# ACP Questionnaire - Advance Care Planning (PZP) v1.0.0-rc2

* [**Table of Contents**](toc.md)
* [**Artifacts Summary**](artifacts.md)
* **ACP Questionnaire**

## Questionnaire: ACP Questionnaire 

| | |
| :--- | :--- |
| *Official URL*:https://api.iknl.nl/docs/pzp/r4/Questionnaire/ACP-zib2020 | *Version*:1.0.0-rc2 |
| Draft as of 2026-03-03 | *Computable Name*:ACPzib2020 |
| **Copyright/Legal**: This form is subject to copyright, user rights and a disclaimer, as specified for all IKNL information standards. For details, see the paragraph on Gebruikersrechten en disclaimer at https://iknl.nl/onderzoek/eenheid-van-taal. | |

 
This form was developed to clearly document agreements resulting from the advance care planning (ACP) process. It is NOT a checklist. It can only be completed by a healthcare provider after a professional and nuanced conversation. For advice on conducting these conversations, please refer to the guideline for advance care planning in the palliative phase and Palliaweb, see https://palliaweb.nl/zorgpraktijk/proactieve-zorgplanning. Enter 'unknown' if a topic is not discussed or if the patient does not (yet) have an opinion.When transferring to a long-term care setting, consider adding conversation records about advance care planning (ACP) to the transfer documents. 

 
This form was developed to clearly document agreements resulting from the advance care planning (ACP) process. 



## Resource Content

```json
{
  "resourceType" : "Questionnaire",
  "id" : "ACP-zib2020",
  "url" : "https://api.iknl.nl/docs/pzp/r4/Questionnaire/ACP-zib2020",
  "version" : "1.0.0-rc2",
  "name" : "ACPzib2020",
  "title" : "Uniform vastleggen proactieve zorgpanning (PZP) o.b.v. zibs2020 - ReleaseCandidate2 03-03-2026",
  "status" : "draft",
  "experimental" : false,
  "date" : "2026-03-03T12:29:58+01:00",
  "publisher" : "IKNL",
  "contact" : [{
    "name" : "IKNL",
    "telecom" : [{
      "system" : "url",
      "value" : "https://iknl.nl/"
    },
    {
      "system" : "email",
      "value" : "info@iknl.nl"
    }]
  }],
  "description" : "This form was developed to clearly document agreements resulting from the advance care planning (ACP) process. It is NOT a checklist. It can only be completed by a healthcare provider after a professional and nuanced conversation. For advice on conducting these conversations, please refer to the guideline for advance care planning in the palliative phase and Palliaweb, see https://palliaweb.nl/zorgpraktijk/proactieve-zorgplanning. \nEnter 'unknown' if a topic is not discussed or if the patient does not (yet) have an opinion.When transferring to a long-term care setting, consider adding conversation records about advance care planning (ACP) to the transfer documents.",
  "purpose" : "This form was developed to clearly document agreements resulting from the advance care planning (ACP) process.",
  "copyright" : "This form is subject to copyright, user rights and a disclaimer, as specified for all IKNL information standards. For details, see the paragraph on Gebruikersrechten en disclaimer at https://iknl.nl/onderzoek/eenheid-van-taal.",
  "item" : [{
    "linkId" : "963",
    "text" : "Datum van invullen",
    "type" : "dateTime",
    "required" : false,
    "repeats" : false
  },
  {
    "linkId" : "7",
    "text" : "Naam patiënt",
    "type" : "group",
    "repeats" : false,
    "item" : [{
      "linkId" : "964",
      "text" : "Voornamen",
      "type" : "string",
      "required" : false,
      "repeats" : false
    },
    {
      "linkId" : "965",
      "text" : "Voorvoegsels",
      "type" : "string",
      "required" : false,
      "repeats" : false
    },
    {
      "linkId" : "966",
      "text" : "Achternaam",
      "type" : "string",
      "required" : false,
      "repeats" : false
    }]
  },
  {
    "linkId" : "967",
    "text" : "Geboortedatum patiënt",
    "type" : "date",
    "required" : false,
    "repeats" : false
  },
  {
    "linkId" : "8",
    "text" : "Gesprek gevoerd door:",
    "type" : "group",
    "repeats" : false,
    "item" : [{
      "linkId" : "16",
      "text" : "Naam zorgverlener",
      "type" : "group",
      "repeats" : false,
      "item" : [{
        "linkId" : "968",
        "text" : "Voornamen",
        "type" : "string",
        "required" : false,
        "repeats" : false
      },
      {
        "linkId" : "969",
        "text" : "Voorvoegsels",
        "type" : "string",
        "required" : false,
        "repeats" : false
      },
      {
        "linkId" : "970",
        "text" : "Achternaam",
        "type" : "string",
        "required" : false,
        "repeats" : false
      }]
    },
    {
      "linkId" : "1405",
      "text" : "Functie (Specialisme)",
      "type" : "choice",
      "required" : false,
      "repeats" : false,
      "answerOption" : [{
        "valueCoding" : {
          "system" : "http://fhir.nl/fhir/NamingSystem/uzi-rolcode",
          "code" : "01.000",
          "display" : "Arts"
        }
      },
      {
        "valueCoding" : {
          "system" : "http://fhir.nl/fhir/NamingSystem/uzi-rolcode",
          "code" : "01.015",
          "display" : "Huisarts"
        }
      },
      {
        "valueCoding" : {
          "system" : "http://fhir.nl/fhir/NamingSystem/uzi-rolcode",
          "code" : "01.047",
          "display" : "Specialist ouderengeneeskunde"
        }
      },
      {
        "valueCoding" : {
          "system" : "http://fhir.nl/fhir/NamingSystem/uzi-rolcode",
          "code" : "30.000",
          "display" : "Verpleegkundige"
        }
      },
      {
        "valueCoding" : {
          "system" : "http://fhir.nl/fhir/NamingSystem/uzi-rolcode",
          "code" : "81.000",
          "display" : "Physician assistant"
        }
      },
      {
        "valueCoding" : {
          "system" : "http://fhir.nl/fhir/NamingSystem/uzi-rolcode",
          "code" : "99.000",
          "display" : "Zorgverlener andere zorg"
        }
      }]
    }]
  },
  {
    "linkId" : "26",
    "prefix" : "1",
    "text" : "Wilsbekwaamheid & Wettelijke vertegenwoordiging",
    "type" : "group",
    "repeats" : false,
    "item" : [{
      "linkId" : "1406",
      "text" : "Is de patiënt op dit moment wilsbekwaam m.b.t. medische behandelbeslissingen?",
      "type" : "choice",
      "required" : false,
      "repeats" : false,
      "answerOption" : [{
        "valueCoding" : {
          "code" : "1",
          "display" : "Ja"
        }
      },
      {
        "valueCoding" : {
          "code" : "0",
          "display" : "Nee"
        }
      }],
      "item" : [{
        "linkId" : "1407",
        "text" : "Toelichting",
        "type" : "string",
        "required" : false,
        "repeats" : false
      }]
    },
    {
      "linkId" : "29",
      "text" : "Bij wilsonbekwaamheid m.b.t. medische behandelbeslissingen is/wordt de wettelijke vertegenwoordiger:",
      "type" : "group",
      "repeats" : false,
      "item" : [{
        "linkId" : "30",
        "prefix" : "a)",
        "text" : "Naam wettelijk vertegenwoordiger",
        "type" : "group",
        "repeats" : false,
        "item" : [{
          "linkId" : "973",
          "text" : "Voornamen",
          "type" : "string",
          "required" : false,
          "repeats" : false
        },
        {
          "linkId" : "974",
          "text" : "Voorvoegsels",
          "type" : "string",
          "required" : false,
          "repeats" : false
        },
        {
          "linkId" : "975",
          "text" : "Achternaam",
          "type" : "string",
          "required" : false,
          "repeats" : false
        }]
      },
      {
        "linkId" : "39",
        "prefix" : "b)",
        "text" : "Contactgegevens wettelijk vertegenwoordiger",
        "type" : "group",
        "repeats" : false,
        "item" : [{
          "linkId" : "40",
          "text" : "Telefoonnummers",
          "type" : "group",
          "repeats" : true,
          "item" : [{
            "linkId" : "976",
            "text" : "Telefoonnummer",
            "type" : "string",
            "required" : false,
            "repeats" : false
          },
          {
            "linkId" : "977",
            "text" : "TelecomType",
            "type" : "choice",
            "required" : false,
            "repeats" : false,
            "answerOption" : [{
              "valueCoding" : {
                "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1",
                "code" : "LL",
                "display" : "Land Line"
              }
            },
            {
              "valueCoding" : {
                "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1",
                "code" : "FAX",
                "display" : "Fax"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://terminology.hl7.org/CodeSystem/v3-AddressUse",
                "code" : "PG",
                "display" : "Pieper"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://terminology.hl7.org/CodeSystem/v3-AddressUse",
                "code" : "MC",
                "display" : "Mobiel telefoonnummer"
              }
            }]
          },
          {
            "linkId" : "978",
            "text" : "NummerSoort",
            "type" : "choice",
            "required" : false,
            "repeats" : false,
            "answerOption" : [{
              "valueCoding" : {
                "system" : "http://terminology.hl7.org/CodeSystem/v3-AddressUse",
                "code" : "HP",
                "display" : "Telefoonnummer thuis"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://terminology.hl7.org/CodeSystem/v3-AddressUse",
                "code" : "TMP",
                "display" : "Tijdelijk telefoonnummer"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://terminology.hl7.org/CodeSystem/v3-AddressUse",
                "code" : "WP",
                "display" : "Zakelijk telefoonnummer"
              }
            }]
          },
          {
            "linkId" : "979",
            "text" : "Toelichting",
            "type" : "string",
            "required" : false,
            "repeats" : false
          }]
        },
        {
          "linkId" : "41",
          "text" : "EmailAdressen",
          "type" : "group",
          "repeats" : true,
          "item" : [{
            "linkId" : "980",
            "text" : "EmailAdres",
            "type" : "string",
            "required" : false,
            "repeats" : false
          },
          {
            "linkId" : "981",
            "text" : "EmailSoort",
            "type" : "choice",
            "required" : false,
            "repeats" : false,
            "answerOption" : [{
              "valueCoding" : {
                "system" : "http://terminology.hl7.org/CodeSystem/v3-AddressUse",
                "code" : "HP",
                "display" : "Privé e-mailadres"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://terminology.hl7.org/CodeSystem/v3-AddressUse",
                "code" : "WP",
                "display" : "Zakelijk e-mailadres"
              }
            }]
          }]
        }]
      },
      {
        "linkId" : "982",
        "prefix" : "c)",
        "text" : "Relatie tot patiënt (1)",
        "type" : "choice",
        "required" : false,
        "repeats" : true,
        "answerOption" : [{
          "valueCoding" : {
            "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.22.472",
            "code" : "24",
            "display" : "Wettelijke vertegenwoordiger"
          },
          "initialSelected" : true
        },
        {
          "valueCoding" : {
            "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.22.472",
            "code" : "01",
            "display" : "Eerste relatie/contactpersoon"
          }
        },
        {
          "valueCoding" : {
            "system" : "http://snomed.info/sct",
            "code" : "310141000146103",
            "display" : "Schriftelijk gemachtigde"
          }
        },
        {
          "valueCoding" : {
            "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.22.472",
            "code" : "03",
            "display" : "Curator (juridisch)"
          }
        },
        {
          "valueCoding" : {
            "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.22.472",
            "code" : "15",
            "display" : "Mentor"
          }
        },
        {
          "valueCoding" : {
            "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.22.472",
            "code" : "09",
            "display" : "Anders"
          }
        }],
        "item" : [{
          "linkId" : "411",
          "text" : "Anders, namelijk:",
          "type" : "string",
          "enableWhen" : [{
            "question" : "982",
            "operator" : "=",
            "answerCoding" : {
              "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.22.472",
              "code" : "09",
              "display" : "Anders"
            }
          }],
          "enableBehavior" : "any",
          "required" : false,
          "repeats" : false
        }]
      },
      {
        "linkId" : "983",
        "prefix" : "c)",
        "text" : "Relatie tot patiënt (2)",
        "type" : "choice",
        "required" : false,
        "repeats" : false,
        "answerOption" : [{
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
            "code" : "DOMPART",
            "display" : "Partner"
          }
        },
        {
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
            "code" : "HUSB",
            "display" : "Echtgenoot"
          }
        },
        {
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
            "code" : "WIFE",
            "display" : "Echtgenote"
          }
        },
        {
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
            "code" : "FTH",
            "display" : "Vader"
          }
        },
        {
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
            "code" : "MTH",
            "display" : "Moeder"
          }
        },
        {
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
            "code" : "SONC",
            "display" : "Zoon"
          }
        },
        {
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
            "code" : "DAUC",
            "display" : "Dochter"
          }
        },
        {
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
            "code" : "BRO",
            "display" : "Broer"
          }
        },
        {
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
            "code" : "SIS",
            "display" : "Zuster"
          }
        },
        {
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
            "code" : "OTH",
            "display" : "Anders"
          }
        }],
        "item" : [{
          "linkId" : "408",
          "text" : "Anders, namelijk:",
          "type" : "string",
          "enableWhen" : [{
            "question" : "983",
            "operator" : "=",
            "answerCoding" : {
              "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
              "code" : "OTH",
              "display" : "Anders"
            }
          }],
          "enableBehavior" : "any",
          "required" : false,
          "repeats" : false
        }]
      },
      {
        "linkId" : "984",
        "prefix" : "d)",
        "text" : "Is de wettelijk vertegenwoordiger ook de eerste contactpersoon?",
        "type" : "choice",
        "required" : false,
        "repeats" : false,
        "answerOption" : [{
          "valueCoding" : {
            "code" : "1",
            "display" : "Ja"
          }
        },
        {
          "valueCoding" : {
            "code" : "0",
            "display" : "Nee"
          }
        }]
      },
      {
        "linkId" : "53",
        "prefix" : "e)",
        "text" : "Naam eerste contactpersoon",
        "type" : "group",
        "enableWhen" : [{
          "question" : "984",
          "operator" : "=",
          "answerCoding" : {
            "code" : "0",
            "display" : "Nee"
          }
        }],
        "enableBehavior" : "any",
        "repeats" : false,
        "item" : [{
          "linkId" : "985",
          "text" : "Voornamen",
          "type" : "string",
          "required" : false,
          "repeats" : false
        },
        {
          "linkId" : "986",
          "text" : "Voorvoegsels",
          "type" : "string",
          "required" : false,
          "repeats" : false
        },
        {
          "linkId" : "987",
          "text" : "Achternaam",
          "type" : "string",
          "required" : false,
          "repeats" : false
        }]
      },
      {
        "linkId" : "61",
        "prefix" : "f)",
        "text" : "Contactgegevens eerste contactpersoon",
        "type" : "group",
        "enableWhen" : [{
          "question" : "984",
          "operator" : "=",
          "answerCoding" : {
            "code" : "0",
            "display" : "Nee"
          }
        }],
        "enableBehavior" : "any",
        "repeats" : false,
        "item" : [{
          "linkId" : "62",
          "text" : "Telefoonnummers",
          "type" : "group",
          "repeats" : true,
          "item" : [{
            "linkId" : "988",
            "text" : "Telefoonnummer",
            "type" : "string",
            "required" : false,
            "repeats" : false
          },
          {
            "linkId" : "989",
            "text" : "TelecomType",
            "type" : "choice",
            "required" : false,
            "repeats" : false,
            "answerOption" : [{
              "valueCoding" : {
                "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1",
                "code" : "LL",
                "display" : "Land Line"
              }
            },
            {
              "valueCoding" : {
                "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1",
                "code" : "FAX",
                "display" : "Fax"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://terminology.hl7.org/CodeSystem/v3-AddressUse",
                "code" : "MC",
                "display" : "Mobiel telefoonnummer"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://terminology.hl7.org/CodeSystem/v3-AddressUse",
                "code" : "PG",
                "display" : "Pieper"
              }
            }]
          },
          {
            "linkId" : "990",
            "text" : "NummerSoort",
            "type" : "choice",
            "required" : false,
            "repeats" : false,
            "answerOption" : [{
              "valueCoding" : {
                "system" : "http://terminology.hl7.org/CodeSystem/v3-AddressUse",
                "code" : "HP",
                "display" : "Telefoonnummer thuis"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://terminology.hl7.org/CodeSystem/v3-AddressUse",
                "code" : "TMP",
                "display" : "Tijdelijk telefoonnummer"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://terminology.hl7.org/CodeSystem/v3-AddressUse",
                "code" : "WP",
                "display" : "Zakelijk telefoonnummer"
              }
            }]
          },
          {
            "linkId" : "991",
            "text" : "Toelichting",
            "type" : "string",
            "required" : false,
            "repeats" : false
          }]
        },
        {
          "linkId" : "66",
          "text" : "EmailAdressen",
          "type" : "group",
          "repeats" : true,
          "item" : [{
            "linkId" : "992",
            "text" : "EmailAdres",
            "type" : "string",
            "required" : false,
            "repeats" : false
          },
          {
            "linkId" : "993",
            "text" : "EmailSoort",
            "type" : "choice",
            "required" : false,
            "repeats" : false,
            "answerOption" : [{
              "valueCoding" : {
                "system" : "http://terminology.hl7.org/CodeSystem/v3-AddressUse",
                "code" : "HP",
                "display" : "Privé e-mailadres"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://terminology.hl7.org/CodeSystem/v3-AddressUse",
                "code" : "WP",
                "display" : "Zakelijk e-mailadres"
              }
            }]
          }]
        }]
      },
      {
        "linkId" : "1644",
        "text" : "Rol",
        "type" : "choice",
        "enableWhen" : [{
          "question" : "984",
          "operator" : "=",
          "answerCoding" : {
            "code" : "0",
            "display" : "Nee"
          }
        }],
        "enableBehavior" : "any",
        "required" : false,
        "repeats" : false,
        "readOnly" : true,
        "answerOption" : [{
          "valueCoding" : {
            "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.22.472",
            "code" : "01",
            "display" : "Eerste relatie/contactpersoon"
          },
          "initialSelected" : true
        }]
      },
      {
        "linkId" : "995",
        "prefix" : "g)",
        "text" : "Relatie tot patiënt",
        "type" : "choice",
        "enableWhen" : [{
          "question" : "984",
          "operator" : "=",
          "answerCoding" : {
            "code" : "0",
            "display" : "Nee"
          }
        }],
        "enableBehavior" : "any",
        "required" : false,
        "repeats" : false,
        "answerOption" : [{
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
            "code" : "DOMPART",
            "display" : "Partner"
          }
        },
        {
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
            "code" : "HUSB",
            "display" : "Echtgenoot"
          }
        },
        {
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
            "code" : "WIFE",
            "display" : "Echtgenote"
          }
        },
        {
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
            "code" : "FTH",
            "display" : "Vader"
          }
        },
        {
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
            "code" : "MTH",
            "display" : "Moeder"
          }
        },
        {
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
            "code" : "SONC",
            "display" : "Zoon"
          }
        },
        {
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
            "code" : "DAUC",
            "display" : "Dochter"
          }
        },
        {
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
            "code" : "BRO",
            "display" : "Broer"
          }
        },
        {
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
            "code" : "SIS",
            "display" : "Zuster"
          }
        },
        {
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
            "code" : "OTH",
            "display" : "Anders"
          }
        }],
        "item" : [{
          "linkId" : "412",
          "text" : "Anders, namelijk:",
          "type" : "string",
          "enableWhen" : [{
            "question" : "995",
            "operator" : "=",
            "answerCoding" : {
              "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
              "code" : "OTH",
              "display" : "Anders"
            }
          }],
          "enableBehavior" : "any",
          "required" : false,
          "repeats" : false
        }]
      }]
    }]
  },
  {
    "linkId" : "78",
    "prefix" : "2",
    "text" : "Gesprek gevoerd in bijzijn van",
    "type" : "group",
    "repeats" : false,
    "item" : [{
      "linkId" : "82",
      "text" : "Patiënt",
      "type" : "choice",
      "required" : false,
      "repeats" : false,
      "answerOption" : [{
        "valueCoding" : {
          "code" : "Patiënt",
          "display" : "Patiënt"
        }
      }]
    },
    {
      "linkId" : "997",
      "text" : "Rol",
      "type" : "choice",
      "required" : false,
      "repeats" : true,
      "answerOption" : [{
        "valueCoding" : {
          "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.22.472",
          "code" : "03",
          "display" : "Curator (juridisch)"
        }
      },
      {
        "valueCoding" : {
          "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.22.472",
          "code" : "15",
          "display" : "Mentor"
        }
      },
      {
        "valueCoding" : {
          "system" : "http://snomed.info/sct",
          "code" : "310141000146103",
          "display" : "Schriftelijk gemachtigde"
        }
      },
      {
        "valueCoding" : {
          "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.22.472",
          "code" : "09",
          "display" : "Anders"
        }
      }],
      "item" : [{
        "linkId" : "414",
        "text" : "Anders, namelijk:",
        "type" : "string",
        "required" : false,
        "repeats" : false
      }]
    },
    {
      "linkId" : "998",
      "text" : "Relatie tot patiënt",
      "type" : "choice",
      "required" : false,
      "repeats" : true,
      "answerOption" : [{
        "valueCoding" : {
          "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
          "code" : "DOMPART",
          "display" : "Partner"
        }
      },
      {
        "valueCoding" : {
          "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
          "code" : "HUSB",
          "display" : "Echtgenoot"
        }
      },
      {
        "valueCoding" : {
          "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
          "code" : "WIFE",
          "display" : "Echtgenote"
        }
      },
      {
        "valueCoding" : {
          "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
          "code" : "FTH",
          "display" : "Vader"
        }
      },
      {
        "valueCoding" : {
          "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
          "code" : "MTH",
          "display" : "Moeder"
        }
      },
      {
        "valueCoding" : {
          "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
          "code" : "SONC",
          "display" : "Zoon"
        }
      },
      {
        "valueCoding" : {
          "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
          "code" : "DAUC",
          "display" : "Dochter"
        }
      },
      {
        "valueCoding" : {
          "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
          "code" : "BRO",
          "display" : "Broer"
        }
      },
      {
        "valueCoding" : {
          "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
          "code" : "SIS",
          "display" : "Zuster"
        }
      },
      {
        "valueCoding" : {
          "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
          "code" : "OTH",
          "display" : "Anders"
        }
      }],
      "item" : [{
        "linkId" : "413",
        "text" : "Anders, namelijk:",
        "type" : "string",
        "enableWhen" : [{
          "question" : "998",
          "operator" : "=",
          "answerCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
            "code" : "OTH",
            "display" : "Anders"
          }
        }],
        "enableBehavior" : "any",
        "required" : false,
        "repeats" : false
      }]
    }]
  },
  {
    "linkId" : "586",
    "prefix" : "3",
    "text" : "Belangrijkste overeengekomen doel van medisch beleid",
    "type" : "group",
    "repeats" : false,
    "item" : [{
      "linkId" : "1408",
      "text" : "Belangrijkste doel van behandeling ([MetingNaam])",
      "type" : "choice",
      "required" : false,
      "repeats" : false,
      "readOnly" : true,
      "answerOption" : [{
        "valueCoding" : {
          "system" : "http://snomed.info/sct",
          "code" : "180771000146100",
          "display" : "Focus van behandeling (waarneembare entiteit)"
        },
        "initialSelected" : true
      }]
    },
    {
      "linkId" : "999",
      "text" : "Doel ([MetingWaarde])",
      "type" : "choice",
      "required" : false,
      "repeats" : false,
      "answerOption" : [{
        "valueCoding" : {
          "system" : "http://snomed.info/sct",
          "code" : "385987000",
          "display" : "Curatief / actief ziektebeleid"
        }
      },
      {
        "valueCoding" : {
          "system" : "http://snomed.info/sct",
          "code" : "1351964001",
          "display" : "Palliatief met als doel levensverlenging én symptoomverlichting"
        }
      },
      {
        "valueCoding" : {
          "system" : "http://snomed.info/sct",
          "code" : "225353007",
          "display" : "Palliatief met als doel symptoomverlichting, waarbij levensverlenging niet gewenst is"
        }
      },
      {
        "valueCoding" : {
          "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
          "code" : "UNK",
          "display" : "Nog onbekend"
        }
      }]
    }]
  },
  {
    "linkId" : "83",
    "prefix" : "4",
    "text" : "Behandelgrenzen",
    "type" : "group",
    "repeats" : false,
    "item" : [{
      "linkId" : "1409",
      "prefix" : "a)",
      "text" : "Reanimatie",
      "type" : "group",
      "repeats" : false,
      "item" : [{
        "linkId" : "1410",
        "text" : "Behandeling",
        "type" : "choice",
        "required" : false,
        "repeats" : false,
        "readOnly" : true,
        "answerOption" : [{
          "valueCoding" : {
            "system" : "http://snomed.info/sct",
            "code" : "89666000",
            "display" : "cardiopulmonale resuscitatie"
          },
          "initialSelected" : true
        }]
      },
      {
        "linkId" : "1386",
        "text" : "BehandelBesluit",
        "type" : "choice",
        "required" : false,
        "repeats" : false,
        "answerOption" : [{
          "valueCoding" : {
            "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.25.1",
            "code" : "0",
            "display" : "Wel uitvoeren"
          }
        },
        {
          "valueCoding" : {
            "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.25.1",
            "code" : "1",
            "display" : "Anders"
          }
        },
        {
          "valueCoding" : {
            "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.25.1",
            "code" : "2",
            "display" : "Niet uitvoeren"
          }
        },
        {
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
            "code" : "UNK",
            "display" : "Onbekend"
          }
        }],
        "item" : [{
          "linkId" : "1001",
          "text" : "SpecificatieAnders",
          "type" : "string",
          "enableWhen" : [{
            "question" : "1386",
            "operator" : "=",
            "answerCoding" : {
              "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.25.1",
              "code" : "1",
              "display" : "Anders"
            }
          }],
          "enableBehavior" : "any",
          "required" : false,
          "repeats" : false
        },
        {
          "linkId" : "1002",
          "text" : "Toelichting",
          "type" : "string",
          "required" : false,
          "repeats" : false
        }]
      }]
    },
    {
      "linkId" : "1411",
      "prefix" : "b)",
      "text" : "Kunstmatige invasieve beademing",
      "type" : "group",
      "repeats" : false,
      "item" : [{
        "linkId" : "1412",
        "text" : "Behandeling",
        "type" : "choice",
        "required" : false,
        "repeats" : false,
        "readOnly" : true,
        "answerOption" : [{
          "valueCoding" : {
            "system" : "http://snomed.info/sct",
            "code" : "40617009",
            "display" : "kunstmatige beademing"
          },
          "initialSelected" : true
        }]
      },
      {
        "linkId" : "1387",
        "text" : "BehandelBesluit",
        "type" : "choice",
        "required" : false,
        "repeats" : false,
        "answerOption" : [{
          "valueCoding" : {
            "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.25.1",
            "code" : "0",
            "display" : "Wel uitvoeren"
          }
        },
        {
          "valueCoding" : {
            "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.25.1",
            "code" : "1",
            "display" : "Anders"
          }
        },
        {
          "valueCoding" : {
            "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.25.1",
            "code" : "2",
            "display" : "Niet uitvoeren"
          }
        },
        {
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
            "code" : "UNK",
            "display" : "Onbekend"
          }
        }],
        "item" : [{
          "linkId" : "1388",
          "text" : "SpecificatieAnders",
          "type" : "string",
          "enableWhen" : [{
            "question" : "1387",
            "operator" : "=",
            "answerCoding" : {
              "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.25.1",
              "code" : "1",
              "display" : "Anders"
            }
          }],
          "enableBehavior" : "any",
          "required" : false,
          "repeats" : false
        },
        {
          "linkId" : "1389",
          "text" : "Toelichting",
          "type" : "string",
          "required" : false,
          "repeats" : false
        }]
      }]
    },
    {
      "linkId" : "1413",
      "prefix" : "c)",
      "text" : "Opname op intensive care",
      "type" : "group",
      "repeats" : false,
      "item" : [{
        "linkId" : "1414",
        "text" : "Behandeling",
        "type" : "choice",
        "required" : false,
        "repeats" : false,
        "readOnly" : true,
        "answerOption" : [{
          "valueCoding" : {
            "system" : "http://snomed.info/sct",
            "code" : "305351004",
            "display" : "opname op intensive care"
          },
          "initialSelected" : true
        }]
      },
      {
        "linkId" : "1390",
        "text" : "BehandelBesluit",
        "type" : "choice",
        "required" : false,
        "repeats" : false,
        "answerOption" : [{
          "valueCoding" : {
            "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.25.1",
            "code" : "0",
            "display" : "Wel uitvoeren"
          }
        },
        {
          "valueCoding" : {
            "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.25.1",
            "code" : "1",
            "display" : "Anders"
          }
        },
        {
          "valueCoding" : {
            "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.25.1",
            "code" : "2",
            "display" : "Niet uitvoeren"
          }
        },
        {
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
            "code" : "UNK",
            "display" : "Onbekend"
          }
        }],
        "item" : [{
          "linkId" : "1391",
          "text" : "SpecificatieAnders",
          "type" : "string",
          "enableWhen" : [{
            "question" : "1390",
            "operator" : "=",
            "answerCoding" : {
              "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.25.1",
              "code" : "1",
              "display" : "Anders"
            }
          }],
          "enableBehavior" : "any",
          "required" : false,
          "repeats" : false
        },
        {
          "linkId" : "1392",
          "text" : "Toelichting",
          "type" : "string",
          "required" : false,
          "repeats" : false
        }]
      }]
    },
    {
      "linkId" : "1415",
      "prefix" : "d)",
      "text" : "Opname in ziekenhuis",
      "type" : "group",
      "repeats" : false,
      "item" : [{
        "linkId" : "1416",
        "text" : "Behandeling",
        "type" : "choice",
        "required" : false,
        "repeats" : false,
        "readOnly" : true,
        "answerOption" : [{
          "valueCoding" : {
            "system" : "http://snomed.info/sct",
            "code" : "32485007",
            "display" : "opname in ziekenhuis"
          },
          "initialSelected" : true
        }]
      },
      {
        "linkId" : "1393",
        "text" : "BehandelBesluit",
        "type" : "choice",
        "required" : false,
        "repeats" : false,
        "answerOption" : [{
          "valueCoding" : {
            "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.25.1",
            "code" : "0",
            "display" : "Wel uitvoeren"
          }
        },
        {
          "valueCoding" : {
            "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.25.1",
            "code" : "1",
            "display" : "Anders"
          }
        },
        {
          "valueCoding" : {
            "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.25.1",
            "code" : "2",
            "display" : "Niet uitvoeren"
          }
        },
        {
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
            "code" : "UNK",
            "display" : "Onbekend"
          }
        }],
        "item" : [{
          "linkId" : "1394",
          "text" : "SpecificatieAnders",
          "type" : "string",
          "enableWhen" : [{
            "question" : "1393",
            "operator" : "=",
            "answerCoding" : {
              "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.25.1",
              "code" : "1",
              "display" : "Anders"
            }
          }],
          "enableBehavior" : "any",
          "required" : false,
          "repeats" : false
        },
        {
          "linkId" : "1395",
          "text" : "Toelichting",
          "type" : "string",
          "required" : false,
          "repeats" : false
        }]
      }]
    },
    {
      "linkId" : "1417",
      "prefix" : "e)",
      "text" : "Behandeling met antibiotica",
      "type" : "group",
      "repeats" : false,
      "item" : [{
        "linkId" : "1418",
        "text" : "Behandeling",
        "type" : "choice",
        "required" : false,
        "repeats" : false,
        "readOnly" : true,
        "answerOption" : [{
          "valueCoding" : {
            "system" : "http://snomed.info/sct",
            "code" : "281789004",
            "display" : "antibiotische therapie"
          },
          "initialSelected" : true
        }]
      },
      {
        "linkId" : "1396",
        "text" : "BehandelBesluit",
        "type" : "choice",
        "required" : false,
        "repeats" : false,
        "answerOption" : [{
          "valueCoding" : {
            "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.25.1",
            "code" : "0",
            "display" : "Wel uitvoeren"
          }
        },
        {
          "valueCoding" : {
            "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.25.1",
            "code" : "1",
            "display" : "Anders"
          }
        },
        {
          "valueCoding" : {
            "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.25.1",
            "code" : "2",
            "display" : "Niet uitvoeren"
          }
        },
        {
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
            "code" : "UNK",
            "display" : "Onbekend"
          }
        }],
        "item" : [{
          "linkId" : "1397",
          "text" : "SpecificatieAnders",
          "type" : "string",
          "enableWhen" : [{
            "question" : "1396",
            "operator" : "=",
            "answerCoding" : {
              "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.25.1",
              "code" : "1",
              "display" : "Anders"
            }
          }],
          "enableBehavior" : "any",
          "required" : false,
          "repeats" : false
        },
        {
          "linkId" : "1398",
          "text" : "Toelichting",
          "type" : "string",
          "required" : false,
          "repeats" : false
        }]
      }]
    },
    {
      "linkId" : "1419",
      "prefix" : "f)",
      "text" : "Toediening van een bloedproduct",
      "type" : "group",
      "repeats" : false,
      "item" : [{
        "linkId" : "1420",
        "text" : "Behandeling",
        "type" : "choice",
        "required" : false,
        "repeats" : false,
        "readOnly" : true,
        "answerOption" : [{
          "valueCoding" : {
            "system" : "http://snomed.info/sct",
            "code" : "116762002",
            "display" : "toediening van bloedproduct"
          },
          "initialSelected" : true
        }]
      },
      {
        "linkId" : "1399",
        "text" : "BehandelBesluit",
        "type" : "choice",
        "required" : false,
        "repeats" : false,
        "answerOption" : [{
          "valueCoding" : {
            "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.25.1",
            "code" : "0",
            "display" : "Wel uitvoeren"
          }
        },
        {
          "valueCoding" : {
            "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.25.1",
            "code" : "1",
            "display" : "Anders"
          }
        },
        {
          "valueCoding" : {
            "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.25.1",
            "code" : "2",
            "display" : "Niet uitvoeren"
          }
        },
        {
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
            "code" : "UNK",
            "display" : "Onbekend"
          }
        }],
        "item" : [{
          "linkId" : "1400",
          "text" : "SpecificatieAnders",
          "type" : "string",
          "enableWhen" : [{
            "question" : "1399",
            "operator" : "=",
            "answerCoding" : {
              "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.25.1",
              "code" : "1",
              "display" : "Anders"
            }
          }],
          "enableBehavior" : "any",
          "required" : false,
          "repeats" : false
        },
        {
          "linkId" : "1401",
          "text" : "Toelichting",
          "type" : "string",
          "required" : false,
          "repeats" : false
        }]
      }]
    },
    {
      "linkId" : "1421",
      "prefix" : "g)",
      "text" : "Overige behandelgrenzen",
      "type" : "group",
      "repeats" : false,
      "item" : [{
        "linkId" : "1422",
        "text" : "Behandeling",
        "type" : "choice",
        "required" : false,
        "repeats" : false,
        "readOnly" : true,
        "answerOption" : [{
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
            "code" : "OTH",
            "display" : "Other"
          },
          "initialSelected" : true
        }]
      },
      {
        "linkId" : "1402",
        "text" : "BehandelBesluit",
        "type" : "choice",
        "required" : false,
        "repeats" : false,
        "answerOption" : [{
          "valueCoding" : {
            "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.25.1",
            "code" : "0",
            "display" : "Wel uitvoeren"
          }
        },
        {
          "valueCoding" : {
            "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.25.1",
            "code" : "2",
            "display" : "Niet uitvoeren"
          }
        },
        {
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
            "code" : "UNK",
            "display" : "Onbekend"
          }
        }],
        "item" : [{
          "linkId" : "1404",
          "text" : "Toelichting",
          "type" : "string",
          "required" : false,
          "repeats" : false
        }]
      }]
    },
    {
      "linkId" : "1006",
      "prefix" : "h)",
      "text" : "Heeft de patiënt een ICD?",
      "type" : "choice",
      "required" : false,
      "repeats" : false,
      "answerOption" : [{
        "valueCoding" : {
          "system" : "http://snomed.info/sct",
          "code" : "373066001",
          "display" : "Ja"
        }
      },
      {
        "valueCoding" : {
          "system" : "http://snomed.info/sct",
          "code" : "373067005",
          "display" : "Nee"
        }
      },
      {
        "valueCoding" : {
          "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
          "code" : "UNK",
          "display" : "Nog onbekend"
        }
      }],
      "item" : [{
        "linkId" : "1008",
        "text" : "ProductType van ICD",
        "type" : "choice",
        "enableWhen" : [{
          "question" : "1006",
          "operator" : "=",
          "answerCoding" : {
            "system" : "http://snomed.info/sct",
            "code" : "373066001",
            "display" : "Ja"
          }
        }],
        "enableBehavior" : "any",
        "required" : false,
        "repeats" : false,
        "answerOption" : [{
          "valueCoding" : {
            "system" : "http://snomed.info/sct",
            "code" : "72506001",
            "display" : "implanteerbare cardioverter-defibrillator"
          }
        },
        {
          "valueCoding" : {
            "system" : "http://snomed.info/sct",
            "code" : "465460004",
            "display" : "univentriculaire implanteerbare cardioverter-defibrillator"
          }
        },
        {
          "valueCoding" : {
            "system" : "http://snomed.info/sct",
            "code" : "468542000",
            "display" : "implanteerbare tweekamercardioverter-defibrillator"
          }
        },
        {
          "valueCoding" : {
            "system" : "http://snomed.info/sct",
            "code" : "704707009",
            "display" : "implanteerbare biventriculaire cardioverter-defibrillator"
          }
        },
        {
          "valueCoding" : {
            "system" : "http://snomed.info/sct",
            "code" : "1263462004",
            "display" : "pulsgenerator van defibrillator voor cardiale resynchronisatietherapie"
          }
        },
        {
          "valueCoding" : {
            "system" : "http://snomed.info/sct",
            "code" : "1236894001",
            "display" : "subcutane implanteerbare cardioverter-defibrillator"
          }
        }]
      },
      {
        "linkId" : "1009",
        "text" : "Toelichting",
        "type" : "string",
        "enableWhen" : [{
          "question" : "1006",
          "operator" : "=",
          "answerCoding" : {
            "system" : "http://snomed.info/sct",
            "code" : "373066001",
            "display" : "Ja"
          }
        }],
        "enableBehavior" : "any",
        "required" : false,
        "repeats" : false
      }]
    },
    {
      "linkId" : "1425",
      "prefix" : "i)",
      "text" : "Is er een afspraak over het moment van uitzetten ICD?",
      "type" : "group",
      "enableWhen" : [{
        "question" : "1006",
        "operator" : "=",
        "answerCoding" : {
          "system" : "http://snomed.info/sct",
          "code" : "373066001",
          "display" : "Ja"
        }
      }],
      "enableBehavior" : "any",
      "repeats" : false,
      "item" : [{
        "linkId" : "1426",
        "text" : "Behandeling van uitzetten ICD (Behandeling)",
        "type" : "choice",
        "required" : false,
        "repeats" : false,
        "readOnly" : true,
        "answerOption" : [{
          "valueCoding" : {
            "system" : "http://snomed.info/sct",
            "code" : "400231000146108",
            "display" : "uitzetten van cardioverter-defibrillator in laatste levensfase (verrichting)"
          },
          "initialSelected" : true
        }]
      },
      {
        "linkId" : "1005",
        "text" : "Afspraak uitzetten ICD (BehandelBesluit)",
        "type" : "choice",
        "enableWhen" : [{
          "question" : "1006",
          "operator" : "=",
          "answerCoding" : {
            "system" : "http://snomed.info/sct",
            "code" : "373066001",
            "display" : "Ja"
          }
        }],
        "enableBehavior" : "any",
        "required" : false,
        "repeats" : false,
        "answerOption" : [{
          "valueCoding" : {
            "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.25.1",
            "code" : "0",
            "display" : "Wel uitvoeren"
          }
        },
        {
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
            "code" : "ASKU",
            "display" : "Nee, nog geen besluit genomen"
          }
        },
        {
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
            "code" : "NASK",
            "display" : "Niet besproken"
          }
        }],
        "item" : [{
          "linkId" : "1010",
          "text" : "Toelichting gemaakte afspraken",
          "type" : "string",
          "required" : false,
          "repeats" : false
        }]
      }]
    }]
  },
  {
    "linkId" : "107",
    "prefix" : "5",
    "text" : "Behandelwensen",
    "type" : "group",
    "repeats" : false,
    "item" : [{
      "linkId" : "1427",
      "prefix" : "a)",
      "text" : "Wat zouden zorgverleners, volgens de patiënt, moeten weten om goede zorg te kunnen verlenen? Heeft deze patiënt specifieke wensen met betrekking tot zijn zorg? (incl. culturele/religieuze/sociale/spirituele aspecten)",
      "type" : "group",
      "repeats" : false,
      "item" : [{
        "linkId" : "1428",
        "text" : "Wens en verwachting patient ([MetingNaam])",
        "type" : "choice",
        "required" : false,
        "repeats" : false,
        "readOnly" : true,
        "answerOption" : [{
          "valueCoding" : {
            "system" : "http://snomed.info/sct",
            "code" : "153851000146100",
            "display" : "Wensen en verwachtingen met betrekking tot uitkomst van behandeling"
          },
          "initialSelected" : true
        }]
      },
      {
        "linkId" : "1190",
        "text" : "Wens en verwachting patient ([MetingWaarde])",
        "type" : "string",
        "required" : false,
        "repeats" : false
      }]
    },
    {
      "linkId" : "1429",
      "prefix" : "b)",
      "text" : "Gewenste plek van overlijden",
      "type" : "group",
      "repeats" : false,
      "item" : [{
        "linkId" : "1430",
        "text" : "Gewenste plek van overlijden ([MetingNaam])",
        "type" : "choice",
        "required" : false,
        "repeats" : false,
        "readOnly" : true,
        "answerOption" : [{
          "valueCoding" : {
            "system" : "http://snomed.info/sct",
            "code" : "395091006",
            "display" : "Gewenste plek van overlijden"
          },
          "initialSelected" : true
        }]
      },
      {
        "linkId" : "1191",
        "text" : "Voorkeursplek ([MetingWaarde])",
        "type" : "choice",
        "required" : false,
        "repeats" : false,
        "answerOption" : [{
          "valueCoding" : {
            "system" : "http://snomed.info/sct",
            "code" : "264362003",
            "display" : "Thuis"
          }
        },
        {
          "valueCoding" : {
            "system" : "http://snomed.info/sct",
            "code" : "22232009",
            "display" : "Ziekenhuis"
          }
        },
        {
          "valueCoding" : {
            "system" : "http://snomed.info/sct",
            "code" : "108344006",
            "display" : "Verpleeghuis"
          }
        },
        {
          "valueCoding" : {
            "system" : "http://snomed.info/sct",
            "code" : "284546000",
            "display" : "Hospice"
          }
        },
        {
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
            "code" : "OTH",
            "display" : "Anders"
          }
        },
        {
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
            "code" : "UNK",
            "display" : "Nog onbekend"
          }
        }],
        "item" : [{
          "linkId" : "1192",
          "text" : "Toelichting",
          "type" : "string",
          "required" : false,
          "repeats" : false
        }]
      }]
    },
    {
      "linkId" : "1431",
      "prefix" : "c)",
      "text" : "Euthanasie standpunt",
      "type" : "group",
      "repeats" : false,
      "item" : [{
        "linkId" : "1432",
        "text" : "Euthanasie standpunt ([MetingNaam])",
        "type" : "choice",
        "required" : false,
        "repeats" : false,
        "readOnly" : true,
        "answerOption" : [{
          "valueCoding" : {
            "system" : "http://snomed.info/sct",
            "code" : "340171000146104",
            "display" : "Standpunt ten opzichte van euthanasie (waarneembare entiteit)"
          },
          "initialSelected" : true
        }]
      },
      {
        "linkId" : "1193",
        "text" : "Euthanasie standpunt ([MetingWaarde])",
        "type" : "choice",
        "required" : false,
        "repeats" : false,
        "answerOption" : [{
          "valueCoding" : {
            "system" : "http://snomed.info/sct",
            "code" : "340181000146102",
            "display" : "Heeft euthanasieverklaring"
          }
        },
        {
          "valueCoding" : {
            "system" : "http://snomed.info/sct",
            "code" : "340201000146103",
            "display" : "Wenst geen euthanasie"
          }
        },
        {
          "valueCoding" : {
            "system" : "http://snomed.info/sct",
            "code" : "340191000146100",
            "display" : "Geen euthanasieverklaring, zou wel verzoek kunnen doen in bepaalde situaties"
          }
        },
        {
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
            "code" : "UNK",
            "display" : "Nog onbekend"
          }
        }],
        "item" : [{
          "linkId" : "1194",
          "text" : "Toelichting",
          "type" : "string",
          "required" : false,
          "repeats" : false
        }]
      }]
    },
    {
      "linkId" : "1433",
      "prefix" : "d)",
      "text" : "Keuze orgaandonatie vastgelegd in donorregister?",
      "type" : "group",
      "repeats" : false,
      "item" : [{
        "linkId" : "1434",
        "text" : "Keuze orgaandonatie vastgelegd in donorregister? ([MetingNaam])",
        "type" : "choice",
        "required" : false,
        "repeats" : false,
        "readOnly" : true,
        "answerOption" : [{
          "valueCoding" : {
            "system" : "http://snomed.info/sct",
            "code" : "570801000146104",
            "display" : "Geregistreerd in orgaan donorregister (bevinding)"
          },
          "initialSelected" : true
        }]
      },
      {
        "linkId" : "1435",
        "text" : "Keuze orgaandonatie in donorregister ([MetingWaarde])",
        "type" : "choice",
        "required" : false,
        "repeats" : false,
        "answerOption" : [{
          "valueCoding" : {
            "system" : "http://snomed.info/sct",
            "code" : "373066001",
            "display" : "Ja"
          }
        },
        {
          "valueCoding" : {
            "system" : "http://snomed.info/sct",
            "code" : "373067005",
            "display" : "Nee"
          }
        },
        {
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
            "code" : "UNK",
            "display" : "Nog onbekend"
          }
        }]
      }]
    }]
  },
  {
    "linkId" : "598",
    "prefix" : "6",
    "text" : "Wat verder nog belangrijk is",
    "type" : "group",
    "repeats" : false,
    "item" : [{
      "linkId" : "1436",
      "text" : "Wat verder nog belangrijk is ([MetingNaam])",
      "type" : "choice",
      "required" : false,
      "repeats" : false,
      "readOnly" : true,
      "answerOption" : [{
        "valueCoding" : {
          "system" : "http://snomed.info/sct",
          "code" : "247751003",
          "display" : "Gevoel van zingeving (waarneembare entiteit)"
        },
        "initialSelected" : true
      }]
    },
    {
      "linkId" : "1196",
      "text" : "Wat verder nog belangrijk is ([MetingWaarde])",
      "type" : "string",
      "required" : false,
      "repeats" : false
    }]
  },
  {
    "linkId" : "115",
    "prefix" : "7",
    "text" : "Eerder vastgelegde behandelwensen",
    "type" : "group",
    "repeats" : false,
    "item" : [{
      "linkId" : "1197",
      "prefix" : "a)",
      "text" : "Heeft de patiënt eerder behandelafspraken vastgelegd?",
      "type" : "choice",
      "required" : false,
      "repeats" : false,
      "answerOption" : [{
        "valueCoding" : {
          "system" : "http://snomed.info/sct",
          "code" : "373066001",
          "display" : "Ja"
        }
      },
      {
        "valueCoding" : {
          "system" : "http://snomed.info/sct",
          "code" : "373067005",
          "display" : "Nee"
        }
      },
      {
        "valueCoding" : {
          "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
          "code" : "UNK",
          "display" : "Nog onbekend"
        }
      }],
      "item" : [{
        "linkId" : "1198",
        "text" : "Toelichting",
        "type" : "string",
        "required" : false,
        "repeats" : false
      }]
    },
    {
      "linkId" : "1199",
      "prefix" : "b)",
      "text" : "Staan in eerder vastgelegde behandelafspraken andere wensen dan nu in deze verklaring?",
      "type" : "choice",
      "enableWhen" : [{
        "question" : "1197",
        "operator" : "=",
        "answerCoding" : {
          "system" : "http://snomed.info/sct",
          "code" : "373066001",
          "display" : "Ja"
        }
      }],
      "enableBehavior" : "any",
      "required" : false,
      "repeats" : false,
      "answerOption" : [{
        "valueCoding" : {
          "system" : "http://snomed.info/sct",
          "code" : "373066001",
          "display" : "Ja"
        }
      },
      {
        "valueCoding" : {
          "system" : "http://snomed.info/sct",
          "code" : "373067005",
          "display" : "Nee"
        }
      },
      {
        "valueCoding" : {
          "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
          "code" : "UNK",
          "display" : "Nog onbekend"
        }
      }]
    }]
  },
  {
    "linkId" : "119",
    "prefix" : "8",
    "text" : "Informatie delen",
    "type" : "group",
    "repeats" : false,
    "item" : [{
      "linkId" : "1200",
      "prefix" : "a)",
      "text" : "Heeft u patient geïnformeerd over eigen verantwoordelijkheid om deze behandelafspraken met naasten te bespreken?",
      "type" : "choice",
      "required" : false,
      "repeats" : false,
      "answerOption" : [{
        "valueCoding" : {
          "code" : "1",
          "display" : "Ja"
        }
      },
      {
        "valueCoding" : {
          "code" : "0",
          "display" : "Nee"
        }
      }]
    },
    {
      "linkId" : "1201",
      "prefix" : "b)",
      "text" : "Patiënt gaat akkoord met het delen van deze behandelafspraken met andere betrokken hulpverleners",
      "type" : "choice",
      "required" : false,
      "repeats" : false,
      "answerOption" : [{
        "valueCoding" : {
          "system" : "http://snomed.info/sct",
          "code" : "441898007",
          "display" : "Akkoord"
        }
      },
      {
        "valueCoding" : {
          "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
          "code" : "UNK",
          "display" : "Nog onbekend"
        }
      }]
    }]
  }]
}

```
