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 - Detailed Descriptions

Draft as of 2026-08-11

Definitions for the ACP-AdvanceDirective resource profile

- Key Elements Table
- Differential Table
- Snapshot Table

Guidance on how to interpret the contents of this table can be foundhere

0. Consent
Definition | A record of a healthcare consumer’s policy choices, which permits or denies identified recipient(s) or recipient role(s) to perform one or more actions within a given policy context, for specific purposes and periods of time. This is the base resource type for everything.
Short | LivingWillBase Resource
Comments | Broadly, there are 3 key areas of consent for patients: Consent around sharing information (aka Privacy Consent Directive - Authorization to Collect, Use, or Disclose information), consent for specific treatment, or kinds of treatment, and general advance care directives.
Control | 0..*
Alternate Names | Wilsverklaring
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (`contained.contained.empty()`) dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (`contained.text.empty()`) dom-4: 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()`) dom-3: 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()`) ppc-1: Either a Policy or PolicyRule (`policy.exists() or policyRule.exists()`)
2. Consent.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.
Short | A set of rules under which this content was created
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.
Control | 0..1
Type | uri
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
4. Consent.extension:disorder
Slice Name | disorder
Definition | Optional Extension Element - found in all resources.
Short | Optional Extensions Element
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(HCIM AdvanceDirective Disorder) (Extension Type: Reference(HCIM Problem))
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() | (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
6. Consent.extension:comment
Slice Name | comment
Definition | Optional Extension Element - found in all resources.
Short | Comment
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Comment) (Extension Type: string)
Alternate Names | Toelichting
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() | (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
8. Consent.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Short | Extensions that cannot be ignored
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Alternate Names | extensions, user content
10. Consent.status
Definition | Indicates the current state of this consent.
Short | draft | proposed | active | rejected | inactive | entered-in-error
Comments | This element is labeled as a modifier because the status contains the codes rejected and entered-in-error that mark the Consent as not currently valid.
Control | 1..1
Binding | The codes SHALL be taken from ConsentState http://hl7.org/fhir/ValueSet/consent-state-codes|3.0.2 (required to `http://hl7.org/fhir/ValueSet/consent-state-codes|3.0.2` ) Indicates the state of the consent
Type | code
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | The Consent Directive that is pointed to might be in various lifecycle states, e.g., a revoked Consent Directive.
12. Consent.category
Definition | A classification of the type of consents found in the statement. This element supports indexing and retrieval of consent statements.
Short | Classification of the consent statement - for indexing/retrieval
Control | 20..*
Binding | For example codes, see Consent Category Codes http://hl7.org/fhir/ValueSet/consent-category|3.0.2 (example to `http://hl7.org/fhir/ValueSet/consent-category|3.0.2` ) A classification of the type of consents found in a consent statement
Type | CodeableConcept
Summary | true
Slicing | This element introduces a set of slices on `Consent.category`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ $this
14. Consent.category:livingWill
Slice Name | livingWill
Definition | Category SNOMED code used for indexing/retrieval of the HCIM AdvanceDirective. A classification of the type of consents found in the statement. This element supports indexing and retrieval of consent statements.
Short | Living will and advance directive recordClassification of the consent statement - for indexing/retrieval
Control | 10..1*
Binding | For example codes, see Consent Category Codes http://hl7.org/fhir/ValueSet/consent-category|3.0.2 (example to `http://hl7.org/fhir/ValueSet/consent-category|3.0.2` ) A classification of the type of consents found in a consent statement
Type | CodeableConcept
Summary | true
Pattern Value | `{ "coding" : [{ "system" : "http://snomed.info/sct", "code" : "11341000146107" }] }`
16. Consent.category:typeOfLivingWill
Slice Name | typeOfLivingWill
Definition | List of the different types of living wills. A classification of the type of consents found in the statement. This element supports indexing and retrieval of consent statements.
Short | TypeOfLivingWillClassification of the consent statement - for indexing/retrieval
Control | 10..1*
Binding | The codes SHALL be taken from For example codes, see WilsverklaringTypeCodelijst (2017-12-31T00:00:00)http://hl7.org/fhir/ValueSet/consent-category|3.0.2 (required to `http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.7.15.1--20171231000000|2017-12-31T00:00:00` ) List of the different types of living wills. A classification of the type of consents found in a consent statement
Type | CodeableConcept
Summary | true
Alternate Names | WilsverklaringType
18. Consent.category:typeOfLivingWill.coding
Definition | A reference to a code defined by a terminology system.
Short | Code defined by a terminology system
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 10..*
Type | Coding
Summary | true
Requirements | Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.
20. Consent.category:typeOfLivingWill.coding.system
Definition | The identification of the code system that defines the meaning of the symbol in the code.
Short | Identity of the terminology system
Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.
Control | 10..1
Type | uri
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to be unambiguous about the source of the definition of the symbol.
22. Consent.category:typeOfLivingWill.coding.code
Definition | A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Short | Symbol in syntax defined by the system
Control | 10..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to refer to a particular code in the system.
24. Consent.patient
Definition | The patient/healthcare consumer to whom this consent applies.
Short | Who the consent applies to
Comments | Commonly, the patient the consent pertains to is the author, but for young and old people, it may be some other person.
Control | 1..1
Type | Reference(ACP Patient, Patient)
Summary | true
26. Consent.dateTime
Definition | The date on which the living will was recorded. When this Consent was issued / created / indexed.
Short | LivingWillDateWhen this Consent was created or indexed
Comments | This is not the time of the original consent, but the time that this statement was made or derived.
Control | 10..1
Type | dateTime
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Alternate Names | WilsverklaringDatum
28. Consent.consentingParty
Definition | The person who is the legal representative or is appointed as the authorized representative in the signed authorization. Either the Grantor, which is the entity responsible for granting the rights listed in a Consent Directive or the Grantee, which is the entity responsible for complying with the Consent Directive, including any obligations or limitations on authorizations and enforcement of prohibitions.
Short | RepresentativeWho is agreeing to the policy and exceptions
Comments | Commonly, the patient the consent pertains to is the consentor, but particularly for young and old people, it may be some other person - e.g. a legal guardian.
Control | 0..1*
Type | Reference(nl-core-relatedperson, Organization, Patient, Practitioner, RelatedPerson)
Summary | true
Alternate Names | consentor, Vertegenwoordiger
30. Consent.source[x]
Definition | The source on which this consent statement is based. The source might be a scanned original paper form, or a reference to a consent that links back to such a source, a reference to a document repository (e.g. XDS) that stores the original consent document.
Short | LivingWillDocumentSource from which this consent is taken
Comments | The source can be contained inline (Attachment), referenced directly (Consent), referenced in a consent repository (DocumentReference), or simply by an identifier (Identifier), e.g. a CDA document id.
Control | 0..1
Type | Attachment, Identifier, Reference(Consent, DocumentReference, Contract, QuestionnaireResponse)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Summary | true
Alternate Names | WilsverklaringDocument

Guidance on how to interpret the contents of this table can be foundhere

0. Consent
2. Consent.extension:disorder
Slice Name | disorder
4. Consent.extension:comment
Slice Name | comment
6. Consent.category:typeOfLivingWill
Slice Name | typeOfLivingWill
8. Consent.patient
Type | Reference(ACP Patient)
10. Consent.dateTime
12. Consent.consentingParty
14. Consent.source[x]
Type | Attachment, Identifier, Reference(Consent, DocumentReference, Contract, QuestionnaireResponse)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]

Guidance on how to interpret the contents of this table can be foundhere

0. Consent
Definition | A record of a healthcare consumer’s policy choices, which permits or denies identified recipient(s) or recipient role(s) to perform one or more actions within a given policy context, for specific purposes and periods of time.
Short | LivingWill
Comments | Broadly, there are 3 key areas of consent for patients: Consent around sharing information (aka Privacy Consent Directive - Authorization to Collect, Use, or Disclose information), consent for specific treatment, or kinds of treatment, and general advance care directives.
Control | 0..*
Alternate Names | Wilsverklaring
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (`contained.contained.empty()`) dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (`contained.text.empty()`) dom-4: 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()`) dom-3: 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()`) ppc-1: Either a Policy or PolicyRule (`policy.exists() or policyRule.exists()`)
2. Consent.id
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Short | Logical id of this artifact
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
Control | 0..1
Type | id
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
4. Consent.meta
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.
Short | Metadata about the resource
Control | 0..1
Type | Meta
Summary | true
6. Consent.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.
Short | A set of rules under which this content was created
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.
Control | 0..1
Type | uri
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
8. Consent.language
Definition | The base language in which the resource is written.
Short | Language of the resource content
Comments | Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from Common Languages (extensible to `http://hl7.org/fhir/ValueSet/languages|3.0.2` ) A human language.
Additional Bindings | Purpose
All Languages | Max Binding
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
10. Consent.text
Definition | A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Short | Text summary of the resource, for human interpretation
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.
Control | 0..1 This element is affected by the following invariants: dom-1
Type | Narrative
Alternate Names | narrative, html, xhtml, display
12. Consent.contained
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Short | Contained, inline Resources
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.
Control | 0..*
Type | Resource
Alternate Names | inline resources, anonymous resources, contained resources
14. Consent.extension
Definition | May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional Content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Slicing | This element introduces a set of slices on `Consent.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
16. Consent.extension:disorder
Slice Name | disorder
Definition | Optional Extension Element - found in all resources.
Short | Optional Extensions Element
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(HCIM AdvanceDirective Disorder) (Extension Type: Reference(HCIM Problem))
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() | (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
18. Consent.extension:comment
Slice Name | comment
Definition | Optional Extension Element - found in all resources.
Short | Comment
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Comment) (Extension Type: string)
Alternate Names | Toelichting
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() | (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
20. Consent.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Short | Extensions that cannot be ignored
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Alternate Names | extensions, user content
22. Consent.identifier
Definition | Unique identifier for this copy of the Consent Statement.
Short | Identifier for this record (external references)
Comments | This identifier is identifies this copy of the consent. Where this identifier is also used elsewhere as the identifier for a consent record (e.g. a CDA consent document) then the consent details are expected to be the same.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..1
Type | Identifier
Summary | true
Example | General: { "system" : "urn:ietf:rfc:3986", "value" : "Local eCMS identifier" }
24. Consent.status
Definition | Indicates the current state of this consent.
Short | draft | proposed | active | rejected | inactive | entered-in-error
Comments | This element is labeled as a modifier because the status contains the codes rejected and entered-in-error that mark the Consent as not currently valid.
Control | 1..1
Binding | The codes SHALL be taken from ConsentState (required to `http://hl7.org/fhir/ValueSet/consent-state-codes|3.0.2` ) Indicates the state of the consent
Type | code
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | The Consent Directive that is pointed to might be in various lifecycle states, e.g., a revoked Consent Directive.
26. Consent.category
Definition | A classification of the type of consents found in the statement. This element supports indexing and retrieval of consent statements.
Short | Classification of the consent statement - for indexing/retrieval
Control | 2..*
Binding | For example codes, see Consent Category Codes (example to `http://hl7.org/fhir/ValueSet/consent-category|3.0.2` ) A classification of the type of consents found in a consent statement
Type | CodeableConcept
Summary | true
Slicing | This element introduces a set of slices on `Consent.category`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ $this
28. Consent.category:livingWill
Slice Name | livingWill
Definition | Category SNOMED code used for indexing/retrieval of the HCIM AdvanceDirective.
Short | Living will and advance directive record
Control | 1..1
Binding | For example codes, see Consent Category Codes (example to `http://hl7.org/fhir/ValueSet/consent-category|3.0.2` ) A classification of the type of consents found in a consent statement
Type | CodeableConcept
Summary | true
Pattern Value | `{ "coding" : [{ "system" : "http://snomed.info/sct", "code" : "11341000146107" }] }`
30. Consent.category:livingWill.id
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
32. Consent.category:livingWill.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional Content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Slicing | This element introduces a set of slices on `Consent.category.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
34. Consent.category:livingWill.coding
Definition | A reference to a code defined by a terminology system.
Short | Code defined by a terminology system
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 0..*
Type | Coding
Summary | true
Requirements | Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.
36. Consent.category:livingWill.coding.id
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
38. Consent.category:livingWill.coding.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional Content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Slicing | This element introduces a set of slices on `Consent.category.coding.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
40. Consent.category:livingWill.coding.system
Definition | The identification of the code system that defines the meaning of the symbol in the code.
Short | Identity of the terminology system
Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.
Control | 0..1
Type | uri
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to be unambiguous about the source of the definition of the symbol.
42. Consent.category:livingWill.coding.version
Definition | The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Short | Version of the system - if relevant
Comments | Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Note | This is a business version Id, not a resource version Id (see discussion)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
44. Consent.category:livingWill.coding.code
Definition | A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Short | Symbol in syntax defined by the system
Control | 0..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to refer to a particular code in the system.
46. Consent.category:livingWill.coding.display
Definition | A representation of the meaning of the code in the system, following the rules of the system.
Short | Representation defined by the system
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Default Value | `Living will and advance directive record (record artifact)`
48. Consent.category:livingWill.coding.userSelected
Definition | Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).
Short | If this coding was chosen directly by the user
Comments | Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Control | 0..1
Type | boolean
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
50. Consent.category:livingWill.text
Definition | A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Short | Plain text representation of the concept
Comments | Very often the text is the same as a displayName of one of the codings.
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
52. Consent.category:typeOfLivingWill
Slice Name | typeOfLivingWill
Definition | List of the different types of living wills.
Short | TypeOfLivingWill
Control | 1..1
Binding | The codes SHALL be taken from WilsverklaringTypeCodelijst (2017-12-31T00:00:00) (required to `http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.7.15.1--20171231000000|2017-12-31T00:00:00` ) List of the different types of living wills.
Type | CodeableConcept
Summary | true
Alternate Names | WilsverklaringType
54. Consent.category:typeOfLivingWill.id
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
56. Consent.category:typeOfLivingWill.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional Content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Slicing | This element introduces a set of slices on `Consent.category.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
58. Consent.category:typeOfLivingWill.coding
Definition | A reference to a code defined by a terminology system.
Short | Code defined by a terminology system
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 1..*
Type | Coding
Summary | true
Requirements | Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.
60. Consent.category:typeOfLivingWill.coding.id
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
62. Consent.category:typeOfLivingWill.coding.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional Content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Slicing | This element introduces a set of slices on `Consent.category.coding.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
64. Consent.category:typeOfLivingWill.coding.system
Definition | The identification of the code system that defines the meaning of the symbol in the code.
Short | Identity of the terminology system
Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.
Control | 1..1
Type | uri
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to be unambiguous about the source of the definition of the symbol.
66. Consent.category:typeOfLivingWill.coding.version
Definition | The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Short | Version of the system - if relevant
Comments | Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Note | This is a business version Id, not a resource version Id (see discussion)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
68. Consent.category:typeOfLivingWill.coding.code
Definition | A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Short | Symbol in syntax defined by the system
Control | 1..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to refer to a particular code in the system.
70. Consent.category:typeOfLivingWill.coding.display
Definition | A representation of the meaning of the code in the system, following the rules of the system.
Short | Representation defined by the system
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
72. Consent.category:typeOfLivingWill.coding.userSelected
Definition | Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).
Short | If this coding was chosen directly by the user
Comments | Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Control | 0..1
Type | boolean
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
74. Consent.category:typeOfLivingWill.text
Definition | A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Short | Plain text representation of the concept
Comments | Very often the text is the same as a displayName of one of the codings.
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
76. Consent.patient
Definition | The patient/healthcare consumer to whom this consent applies.
Short | Who the consent applies to
Comments | Commonly, the patient the consent pertains to is the author, but for young and old people, it may be some other person.
Control | 1..1
Type | Reference(ACP Patient)
Summary | true
78. Consent.period
Definition | Relevant time or time-period when this Consent is applicable.
Short | Period that this consent applies
Comments | This can be a subset of the period of the original statement.
Control | 0..1
Type | Period
Summary | true
Meaning if Missing | all date ranges included
80. Consent.dateTime
Definition | The date on which the living will was recorded.
Short | LivingWillDate
Comments | This is not the time of the original consent, but the time that this statement was made or derived.
Control | 1..1
Type | dateTime
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Alternate Names | WilsverklaringDatum
82. Consent.consentingParty
Definition | The person who is the legal representative or is appointed as the authorized representative in the signed authorization.
Short | Representative
Comments | Commonly, the patient the consent pertains to is the consentor, but particularly for young and old people, it may be some other person - e.g. a legal guardian.
Control | 0..1
Type | Reference(nl-core-relatedperson)
Summary | true
Alternate Names | consentor, Vertegenwoordiger
84. Consent.actor
Definition | Who or what is controlled by this consent. Use group to identify a set of actors by some property they share (e.g. 'admitting officers').
Short | Who|what controlled by this consent (or group, by role)
Control | 0..*
Type | BackboneElement
Summary | true
Meaning if Missing | There is no specific actor associated with the consent
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() | (children().count() > id.count())`)
86. Consent.actor.id
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
88. Consent.actor.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional Content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
90. Consent.actor.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Short | Extensions that cannot be ignored
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Summary | true
Alternate Names | extensions, user content, modifiers
92. Consent.actor.role
Definition | How the individual is involved in the resources content that is described in the consent.
Short | How the actor is involved
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from SecurityRoleType (extensible to `http://hl7.org/fhir/ValueSet/security-role-type|1.8.0` ) How an actor is involved in the consent considerations
Type | CodeableConcept
94. Consent.actor.reference
Definition | The resource that identifies the actor. To identify a actors by type, use group to identify a set of actors by some property they share (e.g. 'admitting officers').
Short | Resource for the actor (or group, by role)
Control | 1..1
Type | Reference(Device, Group, CareTeam, nl-core-organization, nl-core-patient, nl-core-practitioner, nl-core-relatedperson)
96. Consent.actor.reference.id
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
98. Consent.actor.reference.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional Content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Slicing | This element introduces a set of slices on `Consent.actor.reference.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
100. Consent.actor.reference.extension:practitionerRole
Slice Name | practitionerRole
Definition | Optional Extension Element - found in all resources.
Short | Optional Extensions Element
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(PractitionerRole Reference) (Extension Type: Reference(nl-core-practitionerrole))
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() | (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
102. Consent.actor.reference.reference
Definition | A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Short | Literal reference, Relative, internal or absolute URL
Comments | Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
Control | 0..1 This element is affected by the following invariants: ref-1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
104. Consent.actor.reference.identifier
Definition | An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
Short | Logical reference, when literal reference is not known
Comments | When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..1
Type | Identifier
Summary | true
106. Consent.actor.reference.display
Definition | Plain text narrative that identifies the resource in addition to the resource reference.
Short | Text alternative for the resource
Comments | This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
108. Consent.action
Definition | Actions controlled by this consent.
Short | Actions controlled by this consent
Comments | Note that this is the direct action (not the grounds for the action covered in the purpose element). At present, the only action in the understood and tested scope of this resource is 'read'.
Control | 0..*
Binding | For example codes, see Consent Action Codes (example to `http://hl7.org/fhir/ValueSet/consent-action|3.0.2` ) Detailed codes for the consent action.
Type | CodeableConcept
Summary | true
Meaning if Missing | all actions
110. Consent.organization
Definition | The organization that manages the consent, and the framework within which it is executed.
Short | Custodian of the consent
Control | 0..*
Type | Reference(nl-core-organization)
Summary | true
Alternate Names | custodian
112. Consent.source[x]
Definition | The source on which this consent statement is based. The source might be a scanned original paper form, or a reference to a consent that links back to such a source, a reference to a document repository (e.g. XDS) that stores the original consent document.
Short | LivingWillDocument
Comments | The source can be contained inline (Attachment), referenced directly (Consent), referenced in a consent repository (DocumentReference), or simply by an identifier (Identifier), e.g. a CDA document id.
Control | 0..1
Type | Attachment
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Summary | true
Alternate Names | WilsverklaringDocument
114. Consent.policy
Definition | The references to the policies that are included in this consent scope. Policies may be organizational, but are often defined jurisdictionally, or in law.
Short | Policies covered by this consent
Control | 0..*
Type | BackboneElement
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() | (children().count() > id.count())`)
116. Consent.policy.id
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
118. Consent.policy.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional Content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
120. Consent.policy.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Short | Extensions that cannot be ignored
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Summary | true
Alternate Names | extensions, user content, modifiers
122. Consent.policy.authority
Definition | Entity or Organization having regulatory jurisdiction or accountability for enforcing policies pertaining to Consent Directives.
Short | Enforcement source for policy
Control | 0..1 This element is affected by the following invariants: ppc-1
Type | uri
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
124. Consent.policy.uri
Definition | The references to the policies that are included in this consent scope. Policies may be organizational, but are often defined jurisdictionally, or in law.
Short | Specific policy covered by this consent
Comments | Either `.policy` or `.policyRule` should exist following core constraint ppc-1. If no explicit value is recorded, a fallback is to populate `.policy.uri` with <https://wetten.overheid.nl/> if the advance directive is recorded following Dutch law and regulations.
Control | 0..1 This element is affected by the following invariants: ppc-1
Type | uri
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Example | General Dutch Law: http://wetten.overheid.nl/
126. Consent.policyRule
Definition | A referece to the specific computable policy.
Short | Policy that this consents to
Comments | If the policy reference is not known, the resource cannot be processed. Where the reference is absent, there is no particular policy other than what is expressed directly in the consent resource.
Control | 0..1 This element is affected by the following invariants: ppc-1
Type | uri
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Might be a unique identifier of a policy set in XACML, or other rules engine.
128. Consent.securityLabel
Definition | A set of security labels that define which resources are controlled by this consent. If more than one label is specified, all resources must have all the specified labels.
Short | Security Labels that define affected resources
Comments | If the consent specifies a security label of "R" then it applies to all resources that are labeled "R" or lower. E.g. for Confidentiality, it's a high water mark. For other kinds of security labels, subsumption logic applies. Not all of the security labels make sense for use in this element (may define a narrower value set?).
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from All Security Labels (extensible to `http://hl7.org/fhir/ValueSet/security-labels|3.0.2` ) Security Labels from the Healthcare Privacy and Security Classification System.
Type | Coding
Summary | true
130. Consent.purpose
Definition | The context of the activities a user is taking - why the user is accessing the data - that are controlled by this consent.
Short | Context of activities for which the agreement is made
Comments | This element is for discoverability / documentation, and does not modify or qualify the policy (e.g. the policy itself describes the purposes for which it applies).
Control | 0..*
Binding | ​Unless not suitable, these codes SHALL be taken from PurposeOfUse|2014-03-26 (extensible to `http://hl7.org/fhir/ValueSet/v3-PurposeOfUse|2014-03-26` ) What purposes of use are controlled by this exception. If more than one label is specified, operations must have all the specified labels
Type | Coding
Summary | true
132. Consent.dataPeriod
Definition | Clinical or Operational Relevant period of time that bounds the data controlled by this consent.
Short | Timeframe for data controlled by this consent
Comments | This has a different sense to the Consent.period - that is when the consent agreement holds. This is the time period of the data that is controlled by the agreement.
Control | 0..1
Type | Period
Summary | true
134. Consent.data
Definition | The resources controlled by this consent, if specific resources are referenced.
Short | Data controlled by this consent
Control | 0..*
Type | BackboneElement
Summary | true
Meaning if Missing | all data
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() | (children().count() > id.count())`)
136. Consent.data.id
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
138. Consent.data.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional Content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
140. Consent.data.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Short | Extensions that cannot be ignored
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Summary | true
Alternate Names | extensions, user content, modifiers
142. Consent.data.meaning
Definition | How the resource reference is interpreted when testing consent restrictions.
Short | instance | related | dependents | authoredby
Control | 1..1
Binding | The codes SHALL be taken from ConsentDataMeaning (required to `http://hl7.org/fhir/ValueSet/consent-data-meaning|3.0.2` ) How a resource reference is interpreted when testing consent restrictions
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
144. Consent.data.reference
Definition | A reference to a specific resource that defines which resources are covered by this consent.
Short | The actual data reference
Control | 1..1
Type | Reference(Resource)
Summary | true
146. Consent.except
Definition | An exception to the base policy of this consent. An exception can be an addition or removal of access permissions.
Short | Additional rule - addition or removal of permissions
Control | 0..*
Type | BackboneElement
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() | (children().count() > id.count())`)
148. Consent.except.id
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
150. Consent.except.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional Content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
152. Consent.except.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Short | Extensions that cannot be ignored
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Summary | true
Alternate Names | extensions, user content, modifiers
154. Consent.except.type
Definition | Action to take - permit or deny - when the exception conditions are met.
Short | deny | permit
Control | 1..1
Binding | The codes SHALL be taken from ConsentExceptType (required to `http://hl7.org/fhir/ValueSet/consent-except-type|3.0.2` ) How an exception statement is applied, such as adding additional consent or removing consent
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
156. Consent.except.period
Definition | The timeframe in this exception is valid.
Short | Timeframe for this exception
Control | 0..1
Type | Period
Summary | true
158. Consent.except.actor
Definition | Who or what is controlled by this Exception. Use group to identify a set of actors by some property they share (e.g. 'admitting officers').
Short | Who|what controlled by this exception (or group, by role)
Control | 0..*
Type | BackboneElement
Summary | true
Meaning if Missing | There is no specific actor associated with the exception
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() | (children().count() > id.count())`)
160. Consent.except.actor.id
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
162. Consent.except.actor.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional Content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
164. Consent.except.actor.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Short | Extensions that cannot be ignored
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Summary | true
Alternate Names | extensions, user content, modifiers
166. Consent.except.actor.role
Definition | How the individual is involved in the resources content that is described in the exception.
Short | How the actor is involved
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from SecurityRoleType (extensible to `http://hl7.org/fhir/ValueSet/security-role-type|1.8.0` ) How an actor is involved in the consent considerations
Type | CodeableConcept
168. Consent.except.actor.reference
Definition | The resource that identifies the actor. To identify a actors by type, use group to identify a set of actors by some property they share (e.g. 'admitting officers').
Short | Resource for the actor (or group, by role)
Control | 1..1
Type | Reference(Device, Group, CareTeam, nl-core-organization, nl-core-patient, nl-core-practitioner, nl-core-relatedperson)
170. Consent.except.actor.reference.id
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
172. Consent.except.actor.reference.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional Content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Slicing | This element introduces a set of slices on `Consent.except.actor.reference.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
174. Consent.except.actor.reference.extension:practitionerRole
Slice Name | practitionerRole
Definition | Optional Extension Element - found in all resources.
Short | Optional Extensions Element
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(PractitionerRole Reference) (Extension Type: Reference(nl-core-practitionerrole))
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() | (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
176. Consent.except.actor.reference.reference
Definition | A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Short | Literal reference, Relative, internal or absolute URL
Comments | Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
Control | 0..1 This element is affected by the following invariants: ref-1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
178. Consent.except.actor.reference.identifier
Definition | An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
Short | Logical reference, when literal reference is not known
Comments | When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..1
Type | Identifier
Summary | true
180. Consent.except.actor.reference.display
Definition | Plain text narrative that identifies the resource in addition to the resource reference.
Short | Text alternative for the resource
Comments | This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
182. Consent.except.action
Definition | Actions controlled by this Exception.
Short | Actions controlled by this exception
Comments | Note that this is the direct action (not the grounds for the action covered in the purpose element). At present, the only action in the understood and tested scope of this resource is 'read'.
Control | 0..*
Binding | For example codes, see Consent Action Codes (example to `http://hl7.org/fhir/ValueSet/consent-action|3.0.2` ) Detailed codes for the consent action.
Type | CodeableConcept
Summary | true
Meaning if Missing | all actions
184. Consent.except.securityLabel
Definition | A set of security labels that define which resources are controlled by this exception. If more than one label is specified, all resources must have all the specified labels.
Short | Security Labels that define affected resources
Comments | If the consent specifies a security label of "R" then it applies to all resources that are labeled "R" or lower. E.g. for Confidentiality, it's a high water mark. For other kinds of security labels, subsumption logic applies. Not all of the security labels make sense for use in this element (may define a narrower value set?).
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from All Security Labels (extensible to `http://hl7.org/fhir/ValueSet/security-labels|3.0.2` ) Security Labels from the Healthcare Privacy and Security Classification System.
Type | Coding
Summary | true
186. Consent.except.purpose
Definition | The context of the activities a user is taking - why the user is accessing the data - that are controlled by this exception.
Short | Context of activities covered by this exception
Comments | E.g. if the purpose is 'research', then the operational context must be research, in order for the consent to apply. Not all of the security labels make sense for use in this element (may define a narrower value set?).
Control | 0..*
Binding | ​Unless not suitable, these codes SHALL be taken from PurposeOfUse|2014-03-26 (extensible to `http://hl7.org/fhir/ValueSet/v3-PurposeOfUse|2014-03-26` ) What purposes of use are controlled by this exception. If more than one label is specified, operations must have all the specified labels
Type | Coding
Summary | true
188. Consent.except.class
Definition | The class of information covered by this exception. The type can be a FHIR resource type, a profile on a type, or a CDA document, or some other type that indicates what sort of information the consent relates to.
Short | e.g. Resource Type, Profile, or CDA etc
Comments | Multiple types are or'ed together. The intention of the contentType element is that the codes refer to profiles or document types defined in a standard or an implementation guide somewhere.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from Consent Content Class (extensible to `http://hl7.org/fhir/ValueSet/consent-content-class|3.0.2` ) The class (type) of information a consent rule covers
Type | Coding
Summary | true
190. Consent.except.code
Definition | If this code is found in an instance, then the exception applies.
Short | e.g. LOINC or SNOMED CT code, etc in the content
Comments | Typical use of this is a Document code with class = CDA.
Control | 0..*
Binding | For example codes, see Consent Content Codes (example to `http://hl7.org/fhir/ValueSet/consent-content-code|3.0.2` ) If this code is found in an instance, then the exception applies
Type | Coding
Summary | true
192. Consent.except.dataPeriod
Definition | Clinical or Operational Relevant period of time that bounds the data controlled by this exception.
Short | Timeframe for data controlled by this exception
Comments | This has a different sense to the Consent.period - that is when the consent agreement holds. This is the time period of the data that is controlled by the agreement.
Control | 0..1
Type | Period
Summary | true
194. Consent.except.data
Definition | The resources controlled by this exception, if specific resources are referenced.
Short | Data controlled by this exception
Control | 0..*
Type | BackboneElement
Summary | true
Meaning if Missing | all data
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() | (children().count() > id.count())`)
196. Consent.except.data.id
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
198. Consent.except.data.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional Content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
200. Consent.except.data.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Short | Extensions that cannot be ignored
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Summary | true
Alternate Names | extensions, user content, modifiers
202. Consent.except.data.meaning
Definition | How the resource reference is interpreted when testing consent restrictions.
Short | instance | related | dependents | authoredby
Control | 1..1
Binding | The codes SHALL be taken from ConsentDataMeaning (required to `http://hl7.org/fhir/ValueSet/consent-data-meaning|3.0.2` ) How a resource reference is interpreted when testing consent restrictions
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
204. Consent.except.data.reference
Definition | A reference to a specific resource that defines which resources are covered by this consent.
Short | The actual data reference
Control | 1..1
Type | Reference(Resource)
Summary | true