PACIO Advance Directive Interoperability Implementation Guide, published by HL7 Patient Empowerment Working Group. This is not an authorized publication; it is the continuous build for version 0.1.0). This version is based on the current content of https://github.com/HL7/pacio-adi/ and changes regularly. See the Directory of published versions

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: Example-McBee-PreferenceCarePlan1 - XML Representation

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<CarePlan xmlns="http://hl7.org/fhir">
  <id value="Example-McBee-PreferenceCarePlan1"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/us/pacio-adi/StructureDefinition/PADI-PreferenceCarePlan"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>status</b>: active</p><p><b>intent</b>: proposal</p><p><b>category</b>: <span title="Codes: {http://snomed.info/sct 736366004}">Advance care plan</span></p><p><b>subject</b>: <a href="Patient-Example-Smith-Johnson-Patient1.html">Generated Summary: language: en-US; id: 047e62ccf09d4b39a8add708a69b7f38; active: true; Betsy Smith-Johnson ; BetsySJ@example.com; gender: female; birthDate: 1950-11-15; <span title="Codes: {http://terminology.hl7.org/CodeSystem/v3-NullFlavor UNK}">unknown</span></a></p><p><b>addresses</b>: </p><ul><li><span>Unconscious, in a coma, or in a persistent vegetative state with little or no chance of recovery</span></li><li><span>Persistent vegetative state (SNOMED CT 24473007)</span></li><li><span>Irreversible coma (SNOMED CT 73453007)</span></li></ul><p><b>goal</b>: </p><ul><li><a href="Goal-Example-McBee-PersonalInterventionPreference1.html">Generated Summary: lifecycleStatus: proposed; <span title="Codes: {http://loinc.org 75776-5}">Preference on consulting a supportive and palliative care team to help treat physical, emotional, and spiritual discomfort and support family [Reported]</span>; <span title="Codes: ">If I am having significant pain or suffering, I would like my doctors to consult a Supportive and Palliative Care Team to help treat my physical, emotional and spiritual discomfort, and to support my family.</span></a></li><li><a href="Goal-Example-McBee-PersonalInterventionPreference2.html">Generated Summary: lifecycleStatus: proposed; <span title="Codes: {http://loinc.org 75777-3}">Information to tell doctors if my health deteriorates due to a terminal illness and I am unable to interact meaningfully with family, friends, or surroundings [Reported]</span>; <span title="Codes: ">If my health ever deteriorates due to a terminal illness, and my doctors believe I will not be able to interact meaningfully with my family, friends, or surroundings, I prefer that they stop all life-sustaining treatments and let me die as gently as possible.  I realize that I will not receive life-sustaining treatments including but not limited to breathing machines, blood transfusions, dialysis, heart machines, and IV drugs to keep my heart working.  I also realize that medical personnel will not attempt cardiopulmonary resuscitation (CPR), and they will allow me to die naturally.</span></a></li><li><a href="Goal-Example-McBee-PersonalInterventionPreference3.html">Generated Summary: lifecycleStatus: proposed; <span title="Codes: {http://loinc.org 77352-3}">Thoughts on artificial nutrition and hydration [Reported]</span>; <span title="Codes: ">If my response above indicates that I do not want life-sustaining treatments, I expressly authorize my attending physician to withhold or withdraw artificial nutrition and hydration and instruct my healthcare agent (or, if I have not designated a healthcare agent, my default surrogate), my family and the doctors and nurses who are taking care of me to respect this request.</span></a></li><li><a href="Goal-Example-McBee-PersonalInterventionPreference4.html">Generated Summary: lifecycleStatus: proposed; <span title="Codes: {http://loinc.org 75778-1}">Information to tell doctors if I have a severe, irreversible brain injury or illness and can't dress, feed, or bathe myself, or communicate my medical wishes, but can be kept alive [Reported]</span>; <span title="Codes: ">If I have a severe, irreversible brain injury or illness and can’t dress, feed, or bathe myself, or communicate my medical wishes, but doctors can keep me alive in this condition for a long period of time, I would like for them to keep trying life-sustaining treatments for 2 months.</span></a></li><li><a href="Goal-Example-McBee-PersonalInterventionPreference5.html">Generated Summary: lifecycleStatus: proposed; <span title="Codes: {http://loinc.org 75779-9}">Thoughts on cardiopulmonary resuscitation (CPR) [Reported]</span>; <span title="Codes: ">Although I understand that, depending on the situation and circumstances, medical personnel may not be able to follow my wishes, here are my general thoughts on cardiopulmonary resuscitation (CPR): I do not want CPR attempted.</span></a></li><li><a href="Goal-Example-McBee-PersonalInterventionPreference6.html">Generated Summary: lifecycleStatus: proposed; <span title="Codes: {http://loinc.org 75779-9}">Thoughts on cardiopulmonary resuscitation (CPR) [Reported]</span>; <span title="Codes: ">Although I understand that, depending on the situation and circumstances, medical personnel may not be able to follow my wishes, here are my general thoughts on cardiopulmonary resuscitation (CPR): I want my healthcare agent to make the decision, but if my chances are slim to none that I'll leave the hospital, even if they resuscitate me, then I absolutely do not want CPR.</span></a></li><li><a href="Goal-Example-McBee-PersonalInterventionPreference7.html">Generated Summary: lifecycleStatus: proposed; <span title="Codes: {http://loinc.org 75780-7}">Preferred location to spend final days if possible to choose [Reported]</span>; <span title="Codes: ">If it were possible to choose, here is where I would like to spend my final days: At home.I would like to receive hospice care at home if possible.</span></a></li></ul></div>
  </text>
  <status value="active"/>
  <intent value="proposal"/>
  <category>
    <coding>
      <system value="http://snomed.info/sct"/>
      <code value="736366004"/>
      <display value="Advance care plan"/>
    </coding>
  </category>
  <subject>
    <reference value="Patient/Example-Smith-Johnson-Patient1"/>
  </subject>
  <addresses>
    <display
             value="Unconscious, in a coma, or in a persistent vegetative state with little or no chance of recovery"/>
  </addresses>
  <addresses>
    <display value="Persistent vegetative state (SNOMED CT 24473007)"/>
  </addresses>
  <addresses>
    <display value="Irreversible coma (SNOMED CT 73453007)"/>
  </addresses>
  <goal>
    <reference value="Goal/Example-McBee-PersonalInterventionPreference1"/>
  </goal>
  <goal>
    <reference value="Goal/Example-McBee-PersonalInterventionPreference2"/>
  </goal>
  <goal>
    <reference value="Goal/Example-McBee-PersonalInterventionPreference3"/>
  </goal>
  <goal>
    <reference value="Goal/Example-McBee-PersonalInterventionPreference4"/>
  </goal>
  <goal>
    <reference value="Goal/Example-McBee-PersonalInterventionPreference5"/>
  </goal>
  <goal>
    <reference value="Goal/Example-McBee-PersonalInterventionPreference6"/>
  </goal>
  <goal>
    <reference value="Goal/Example-McBee-PersonalInterventionPreference7"/>
  </goal>
</CarePlan>