension.where(url = 'http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources').empty() or source.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 TreatmentDirective(2.2.3) | TreatmentDirective
extension |  | 1..* | Extension | Extension
Slices for extension |  |  |  | Content/Rules for all slices
extension:verification |  | 1..* | Zib TreatmentDirective Verification(1.0.5) | Verification
extension |  | 1..* | Extension | Extension
Slices for extension |  |  |  | Content/Rules for all slices
extension:Verified |  | 1..1 | Extension | Extension
​ value[x] |  | 1..1 | boolean | Verified Fixed Value: true
extension:VerifiedWith |  | 0..* | Extension | Extension
extension:VerificationDate |  | 0..1 | Extension | Extension
extension:comment |  | 0..1 | Comment(1.0.3) | Comment
extension:treatment |  | 0..* | Zib TreatmentDirective Treatment(1.0.2) | Optional Extensions Element
extension:additionalSources |  | 0..* | Consent additionalSources(1.0.3) | Optional Extensions Element
modifierExtension |  | 1..* | Extension | Extension
Slices for modifierExtension |  |  |  | Content/Rules for all slices
modifierExtension:treatmentPermitted |  | 1..1 | Zib TreatmentDirective TreatmentPermitted(1.0.3) | Optional Extensions Element
value[x] |  | 0..1 | CodeableConcept | TreatmentPermitted Binding: ACPYesNoYesWithRestrictionsUnknownVS (1.0.0) (extensible)
patient |  | 1..1 | Reference(ACP Patient(1.0.0)) | Who the consent applies to
period |  |  |  |
start |  | 0..1 | dateTime | StartDate
end |  | 0..1 | dateTime | EndDate
source[x] |  | 0..1 | Reference(ACP AdvanceDirective(1.0.0)) | AdvanceDirective
except |  |  |  |
Slices for extension |  |  |  | Content/Rules for all slices
extension:restrictions |  | 0..* | Zib TreatmentDirective Restrictions(2.0.2) | Optional Extensions Element
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Consent.modifierExtension:treatmentPermitted.​value[x] | Base | extensible | ACP Yes, No, Yes with restrictions, Unknown Codes | 📍1.0.0 | This IG

Snapshot ViewView

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Consent | C | 0..* | Zib TreatmentDirective(2.2.3) | TreatmentDirective Constraints: ppc-1, hcim-treatmentdirective-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 |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:verification |  | 1..* | (Complex) | Verification URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Verification Constraints: ext-1
id |  | 0..1 | string | xml:id (or equivalent in JSON)
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
Slices for extension |  |  |  | Content/Rules for all slices
extension:Verified |  | 1..1 | Extension | Extension
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..0 |  | Additional Content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "Verified"
Slices for valueBoolean |  |  |  | Content/Rules for all slices
valueBoolean:valueBoolean |  | 1..1 | boolean | Verified Fixed Value: true
extension:VerifiedWith |  | 0..* | Extension | Extension
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..0 |  | Additional Content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "VerifiedWith"
Slices for valueCodeableConcept |  |  |  | Content/Rules for all slices
valueCodeableConcept:valueCodeableConcept |  | 0..1 | CodeableConcept | Value of extension Binding: GeverifieerdBijCodelijst (2017-12-31T00:00:00) (extensible): The person with whom the treatment instruction was discussed and verified.
extension:VerificationDate |  | 0..1 | Extension | Extension
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..0 |  | Additional Content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "VerificationDate"
Slices for valueDateTime |  |  |  | Content/Rules for all slices
valueDateTime:valueDateTime |  | 0..1 | dateTime | VerificationDate
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Verification"
extension:comment |  | 0..1 | string | Comment URL: http://nictiz.nl/fhir/StructureDefinition/Comment Constraints: ext-1
extension:treatment |  | 0..* | (Complex) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Treatment Constraints: ext-1
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..0 |  | Additional Content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Treatment"
Slices for value[x] |  |  |  | Content/Rules for all slices
value[x]:valueCodeableConcept |  | 0..1 | CodeableConcept | Treatment Binding: BehandelingCodelijst (2017-12-31T00:00:00) (extensible): The medical treatment to which the treatment instruction applies.
extension:additionalSources |  | 0..* | (Complex) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources Constraints: ext-1
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..0 |  | Additional Content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources"
value[x] |  | 0..1 |  | AdvanceDirective
valueAttachment |  |  | Attachment |
valueIdentifier |  |  | Identifier |
valueReference |  |  | Reference(HCIM AdvanceDirective(2.1.5) | DocumentReference | Contract | QuestionnaireResponse) |
Slices for modifierExtension | ?! | 1..* | Extension | Extension Slice: Unordered, Open by value:url
modifierExtension:treatmentPermitted | ?! | 1..1 | (Complex) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-TreatmentPermitted Constraints: ext-1
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..0 |  | Additional Content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-TreatmentPermitted"
Slices for value[x] |  |  |  | Content/Rules for all slices
value[x]:valueCodeableConcept |  | 0..1 | CodeableConcept | TreatmentPermitted Binding: ACPYesNoYesWithRestrictionsUnknownVS (1.0.0) (extensible)
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
category | Σ | 1..* | CodeableConcept | Classification of the consent statement - for indexing/retrieval Binding: Consent Category Codes (example): A classification of the type of consents found in a consent statement
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
Slices for coding | Σ | 1..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:code
coding:treatmentDirective | Σ | 1..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 Fixed Value: http://snomed.info/sct
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 11291000146105
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
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
start | Σ C | 0..1 | dateTime | StartDate
end | Σ C | 0..1 | dateTime | EndDate
dateTime | Σ | 0..1 | dateTime | When this Consent was created or indexed
consentingParty | Σ | 0..* | Reference(nl-core-relatedperson(2.0.5) | nl-core-organization(2.0.6) | nl-core-patient(2.2.5) | nl-core-practitioner(2.0.7)) | Who is agreeing to the policy and exceptions
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
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 | Reference(ACP AdvanceDirective(1.0.0)) | AdvanceDirective
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)
Slices for extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
extension:restrictions |  | 0..* | string | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Restrictions Constraints: ext-1
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.extension:verification.​extension:VerifiedWith.​valueCodeableConcept:valueCodeableConcept | Base | extensible | GeverifieerdBijCodelijst | 📍2017-12-31T00:00:00 | Nictiz FHIR NL STU3 Zib2017 v2.3
Consent.extension:treatment.​value[x]:valueCodeableConcept | Base | extensible | BehandelingCodelijst | 📍2017-12-31T00:00:00 | Nictiz FHIR NL STU3 Zib2017 v2.3
Consent.modifierExtension:treatmentPermitted.​value[x]:valueCodeableConcept | Base | extensible | ACP Yes, No, Yes with restrictions, Unknown Codes | 📍1.0.0 | This IG
Consent.status | Base | required | ConsentState | 📍3.0.2 | FHIR Std.
Consent.category | Base | example | Consent Category Codes | 📍3.0.2 | FHIR Std.
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:verification, Consent.extension:comment, Consent.extension:treatment, Consent.extension:additionalSources, Consent.modifierExtension:treatmentPermitted, Consent.consentingParty.extension:practitionerRole, Consent.actor.reference.extension:practitionerRole, Consent.except.extension:restrictions, Consent.except.actor.reference.extension:practitionerRole | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
hcim-treatmentdirective-1 | error | Consent | extension.additionalSources may only be used for AdvanceDirective references in addition to first reference in .source[x] | `extension.where(url = 'http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources').empty() or source.exists()`
ppc-1 | error | Consent | Either a Policy or PolicyRule | `policy.exists() or policyRule.exists()`

Summary

Mandatory: 5 elements
Fixed: 1 element

Structures

This structure refers to these other structures:

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

Other representations of profile: CSV, Excel, Schematron