Advance Care Planning (PZP)
1.0.0-rc1 - trial-use

Advance Care Planning (PZP) - Downloaded Version 1.0.0-rc1 See the Directory of published versions

## Resource Profile: ACPAdvanceDirective - Detailed Descriptions

Draft as of 2025-10-30

Definitions for the ACP-AdvanceDirective resource profile.

- Key Elements Table
- Differential Elements Table
- Snapshot Elements Table

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

0. Consent
Definition | A record of a healthcare consumer’s 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 | AdvanceDirectiveA healthcare consumer's choices to permit or deny recipients or roles to perform actions for specific purposes and periods of time
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..*
Is Modifier | false
Alternate Names | Wilsverklaring, nl-core-AdvanceDirective
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (`contained.contained.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 or SHALL refer to the containing resource (`contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`) dom-6: A resource should have narrative for robust management (`text.`div`.exists()`) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (`contained.meta.security.empty()`) ppc-4: IF Scope=adr, there must be a patient (`patient.exists() or scope.coding.where(system='something' and code='adr').exists().not()`) ppc-5: IF Scope=treatment, there must be a patient (`patient.exists() or scope.coding.where(system='something' and code='treatment').exists().not()`) ppc-2: IF Scope=privacy, there must be a patient (`patient.exists() or scope.coding.where(system='something' and code='patient-privacy').exists().not()`) ppc-3: IF Scope=research, there must be a patient (`patient.exists() or scope.coding.where(system='something' and code='research').exists().not()`) ppc-1: Either a Policy or PolicyRule (`policy.exists() or policyRule.exists()`) dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty()) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).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-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty()) dom-6: A resource should have narrative for robust management (text.`div`.exists()) ppc-1: Either a Policy or PolicyRule (policy.exists() or policyRule.exists()) ppc-2: IF Scope=privacy, there must be a patient (patient.exists() or scope.coding.where(system='something' and code='patient-privacy').exists().not()) ppc-3: IF Scope=research, there must be a patient (patient.exists() or scope.coding.where(system='something' and code='research').exists().not()) ppc-4: IF Scope=adr, there must be a patient (patient.exists() or scope.coding.where(system='something' and code='adr').exists().not()) ppc-5: IF Scope=treatment, there must be a patient (patient.exists() or scope.coding.where(system='something' and code='treatment').exists().not())
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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
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(ext AdvanceDirective.Disorder) (Extension Type: Reference(zib Problem))
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. Consent.extension:disorder.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `http://nictiz.nl/fhir/StructureDefinition/ext-AdvanceDirective.Disorder`
8. Consent.extension:disorder.value[x]
Definition | The problem or disorder to which the living will applies. Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | DisorderValue of extension
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Reference(nl core Problem), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Alternate Names | Aandoening
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. Consent.extension:comment
Slice Name | comment
Definition | Optional Extension Element - found in all resources.
Short | Optional Extensions Element
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(ext Comment) (Extension Type: string)
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
12. Consent.extension:comment.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `http://nictiz.nl/fhir/StructureDefinition/ext-Comment`
14. Consent.extension:comment.value[x]
Definition | Comment on the living will: the form, such as a medallion, tattoo, etc., or where the living will can be found. Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | CommentValue of extension
Control | 0..1 This element is affected by the following invariants: ele-1
Type | string, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Alternate Names | Toelichting
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. Consent.extension:encounter
Slice Name | encounter
Definition | An extension to link the Encounter during which the Consent, Goal or DeviceUseStatement was created or to which the creation is tightly associated.
Short | ext Encounter Reference
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(ext Encounter Reference) (Extension Type: Reference(Encounter))
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
18. Consent.extension:encounter.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional 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..0*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `Consent.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
20. Consent.extension:encounter.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ext-EncounterReference`
22. Consent.extension:encounter.value[x]
Definition | The Encounter during which this resource was created or to which the creation is tightly associated. Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | EncounterValue of extension
Comments | This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. completing the administrative registration after the encounter).
Control | 0..1
Type | Reference(Encounter), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. 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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
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..* This element is affected by the following invariants: ele-1
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `Consent.modifierExtension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
26. Consent.status
Definition | Indicates the current state of this consent.
Short | draft | proposed | active | rejected | inactive | entered-in-error
Comments | This element has no functional counterpart in the zib and cannot be implicitly mapped to other zib concepts. An appropriate status needs to be recorded in order to produce a valid instance. 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 This element is affected by the following invariants: ele-1
Binding | The codes SHALL be taken from ConsentState http://hl7.org/fhir/ValueSet/consent-state-codes|4.0.1 (required to `http://hl7.org/fhir/ValueSet/consent-state-codes|4.0.1` ) Indicates the state of the consent.
Type | code
Is Modifier | true because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
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.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. Consent.scope
Definition | A selector of the type of consent being presented: ADR, Privacy, Treatment, Research. This list is now extensible.
Short | Which of the four areas this resource covers (extensible)
Comments | At the moment of writing (02-11-2021) the adr code is incorrectly removed from the ConsentScopeCodes CodeSystem (http://terminology.hl7.org/CodeSystem/consentscope). This will be corrected within the R4 release of FHIR based on this tracker item: https://jira.hl7.org/browse/FHIR-34215.
Control | 1..1 This element is affected by the following invariants: ele-1
Binding | Unless not suitable, these codes SHALL be taken from ConsentScopeCodes http://hl7.org/fhir/ValueSet/consent-scope|4.0.1 (extensible to `http://hl7.org/fhir/ValueSet/consent-scope|4.0.1` ) The four anticipated uses for the Consent Resource.
Type | CodeableConcept
Is Modifier | true because Allows changes to codes based on scope selection
Summary | true
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/consentscope", "code" : "adr" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. 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
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Control | 1..* This element is affected by the following invariants: ele-1
Binding | Unless not suitable, these codes SHALL be taken from ConsentCategoryCodes http://hl7.org/fhir/ValueSet/consent-category|4.0.1 (extensible to `http://hl7.org/fhir/ValueSet/consent-category|4.0.1` ) A classification of the type of consents found in a consent statement.
Type | CodeableConcept
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
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
32. Consent.category:advanceDirectiveCode
Slice Name | advanceDirectiveCode
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
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Control | 1..1* This element is affected by the following invariants: ele-1
Binding | Unless not suitable, these codes SHALL be taken from ConsentCategoryCodes http://hl7.org/fhir/ValueSet/consent-category|4.0.1 (extensible to `http://hl7.org/fhir/ValueSet/consent-category|4.0.1` ) A classification of the type of consents found in a consent statement.
Type | CodeableConcept
Is Modifier | false
Summary | true
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/consentcategorycodes", "code" : "acd" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. 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 | 0..1 This element is affected by the following invariants: ele-1
Type | Reference(Patient, Patient)
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ref-1: SHALL have a contained resource if a local reference is provided (`reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. 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 | 0..1 This element is affected by the following invariants: ele-1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Summary | true
Alternate Names | WilsverklaringDatum
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. 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 | Source 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 This element is affected by the following invariants: ele-1
Type | Choice of: Attachment, Reference(Consent, DocumentReference, Contract, QuestionnaireResponse)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `Consent.source[x]`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: type @ $this
40. Consent.source[x]:sourceAttachment
Slice Name | sourceAttachment
Definition | Scanned source document with the living will and the patient's signature, such as a PDF. 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 This element is affected by the following invariants: ele-1
Type | Attachment, Reference(Consent, DocumentReference, Contract, QuestionnaireResponse)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Summary | true
Alternate Names | WilsverklaringDocument
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
42. Consent.policyRule
Definition | A reference to the specific base computable regulation or policy.
Short | Regulation that this consents to
Comments | If the policyRule is absent, computable consent would need to be constructed from the elements of the Consent resource.
Control | 0..1 This element is affected by the following invariants: ele-1, ppc-1
Binding | Unless not suitable, these codes SHALL be taken from ConsentPolicyRuleCodes http://hl7.org/fhir/ValueSet/consent-policy|4.0.1 (extensible to `http://hl7.org/fhir/ValueSet/consent-policy|4.0.1` ) Regulatory policy examples.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Might be a unique identifier of a policy set in XACML, or other rules engine.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

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

0. Consent
2. Consent.extension:disorder
Slice Name | disorder
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
4. Consent.extension:disorder.value[x]
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
6. Consent.extension:comment
Slice Name | comment
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
8. Consent.extension:comment.value[x]
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
10. Consent.extension:encounter
Slice Name | encounter
Control | 0..1
Type | Extension(ext Encounter Reference) (Extension Type: Reference(Encounter))
12. Consent.extension:encounter.value[x]
Type | Reference(Encounter)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
14. Consent.patient
Type | Reference(Patient)
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
16. Consent.dateTime
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
18. Consent.source[x]:sourceAttachment
Slice Name | sourceAttachment
Type | Attachment
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
20. Consent.provision
22. Consent.provision.actor:representative
Slice Name | representative
24. Consent.provision.actor:representative.reference
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
26. Consent.provision.code
Definition | The following codes are in scope of this profile: For Euthanasia, codes EU (Euthanasieverzoek) or EUD (Euthanasieverzoek met aanvulling Dementie). For Organ Donation, code DO (Verklaring donorschap).
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter

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

0. Consent
Definition | A record of a healthcare consumer’s 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 | AdvanceDirective
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, nl-core-AdvanceDirective
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (`contained.contained.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 or SHALL refer to the containing resource (`contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`) dom-6: A resource should have narrative for robust management (`text.`div`.exists()`) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (`contained.meta.security.empty()`) ppc-4: IF Scope=adr, there must be a patient (`patient.exists() or scope.coding.where(system='something' and code='adr').exists().not()`) ppc-5: IF Scope=treatment, there must be a patient (`patient.exists() or scope.coding.where(system='something' and code='treatment').exists().not()`) ppc-2: IF Scope=privacy, there must be a patient (`patient.exists() or scope.coding.where(system='something' and code='patient-privacy').exists().not()`) ppc-3: IF Scope=research, there must be a patient (`patient.exists() or scope.coding.where(system='something' and code='research').exists().not()`) 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
Summary | true
4. Consent.meta
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Short | Metadata about the resource
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Meta
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
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 This element is affected by the following invariants: ele-1
Binding | The codes SHOULD be taken from CommonLanguages (preferred to `http://hl7.org/fhir/ValueSet/languages|4.0.1` ) A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
10. Consent.text
Definition | A human-readable narrative that contains a summary of the resource and can 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 information is added later.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Narrative
Alternate Names | narrative, html, xhtml, display
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
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. 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 can 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..* This element is affected by the following invariants: ele-1
Type | Extension
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
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(ext AdvanceDirective.Disorder) (Extension Type: Reference(zib Problem))
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
18. Consent.extension:disorder.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 | Unique id for inter-element referencing
Control | 0..1
Type | string
XML Format | In the XML format, this property is represented as an attribute.
20. Consent.extension:disorder.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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 can 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..* This element is affected by the following invariants: ele-1
Type | Extension
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Consent.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
22. Consent.extension:disorder.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `http://nictiz.nl/fhir/StructureDefinition/ext-AdvanceDirective.Disorder`
24. Consent.extension:disorder.value[x]
Definition | The problem or disorder to which the living will applies.
Short | Disorder
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Reference(nl core Problem)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Alternate Names | Aandoening
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
26. Consent.extension:comment
Slice Name | comment
Definition | Optional Extension Element - found in all resources.
Short | Optional Extensions Element
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(ext Comment) (Extension Type: string)
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
28. Consent.extension:comment.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 | Unique id for inter-element referencing
Control | 0..1
Type | string
XML Format | In the XML format, this property is represented as an attribute.
30. Consent.extension:comment.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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 can 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..* This element is affected by the following invariants: ele-1
Type | Extension
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Consent.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
32. Consent.extension:comment.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
XML Format | In the XML format, this property is represented as an attribute.
Fixed Value | `http://nictiz.nl/fhir/StructureDefinition/ext-Comment`
34. Consent.extension:comment.value[x]
Definition | Comment on the living will: the form, such as a medallion, tattoo, etc., or where the living will can be found.
Short | Comment
Control | 0..1 This element is affected by the following invariants: ele-1
Type | string
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Alternate Names | Toelichting
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
36. Consent.extension:encounter
Slice Name | encounter
Definition | An extension to link the Encounter during which the Consent, Goal or DeviceUseStatement was created or to which the creation is tightly associated.
Short | ext Encounter Reference
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(ext Encounter Reference) (Extension Type: Reference(Encounter))
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
38. Consent.extension:encounter.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 | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
40. Consent.extension:encounter.extension
Definition | An Extension
Short | Extension
Control | 0..0
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Consent.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
42. Consent.extension:encounter.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ext-EncounterReference`
44. Consent.extension:encounter.value[x]
Definition | The Encounter during which this resource was created or to which the creation is tightly associated.
Short | Encounter
Comments | This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. completing the administrative registration after the encounter).
Control | 0..1
Type | Reference(Encounter)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
46. 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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
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..* This element is affected by the following invariants: ele-1
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Consent.modifierExtension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
48. Consent.identifier
Definition | Unique identifier for this copy of the Consent Statement.
Short | Identifier for this record (external references)
Comments | This identifier 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..* This element is affected by the following invariants: ele-1
Type | Identifier
Summary | true
Example | General: { "system" : "urn:ietf:rfc:3986", "value" : "Local eCMS identifier" }
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
50. Consent.status
Definition | Indicates the current state of this consent.
Short | draft | proposed | active | rejected | inactive | entered-in-error
Comments | This element has no functional counterpart in the zib and cannot be implicitly mapped to other zib concepts. An appropriate status needs to be recorded in order to produce a valid instance.
Control | 1..1 This element is affected by the following invariants: ele-1
Binding | The codes SHALL be taken from ConsentState (required to `http://hl7.org/fhir/ValueSet/consent-state-codes|4.0.1` ) Indicates the state of the consent.
Type | code
Is Modifier | true because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
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.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
52. Consent.scope
Definition | A selector of the type of consent being presented: ADR, Privacy, Treatment, Research. This list is now extensible.
Short | Which of the four areas this resource covers (extensible)
Comments | At the moment of writing (02-11-2021) the adr code is incorrectly removed from the ConsentScopeCodes CodeSystem (http://terminology.hl7.org/CodeSystem/consentscope). This will be corrected within the R4 release of FHIR based on this tracker item: https://jira.hl7.org/browse/FHIR-34215.
Control | 1..1 This element is affected by the following invariants: ele-1
Binding | Unless not suitable, these codes SHALL be taken from ConsentScopeCodes (extensible to `http://hl7.org/fhir/ValueSet/consent-scope|4.0.1` ) The four anticipated uses for the Consent Resource.
Type | CodeableConcept
Is Modifier | true because Allows changes to codes based on scope selection
Summary | true
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/consentscope", "code" : "adr" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
54. 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
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Control | 1..* This element is affected by the following invariants: ele-1
Binding | Unless not suitable, these codes SHALL be taken from ConsentCategoryCodes (extensible to `http://hl7.org/fhir/ValueSet/consent-category|4.0.1` ) A classification of the type of consents found in a consent statement.
Type | CodeableConcept
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
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
56. Consent.category:advanceDirectiveCode
Slice Name | advanceDirectiveCode
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
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Control | 1..1 This element is affected by the following invariants: ele-1
Binding | Unless not suitable, these codes SHALL be taken from ConsentCategoryCodes (extensible to `http://hl7.org/fhir/ValueSet/consent-category|4.0.1` ) A classification of the type of consents found in a consent statement.
Type | CodeableConcept
Summary | true
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/consentcategorycodes", "code" : "acd" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
58. 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 | 0..1 This element is affected by the following invariants: ele-1
Type | Reference(Patient)
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ref-1: SHALL have a contained resource if a local reference is provided (`reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`)
60. 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 | 0..1 This element is affected by the following invariants: ele-1
Type | dateTime
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Summary | true
Alternate Names | WilsverklaringDatum
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
62. Consent.performer
Definition | 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 | Who is agreeing to the policy and rules
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..* This element is affected by the following invariants: ele-1
Type | Reference(Organization, Patient, Practitioner, RelatedPerson, PractitionerRole)
Summary | true
Alternate Names | consentor
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ref-1: SHALL have a contained resource if a local reference is provided (`reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`)
64. Consent.organization
Definition | The organization that manages the consent, and the framework within which it is executed.
Short | Custodian of the consent
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Reference(Organization)
Summary | true
Alternate Names | custodian
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ref-1: SHALL have a contained resource if a local reference is provided (`reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`)
66. 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 | Source 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 This element is affected by the following invariants: ele-1
Type | Choice of: Attachment, Reference(Consent, DocumentReference, Contract, QuestionnaireResponse)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Consent.source[x]`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: type @ $this
68. Consent.source[x]:sourceAttachment
Slice Name | sourceAttachment
Definition | Scanned source document with the living will and the patient's signature, such as a PDF.
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 This element is affected by the following invariants: ele-1
Type | Attachment
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Summary | true
Alternate Names | WilsverklaringDocument
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
70. 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..* This element is affected by the following invariants: ele-1
Type | BackboneElement
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
72. 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 | Unique id for inter-element referencing
Control | 0..1
Type | string
XML Format | In the XML format, this property is represented as an attribute.
74. Consent.policy.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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 can 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..* This element is affected by the following invariants: ele-1
Type | Extension
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Consent.policy.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
76. 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
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..* This element is affected by the following invariants: ele-1
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
78. Consent.policy.authority
Definition | Entity or Organization having regulatory jurisdiction or accountability for enforcing policies pertaining to Consent Directives.
Short | Enforcement source for policy
Comments | see http://en.wikipedia.org/wiki/Uniform_resource_identifier
Control | 0..1 This element is affected by the following invariants: ele-1, ppc-1
Type | uri
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
80. 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: ele-1, ppc-1
Type | uri
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
82. Consent.policyRule
Definition | A reference to the specific base computable regulation or policy.
Short | Regulation that this consents to
Comments | If the policyRule is absent, computable consent would need to be constructed from the elements of the Consent resource.
Control | 0..1 This element is affected by the following invariants: ele-1, ppc-1
Binding | Unless not suitable, these codes SHALL be taken from ConsentPolicyRuleCodes (extensible to `http://hl7.org/fhir/ValueSet/consent-policy|4.0.1` ) Regulatory policy examples.
Type | CodeableConcept
Summary | true
Requirements | Might be a unique identifier of a policy set in XACML, or other rules engine.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
84. Consent.verification
Definition | Whether a treatment instruction (e.g. artificial respiration yes or no) was verified with the patient, his/her family or another authorized person.
Short | Consent Verified by patient or family
Control | 0..* This element is affected by the following invariants: ele-1
Type | BackboneElement
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
86. Consent.verification.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 | Unique id for inter-element referencing
Control | 0..1
Type | string
XML Format | In the XML format, this property is represented as an attribute.
88. Consent.verification.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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 can 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..* This element is affected by the following invariants: ele-1
Type | Extension
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Consent.verification.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
90. Consent.verification.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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
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..* This element is affected by the following invariants: ele-1
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
92. Consent.verification.verified
Definition | Has the instruction been verified.
Short | Has been verified
Control | 1..1 This element is affected by the following invariants: ele-1
Type | boolean
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
94. Consent.verification.verifiedWith
Definition | Who verified the instruction (Patient, Relative or other Authorized Person).
Short | Person who verified
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Reference(Patient, RelatedPerson)
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ref-1: SHALL have a contained resource if a local reference is provided (`reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`)
96. Consent.verification.verificationDate
Definition | Date verification was collected.
Short | When consent verified
Control | 0..1 This element is affected by the following invariants: ele-1
Type | dateTime
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
98. Consent.provision
Definition | An exception to the base policy of this consent. An exception can be an addition or removal of access permissions.
Short | Constraints to the base Consent.policyRule
Control | 0..1 This element is affected by the following invariants: ele-1
Type | BackboneElement
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
100. Consent.provision.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 | Unique id for inter-element referencing
Control | 0..1
Type | string
XML Format | In the XML format, this property is represented as an attribute.
102. Consent.provision.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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 can 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..* This element is affected by the following invariants: ele-1
Type | Extension
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Consent.provision.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
104. Consent.provision.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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
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..* This element is affected by the following invariants: ele-1
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
106. Consent.provision.type
Definition | Action to take - permit or deny - when the rule conditions are met. Not permitted in root rule, required in all nested rules.
Short | deny | permit
Comments | Note that FHIR strings SHALL NOT exceed 1MB in size
Control | 0..1 This element is affected by the following invariants: ele-1
Binding | The codes SHALL be taken from ConsentProvisionType (required to `http://hl7.org/fhir/ValueSet/consent-provision-type|4.0.1` ) How a rule 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
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
108. Consent.provision.period
Definition | The timeframe in this rule is valid.
Short | Timeframe for this rule
Comments | A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Period
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) per-1: If present, start SHALL have a lower value than end (`start.hasValue().not() or end.hasValue().not() or (start <= end)`)
110. Consent.provision.actor
Definition | Who or what is controlled by this rule. Use group to identify a set of actors by some property they share (e.g. 'admitting officers').
Short | Who|what controlled by this rule (or group, by role)
Control | 0..* This element is affected by the following invariants: ele-1
Type | BackboneElement
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() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Consent.provision.actor`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ role
112. Consent.provision.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 | Unique id for inter-element referencing
Control | 0..1
Type | string
XML Format | In the XML format, this property is represented as an attribute.
114. Consent.provision.actor.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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 can 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..* This element is affected by the following invariants: ele-1
Type | Extension
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Consent.provision.actor.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
116. Consent.provision.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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
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..* This element is affected by the following invariants: ele-1
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
118. Consent.provision.actor.role
Definition | How the individual is involved in the resources content that is described in the exception.
Short | How the actor is involved
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Control | 1..1 This element is affected by the following invariants: ele-1
Binding | Unless not suitable, these codes SHALL be taken from SecurityRoleType (extensible to `http://hl7.org/fhir/ValueSet/security-role-type|4.0.1` ) How an actor is involved in the consent considerations.
Type | CodeableConcept
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
120. Consent.provision.actor.reference
Definition | The resource that identifies the actor. To identify 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)
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Reference(Device, Group, CareTeam, Organization, Patient, Practitioner, RelatedPerson, PractitionerRole)
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ref-1: SHALL have a contained resource if a local reference is provided (`reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`)
122. Consent.provision.actor:representative
Slice Name | representative
Definition | Who or what is controlled by this rule. Use group to identify a set of actors by some property they share (e.g. 'admitting officers').
Short | Who|what controlled by this rule (or group, by role)
Control | 0..1 This element is affected by the following invariants: ele-1
Type | BackboneElement
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() or (children().count() > id.count())`)
124. Consent.provision.actor:representative.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 | Unique id for inter-element referencing
Control | 0..1
Type | string
XML Format | In the XML format, this property is represented as an attribute.
126. Consent.provision.actor:representative.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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 can 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..* This element is affected by the following invariants: ele-1
Type | Extension
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Consent.provision.actor.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
128. Consent.provision.actor:representative.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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
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..* This element is affected by the following invariants: ele-1
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
130. Consent.provision.actor:representative.role
Definition | How the individual is involved in the resources content that is described in the exception.
Short | How the actor is involved
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Control | 1..1 This element is affected by the following invariants: ele-1
Binding | Unless not suitable, these codes SHALL be taken from SecurityRoleType (extensible to `http://hl7.org/fhir/ValueSet/security-role-type|4.0.1` ) How an actor is involved in the consent considerations.
Type | CodeableConcept
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode", "code" : "RESPRSN" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
132. Consent.provision.actor:representative.reference
Definition | The person who is the legal representative or is appointed as the authorized representative in the signed authorization.
Short | Representative
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Reference(Device, Group, CareTeam, Organization, Patient, Practitioner, RelatedPerson, PractitionerRole, nl core ContactPerson)
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Alternate Names | Vertegenwoordiger
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ref-1: SHALL have a contained resource if a local reference is provided (`reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`)
134. Consent.provision.action
Definition | Actions controlled by this Rule.
Short | Actions controlled by this rule
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..* This element is affected by the following invariants: ele-1
Binding | For example codes, see ConsentActionCodes (example to `http://hl7.org/fhir/ValueSet/consent-action|4.0.1` ) Detailed codes for the consent action.
Type | CodeableConcept
Summary | true
Meaning if Missing | all actions
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
136. Consent.provision.securityLabel
Definition | A security label, comprised of 0..* security label fields (Privacy tags), which define which resources are controlled by this exception.
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. When the purpose of use tag is on the data, access request purpose of use shall not conflict.
Control | 0..* This element is affected by the following invariants: ele-1
Binding | Unless not suitable, these codes SHALL be taken from All Security Labels (extensible to `http://hl7.org/fhir/ValueSet/security-labels|4.0.1` ) Security Labels from the Healthcare Privacy and Security Classification System.
Type | Coding
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
138. Consent.provision.purpose
Definition | The context of the activities a user is taking - why the user is accessing the data - that are controlled by this rule.
Short | Context of activities covered by this rule
Comments | When the purpose of use tag is on the data, access request purpose of use shall not conflict.
Control | 0..* This element is affected by the following invariants: ele-1
Binding | Unless not suitable, these codes SHALL be taken from PurposeOfUse (3.1.0) (extensible to `http://terminology.hl7.org/ValueSet/v3-PurposeOfUse|3.1.0` ) 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
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
140. Consent.provision.class
Definition | The class of information covered by this rule. 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, 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..* This element is affected by the following invariants: ele-1
Binding | Unless not suitable, these codes SHALL be taken from ConsentContentClass (extensible to `http://hl7.org/fhir/ValueSet/consent-content-class|4.0.1` ) The class (type) of information a consent rule covers.
Type | Coding
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
142. Consent.provision.code
Definition | The following codes are in scope of this profile: For Euthanasia, codes EU (Euthanasieverzoek) or EUD (Euthanasieverzoek met aanvulling Dementie). For Organ Donation, code DO (Verklaring donorschap).
Short | LivingWillType
Comments | Typical use of this is a Document code with class = CDA.
Control | 0..1 This element is affected by the following invariants: ele-1
Binding | The codes SHALL be taken from WilsverklaringTypeCodelijst (2020-09-01T00:00:00) (required to `http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.7.15.1--20200901000000|2020-09-01T00:00:00` ) If this code is found in an instance, then the exception applies.
Type | CodeableConcept
Obligations |
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Summary | true
Alternate Names | WilsverklaringType
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
144. Consent.provision.dataPeriod
Definition | Clinical or Operational Relevant period of time that bounds the data controlled by this rule.
Short | Timeframe for data controlled by this rule
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 This element is affected by the following invariants: ele-1
Type | Period
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) per-1: If present, start SHALL have a lower value than end (`start.hasValue().not() or end.hasValue().not() or (start <= end)`)
146. Consent.provision.data
Definition | The resources controlled by this rule if specific resources are referenced.
Short | Data controlled by this rule
Control | 0..* This element is affected by the following invariants: ele-1
Type | BackboneElement
Summary | true
Meaning if Missing | all data
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
148. Consent.provision.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 | Unique id for inter-element referencing
Control | 0..1
Type | string
XML Format | In the XML format, this property is represented as an attribute.
150. Consent.provision.data.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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 can 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..* This element is affected by the following invariants: ele-1
Type | Extension
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Consent.provision.data.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
152. Consent.provision.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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
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..* This element is affected by the following invariants: ele-1
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
154. Consent.provision.data.meaning
Definition | How the resource reference is interpreted when testing consent restrictions.
Short | instance | related | dependents | authoredby
Comments | Note that FHIR strings SHALL NOT exceed 1MB in size
Control | 1..1 This element is affected by the following invariants: ele-1
Binding | The codes SHALL be taken from ConsentDataMeaning (required to `http://hl7.org/fhir/ValueSet/consent-data-meaning|4.0.1` ) 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
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
156. Consent.provision.data.reference
Definition | A reference to a specific resource that defines which resources are covered by this consent.
Short | The actual data reference
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Reference(Resource)
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ref-1: SHALL have a contained resource if a local reference is provided (`reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))`)
158. Consent.provision.provision
Definition | Rules which provide exceptions to the base rule or subrules.
Short | Nested Exception Rules
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/Consent#Consent.provision