obligation
type: CodeSystem
node role: treeRoot
id:
  v: obligation
text:
  status:
    v: generated
  div:
    v: Generated Narrative: CodeSystem obligation Properties This code system defines the following properties for its concepts Name Code URI Type Description Not Selectable not-selectable http://hl7.org/fhir/concept-properties#notSelectable boolean Codes with this property set are not intended to appear in instances. They are for grouping/subsetting purposes only. Parent parent http://hl7.org/fhir/concept-properties#parent code qualifier qualifier http://hl7.org/fhir/CodeSystem/obligation#qualifier code Indicates the level of adherence expected to the obligation concept converse converse http://hl7.org/fhir/CodeSystem/obligation#converse code Indicates another obligation code with an opposite meaning to this one. A single obligation cannot list two converse codes and an application cannot satisfy both a code and its coverse (though if the obligation strength for both is SHOULD or MAY, an application could conform with both obligations by adhering to one and not the other). security-dependent security-dependent http://hl7.org/fhir/CodeSystem/obligation#security-dependent boolean Obligation codes with this property set to true may be overridden by policies and regulations related to privacy and security, including patient consent. Testing of such obligations will need to take such considerations into account. Concepts This case-sensitive code system http://hl7.org/fhir/CodeSystem/obligation defines the following codes in a Is-A hierarchy: Code Display Definition Not Selectable Parent qualifier converse security-dependent SHALL SHALL The functional requirement is mandatory. Applications that do not implement this functional behavior are considered non-conformant. true SHOULD SHOULD The functional requirement is a recommendation. Applications are strongly encouraged to implement this functional behavior, but are still conformant if they do not. true MAY MAY The functional requirement is an option worthy of consideration but there is no expectation or recommendation associated…
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status
    l: structuredefinition-standards-status
  value: Code
    v: trial-use
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/structuredefinition-wg
    l: structuredefinition-wg
  value: Code
    v: fhir
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm
    l: structuredefinition-fmm
  value: Integer
    v: 1
    extension:
      url:
        v: http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom
        l: structuredefinition-conformance-derivedFrom
      value: Canonical
        v: http://hl7.org/fhir/extensions/ImplementationGuide/hl7.fhir.uv.extensions
        l: hl7.fhir.uv.extensions
url:
  v: http://hl7.org/fhir/CodeSystem/obligation
  l: obligation
identifier:
  system:
    v: urn:ietf:rfc:3986
    l: 3986
  value:
    v: urn:oid:2.16.840.1.113883.4.642.4.2123
version:
  v: 5.3.0-ballot-tc1
name:
  v: ObligationCodes
title:
  v: Obligation Codes
status:
  v: active
experimental:
  v: false
date:
  v: 2025-11-06T23:47:55+00:00
publisher:
  v: HL7 International / FHIR Infrastructure
contact:
  telecom:
    system:
      v: url
    value:
      v: http://www.hl7.org/Special/committees/fiwg
description:
  v: Codes that describe application obligations for handling FHIR content. There are five kinds of codes in this code system: * Categorizer codes: ResourceProducerObligations, ResourcesExchangerObligations, and ResourceConsumerObligations which are used to construct value sets and indicate the contexts in which the obligations apply. Note that many applications will be producers, consumers, and potentially exchangers simultaneously, so there is no need to limit obligations to only one category. These are abstract and cannot be declared as obligations. * Qualifier codes: SHALL/SHOULD/MAY which convey the 'strength' of an obligation. These are also abstract and cannot be declared as obligations. * Generic codes - these describe abstract functional obligation behaviors applications may implement, but do not specify a specific strength. They may be organized in a hierarchy where one generic code specializes another. These are also abstract cannot be declared as obligations. * Leaf obligation codes - these are specific qualified obligations that can be declared by a data element and represent leaf-level obligations. They always inherit from a qualification concept and usually inherit from a functional code concept. These codes *can* be declared as obligations. * Composite codes - these specialise Leaf obligation codes, inheriting the expectations of multiple concrete obligations. They represent common or externally defined combinations of obligations for ease of reference. These codes can also be declared as obligations.
jurisdiction:
  coding:
    system:
      v: http://unstats.un.org/unsd/methods/m49/m49.htm
      l: m49.htm
    code:
      v: 001
case sensitive:
  v: true
hierarchy meaning:
  v: is-a
compositional:
  v: true
content:
  v: complete
property:
  code:
    v: not-selectable
  uri:
    v: http://hl7.org/fhir/concept-properties#notSelectable
    l: notSelectable
  description:
    v: Codes with this property set are not intended to appear in instances. They are for grouping/subsetting purposes only.
  type:
    v: boolean
property:
  code:
    v: parent
  uri:
    v: http://hl7.org/fhir/concept-properties#parent
    l: parent
  type:
    v: code
property:
  code:
    v: qualifier
  uri:
    v: http://hl7.org/fhir/CodeSystem/obligation#qualifier
    l: qualifier
  description:
    v: Indicates the level of adherence expected to the obligation concept
  type:
    v: code
property:
  code:
    v: converse
  uri:
    v: http://hl7.org/fhir/CodeSystem/obligation#converse
    l: converse
  description:
    v: Indicates another obligation code with an opposite meaning to this one. A single obligation cannot list two converse codes and an application cannot satisfy both a code and its coverse (though if the obligation strength for both is SHOULD or MAY, an application could conform with both obligations by adhering to one and not the other).
  type:
    v: code
property:
  code:
    v: security-dependent
  uri:
    v: http://hl7.org/fhir/CodeSystem/obligation#security-dependent
    l: security-dependent
  description:
    v: Obligation codes with this property set to true may be overridden by policies and regulations related to privacy and security, including patient consent. Testing of such obligations will need to take such considerations into account.
  type:
    v: boolean
concept:
  code:
    v: SHALL
  display:
    v: SHALL
  definition:
    v: The functional requirement is mandatory. Applications that do not implement this functional behavior are considered non-conformant.
  property:
    code:
      v: not-selectable
    value: Boolean
      v: true
concept:
  code:
    v: SHOULD
  display:
    v: SHOULD
  definition:
    v: The functional requirement is a recommendation. Applications are strongly encouraged to implement this functional behavior, but are still conformant if they do not.
  property:
    code:
      v: not-selectable
    value: Boolean
      v: true
concept:
  code:
    v: MAY
  display:
    v: MAY
  definition:
    v: The functional requirement is an option worthy of consideration but there is no expectation or recommendation associated with its use. NOTE: Elements not flagged with any obligation are intrinsically still 'MAY' (unless constraints dictate otherwise), but have not specifically been called out by the author as worthy of consideration.
  property:
    code:
      v: not-selectable
    value: Boolean
      v: true
concept:
  code:
    v: ResourceProducerObligations
  display:
    v: ResourceProducerObligations
  definition:
    v: Resource producers are applications that assembles resources in the first place. Resource producers may be a server, client, sender, receiver or some middleware device, and they may store the resource, or merely hand it on.
  property:
    code:
      v: not-selectable
    value: Boolean
      v: true
concept:
  code:
    v: ResourceExchangerObligations
  display:
    v: ResourceExchangerObligations
  definition:
    v: Exchangers do not produce or consume resources; they only pass the resource on. They may store the resource in a persistent store between reception and subsequent transfer. The generic FHIR servers are exchangers, as are most middleware systems. Note that Exchanger obligations may also be taken on by Producers or Consumers if they act as intermediaries between other systems or between systems and users.
  property:
    code:
      v: not-selectable
    value: Boolean
      v: true
concept:
  code:
    v: ResourceConsumerObligations
  display:
    v: ResourceConsumerObligations
  definition:
    v: Resource Consumers are applications that consume resources and do something with them, either displaying them to humans, transferring them to some other format for further re-use, or using them to drive some kind of application logic process AKA decision support. Resource Consumers often store resources, but do not need to, and whether resources are stored or not between receiving them and using them doesn't make any difference to the obligations
  property:
    code:
      v: not-selectable
    value: Boolean
      v: true

code:
  v: able-to-populate
display:
  v: be able to populate
definition:
  v: Conformant applications producing resources SHALL/SHOULD/MAY be able to correctly populate this element. Notes: Typically, this means that an application needs to demonstrate during some conformance testing process that there are some conditions under which it populates the element with a correct value. (i.e. not a data-absent-reason or equivalent.) This obligation does not impose expectations on the circumstances in which the element will be sent, only that it can be in at least some situations.
property:
  code:
    v: not-selectable
  value: Boolean
    v: true
property:
  code:
    v: parent
  value: Code
    v: ResourceProducerObligations

code:
  v: populate-if-known
display:
  v: populate if known
definition:
  v: Conformant applications producing resources SHALL/SHOULD correctly populate this element if they know a value for the element, but it is acceptable if the system is unable to ever know a value for the element. Notes: This obligation does not impose a requirement to be able to know a value, unlike populate and able-to-populate which do. 'Knowing' an element means that a value for the element is available in memory, persistent store, or is otherwise available within the system claiming conformance.
property:
  code:
    v: not-selectable
  value: Boolean
    v: true
property:
  code:
    v: parent
  value: Code
    v: ResourceProducerObligations
property:
  code:
    v: security-dependent
  value: Boolean
    v: true

code:
  v: populate
display:
  v: populate
definition:
  v: Conformant applications producing resources SHALL/SHOULD include this element if a value is known and allowed to be shared. Notes: This implementation obligation means that whenever the producer knows the correct value for an element, it populates it. This is NOT the same as cardinality, as a 'populate' element can be omitted if no data exists or the data that exists is prohibited from being shared. Organizations might be required to formally document their rules for determining when they are 'able to share' as part of conformance testing processes. (e.g. regulatory, consent, etc.)
property:
  code:
    v: not-selectable
  value: Boolean
    v: true
property:
  code:
    v: parent
  value: Code
    v: populate-if-known
property:
  code:
    v: parent
  value: Code
    v: able-to-populate
property:
  code:
    v: security-dependent
  value: Boolean
    v: true

code:
  v: in-narrative
display:
  v: include in narrative
definition:
  v: Conformant applications SHALL/SHOULD/MAY ensure that this data element is represented in any human readable representation of a resource. Notes: When no value for an element is known, the producer populates the narrative with the content of any nested [ElementDefinition.valueAlternatives](http://hl7.org/fhir/R5/elementdefinition-definitions.html#ElementDefinition.valueAlternatives) extensions such as [DataAbsentReason](StructureDefinition-data-absent-reason.html). If no particular reason is known or reportable, the element can simply be indicated as 'unknown' in the narrative.
property:
  code:
    v: not-selectable
  value: Boolean
    v: true
property:
  code:
    v: parent
  value: Code
    v: ResourceProducerObligations
property:
  code:
    v: security-dependent
  value: Boolean
    v: true

code:
  v: exclude-narrative
display:
  v: exclude from narrative
definition:
  v: Conformant applications SHALL/SHOULD ensure that this data element is NOT represented in any human readable representation of a resource. Notes: This may be useful for profiles related to de-identified records
property:
  code:
    v: not-selectable
  value: Boolean
    v: true
property:
  code:
    v: parent
  value: Code
    v: ResourceProducerObligations

code:
  v: user-input
display:
  v: allow user input
definition:
  v: Conformant applications SHALL/SHOULD/MAY ensure that users can enter a value for this element during data input/capture. Notes: Exactly what form the input takes is not specified, but the expectation is that this is a value that comes from the user, and not implied internally by the application.
property:
  code:
    v: not-selectable
  value: Boolean
    v: true
property:
  code:
    v: parent
  value: Code
    v: ResourceProducerObligations

code:
  v: explain
display:
  v: populate or document irrelevance
definition:
  v: Documentation applicable to Conformant applications SHALL/SHOULD explain how this element is handled. Notes: this is really a rule about specifications, implying that another specification (which might be application documentation) either makes this element `populate`, or explains how the use cases that involve this element do not arise, or how they are handled. An example: IPA marks Patient.active must-handle and must-explain. Client applications must process Patient.active correctly if they see it, but many (though *not all*) specifications and/or applications ensure that Patient.active will never be false, and so it will never be populated e.g. MedMij in Netherlands prohibits use of Patient.active, and explains that it is never false.
property:
  code:
    v: not-selectable
  value: Boolean
    v: true
property:
  code:
    v: parent
  value: Code
    v: ResourceProducerObligations

code:
  v: persist
display:
  v: persist
definition:
  v: Conformant applications SHALL/SHOULD/MAY ensure that the value for this element is stored in a persistent data store. Notes: Exactly what the data store is not specified, nor how long it is stored for, but it is understood that the same value will be available in later exchanges
property:
  code:
    v: not-selectable
  value: Boolean
    v: true
property:
  code:
    v: parent
  value: Code
    v: ResourceConsumerObligations
property:
  code:
    v: parent
  value: Code
    v: ResourceProducerObligations

code:
  v: no-alter
display:
  v: not alter
definition:
  v: Conformant applications SHALL/SHOULD ensure that this element does not change between receiving and transfer. Notes: This does not mean that the element value cannot change, only that changing the element value for an element marked with this obligation moves an application from being an exchanger to a Consumer and a Producer, and those obligations apply
property:
  code:
    v: not-selectable
  value: Boolean
    v: true
property:
  code:
    v: parent
  value: Code
    v: ResourceExchangerObligations
property:
  code:
    v: converse
  value: Code
    v: MAY:alter

code:
  v: no-error
display:
  v: not error if present
definition:
  v: Conformant applications SHALL/SHOULD accept resources containing any valid value for the element without error. Notes: Applications are still able to inform the user that a value cannot be processed correctly and may ignore the data, but applications aren't able to reject an instance merely because the element is present (which would be allowed for elements that do not have this obligation). A system MAY raise an error if the value provided is not valid or violates specific business rules. This obligation also applies to elements that only contain an extension in place of a value where (or equivalent), should either of these be allowed on the consumer obligations
property:
  code:
    v: not-selectable
  value: Boolean
    v: true
property:
  code:
    v: parent
  value: Code
    v: ResourceConsumerObligations

code:
  v: reject-invalid
display:
  v: reject invalid
definition:
  v: Conformant applications SHALL/SHOULD check that values for this element meet all data constraints asserted within the profile declaring this obligation. If validity issues are found, the system SHALL/SHOULD not accept the instance. Notes: This applies to validating the element with the obligation, but not resources referenced by it.
property:
  code:
    v: not-selectable
  value: Boolean
    v: true
property:
  code:
    v: parent
  value: Code
    v: ResourceConsumerObligations
property:
  code:
    v: converse
  value: Code
    v: accept-invalid

code:
  v: accept-invalid
display:
  v: accept invalid
definition:
  v: Conformant applications SHALL/SHOULD accept data that does not meet all data constraints asserted within the profile declaring this obligation. This applies to non-valid constraints, not to non-valid syntax or failure to meet base resource validity expectations. Typically used when a system needs to be able to handle data that does not adhere to desired expectations (legacy data, test data, data undergoing authorship that is not yet complete, etc.)
property:
  code:
    v: not-selectable
  value: Boolean
    v: true
property:
  code:
    v: parent
  value: Code
    v: ResourceConsumerObligations
property:
  code:
    v: converse
  value: Code
    v: reject-invalid

code:
  v: handle
display:
  v: correctly handle
definition:
  v: Conformant applications SHALL/SHOULD handle the meaning of this element correctly. Notes: this rule is vague in that doesn't specify any particular handling of the element. But it's important because an application that ignores this element is non-conformant. A good example would be a status code of 'entered-in-error' - how exactly a Resource Consumer handles this depends on the use case etc., but the application can never simply ignore such a status code. Note that whether the resource or information from it is stored for later use is irrelevant - when the resource or information in it is processed, the consequences of the element are considered. That may mean not retaining the information for later use, or informing the user, etc. Typically, this obligation marks that there are known patient safety issues that can arise if the element is ignored. Implementers should pay particular attention to the possible range of values for the element from a safety perspective.
property:
  code:
    v: not-selectable
  value: Boolean
    v: true
property:
  code:
    v: parent
  value: Code
    v: ResourceConsumerObligations

code:
  v: display
display:
  v: display
definition:
  v: Conformant applications SHALL/SHOULD/MAY display the value of this element when presenting the data from the resource to a human user. Notes: exactly how it is displayed is not specified, but it means that a human looking at the content of the resource is made aware of the value of the element so that they can consider the meaning of the resource
property:
  code:
    v: not-selectable
  value: Boolean
    v: true
property:
  code:
    v: parent
  value: Code
    v: handle
property:
  code:
    v: security-dependent
  value: Boolean
    v: true

code:
  v: process
display:
  v: process
definition:
  v: Conformant applications SHALL/SHOULD/MAY consider the value of this element when processing the resource as specified by the IG. Notes: this implies that the IG that specifies this obligation provides details about what processing is to be performed, and the obligation specifially relates to the processing specified in the IG of any [ElementDefinition.valueAlternatives](http://hl7.org/fhir/R5/elementdefinition-definitions.html#ElementDefinition.valueAlternatives) extensions as well as the value (or other extensions explicitly declared beneath the element in the profile containing the obligation. Examples might include consideration in decision support, consideration in claims evaluation, etc.
property:
  code:
    v: not-selectable
  value: Boolean
    v: true
property:
  code:
    v: parent
  value: Code
    v: handle
property:
  code:
    v: security-dependent
  value: Boolean
    v: true

code:
  v: print
display:
  v: print
definition:
  v: Conformant applications SHALL/SHOULD/MAY print the value of this element somewhere. Notes: The form of the printing is not specified. A profile using this value SHALL explain the nature of the printing requirement somehow
property:
  code:
    v: not-selectable
  value: Boolean
    v: true
property:
  code:
    v: parent
  value: Code
    v: handle
property:
  code:
    v: security-dependent
  value: Boolean
    v: true

code:
  v: ignore
display:
  v: ignore
definition:
  v: Conformant applications SHALL/SHOULD/MAY not make any use of the value of this element if received.
property:
  code:
    v: not-selectable
  value: Boolean
    v: true
property:
  code:
    v: parent
  value: Code
    v: ResourceConsumerObligations
property:
  code:
    v: converse
  value: Code
    v: handle

code:
  v: SHALL:able-to-populate
display:
  v: SHALL be able to populate
definition:
  v: Conformant applications producing resources SHALL be able to correctly populate this element. Notes: Typically, this means that an application needs to demonstrate during some conformance testing process that there are some conditions under which it populates the element with a correct value. (i.e. not a data-absent-reason or equivalent.) This obligation does not impose expectations on the circumstances in which the element will be sent, only that it can be in at least some situations.
property:
  code:
    v: qualifier
  value: Code
    v: SHALL
property:
  code:
    v: parent
  value: Code
    v: able-to-populate

code:
  v: SHOULD:able-to-populate
display:
  v: SHOULD be able to populate
definition:
  v: Conformant applications producing resources SHOULD be able to correctly populate this element. Notes: Typically, this means that an application needs to demonstrate during some conformance testing process that there are some conditions under which it populates the element with a correct value. (i.e. not a data-absent-reason or equivalent.) This obligation does not impose expectations on the circumstances in which the element will be sent, only that it shold be in at least some situations.
property:
  code:
    v: qualifier
  value: Code
    v: SHOULD
property:
  code:
    v: parent
  value: Code
    v: able-to-populate

code:
  v: MAY:able-to-populate
display:
  v: MAY be able to populate
definition:
  v: Conformant applications producing resources MAY be able to correctly populate this element. Notes: Typically, this means that an application needs to demonstrate during some conformance testing process that there are some conditions under which it populates the element with a correct value. (i.e. not a data-absent-reason or equivalent.) This obligation does not impose expectations on the circumstances in which the element will be sent, only that it may be in at least some situations. This is a null statement and is the default behavior for originating systems if other obligations are not specified.
property:
  code:
    v: qualifier
  value: Code
    v: MAY
property:
  code:
    v: parent
  value: Code
    v: able-to-populate

code:
  v: SHALL:populate-if-known
display:
  v: SHALL populate if known
definition:
  v: Conformant applications producing resources SHALL correctly populate this element if they know a value for the element, but it is acceptable if the system is unable to ever know a value for the element. Notes: This obligation does not impose a requirement to be able to know a value, unlike populate and able-to-populate which do. 'Knowing' an element means that a value for the element is available in memory, persistent store, or is otherwise available within the system claiming conformance.
property:
  code:
    v: qualifier
  value: Code
    v: SHALL
property:
  code:
    v: parent
  value: Code
    v: populate-if-known
property:
  code:
    v: security-dependent
  value: Boolean
    v: true

code:
  v: SHOULD:populate-if-known
display:
  v: SHOULD populate if known
definition:
  v: Conformant applications producing resources SHOULD correctly populate this element if they know a value for the element, but it is acceptable if the system is unable to ever know a value for the element. Notes: This obligation does not impose a requirement to be able to know a value, unlike populate and able-to-populate which do. 'Knowing' an element means that a value for the element is available in memory, persistent store, or is otherwise available within the system claiming conformance.
property:
  code:
    v: qualifier
  value: Code
    v: SHOULD
property:
  code:
    v: parent
  value: Code
    v: populate-if-known
property:
  code:
    v: security-dependent
  value: Boolean
    v: true

code:
  v: SHALL:populate
display:
  v: SHALL populate
definition:
  v: Conformant applications producing resources SHALL include this element if a value is known and allowed to be shared. Notes: This implementation obligation means that whenever the producer knows the correct value for an element, it populates it. This is NOT the same as cardinality, as a 'populate' element can be omitted if no data exists or the data that exists is prohibited from being shared. Organizations might be required to formally document their rules for determining when they are 'able to share' as part of conformance testing processes. (e.g. regulatory, consent, etc.)
property:
  code:
    v: qualifier
  value: Code
    v: SHALL
property:
  code:
    v: parent
  value: Code
    v: SHALL:able-to-populate
property:
  code:
    v: parent
  value: Code
    v: populate
property:
  code:
    v: security-dependent
  value: Boolean
    v: true

code:
  v: SHOULD:populate
display:
  v: SHOULD populate
definition:
  v: Conformant applications producing resources SHOULD include this element if a value is known and allowed to be shared. Notes: This implementation obligation means that whenever the producer knows the correct value for an element, it should populate it. This is NOT the same as cardinality, as a 'populate' element can be omitted if no data exists or the data that exists is prohibited from being shared. Organizations might be required to formally document their rules for determining when they are 'able to share' as part of conformance testing processes. (e.g. regulatory, consent, etc.)
property:
  code:
    v: qualifier
  value: Code
    v: SHOULD
property:
  code:
    v: parent
  value: Code
    v: SHOULD:able-to-populate
property:
  code:
    v: parent
  value: Code
    v: populate
property:
  code:
    v: security-dependent
  value: Boolean
    v: true

code:
  v: SHALL:in-narrative
display:
  v: SHALL include in narrative
definition:
  v: Conformant applications SHALL ensure that this data element is represented in any human readable representation of a resource. Notes: When no value for an element is known, the producer populates the narrative with the content of any nested [ElementDefinition.valueAlternatives](http://hl7.org/fhir/R5/elementdefinition-definitions.html#ElementDefinition.valueAlternatives) extensions such as [DataAbsentReason](StructureDefinition-data-absent-reason.html). If no particular reason is known or reportable, the element can simply be indicated as 'unknown' in the narrative.
property:
  code:
    v: qualifier
  value: Code
    v: SHALL
property:
  code:
    v: parent
  value: Code
    v: in-narrative
property:
  code:
    v: security-dependent
  value: Boolean
    v: true

code:
  v: SHOULD:in-narrative
display:
  v: SHOULD include in narrative
definition:
  v: Conformant applications SHOULD ensure that this data element is represented in any human readable representation of a resource. Notes: When no value for an element is known, the producer populates the narrative with the content of any nested [ElementDefinition.valueAlternatives](http://hl7.org/fhir/R5/elementdefinition-definitions.html#ElementDefinition.valueAlternatives) extensions such as [DataAbsentReason](StructureDefinition-data-absent-reason.html). If no particular reason is known or reportable, the element can simply be indicated as 'unknown' in the narrative.
property:
  code:
    v: qualifier
  value: Code
    v: SHOULD
property:
  code:
    v: parent
  value: Code
    v: in-narrative
property:
  code:
    v: security-dependent
  value: Boolean
    v: true

code:
  v: MAY:in-narrative
display:
  v: MAY include in narrative
definition:
  v: Conformant applications MAY ensure that this data element is represented in any human readable representation of a resource. Notes: When no value for an element is known, the producer populates the narrative with the content of any nested [ElementDefinition.valueAlternatives](http://hl7.org/fhir/R5/elementdefinition-definitions.html#ElementDefinition.valueAlternatives) extensions such as [DataAbsentReason](StructureDefinition-data-absent-reason.html). If no particular reason is known or reportable, the element can simply be indicated as 'unknown' in the narrative.
property:
  code:
    v: qualifier
  value: Code
    v: MAY
property:
  code:
    v: parent
  value: Code
    v: in-narrative
property:
  code:
    v: security-dependent
  value: Boolean
    v: true

code:
  v: SHALL:exclude-narrative
display:
  v: SHALL exclude from narrative
definition:
  v: Conformant applications SHALL ensure that this data element is NOT represented in any human readable representation of a resource. Notes: This may be useful for profiles related to de-identified records
property:
  code:
    v: qualifier
  value: Code
    v: SHALL
property:
  code:
    v: parent
  value: Code
    v: exclude-narrative

code:
  v: SHOULD:exclude-narrative
display:
  v: SHOULD exclude from narrative
definition:
  v: Conformant applications SHOULD ensure that this data element is NOT represented in any human readable representation of a resource. Notes: This may be useful for profiles related to de-identified records
property:
  code:
    v: qualifier
  value: Code
    v: SHOULD
property:
  code:
    v: parent
  value: Code
    v: exclude-narrative

code:
  v: SHALL:user-input
display:
  v: SHALL allow user input
definition:
  v: Conformant applications SHALL ensure that users can enter a value for this element during data input/capture. Notes: Exactly what form the input takes is not specified, but the expectation is that this is a value that comes from the user, and not implied internally by the application.
property:
  code:
    v: qualifier
  value: Code
    v: SHALL
property:
  code:
    v: parent
  value: Code
    v: user-input

code:
  v: SHOULD:user-input
display:
  v: SHOULD allow user input
definition:
  v: Conformant applications SHOULD ensure that users can enter a value for this element during data input/capture. Notes: Exactly what form the input takes is not specified, but the expectation is that this is a value that comes from the user, and not implied internally by the application.
property:
  code:
    v: qualifier
  value: Code
    v: SHOULD
property:
  code:
    v: parent
  value: Code
    v: user-input

code:
  v: MAY:user-input
display:
  v: MAY allow user input
definition:
  v: Conformant applications MAY ensure that users can enter a value for this element during data input/capture. Notes: Exactly what form the input takes is not specified, but the expectation is that this is a value that comes from the user, and not implied internally by the application.
property:
  code:
    v: qualifier
  value: Code
    v: MAY
property:
  code:
    v: parent
  value: Code
    v: user-input

code:
  v: SHALL:explain
display:
  v: SHALL populate or document irrelevance
definition:
  v: Documentation applicable to Conformant applications SHALL explain how this element is handled. Notes: this is really a rule about specifications, implying that another specification (which might be application documentation) either makes this element `populate`, or explains how the use cases that involve this element do not arise, or how they are handled. An example: IPA marks Patient.active must-handle and must-explain. Client applications must process Patient.active correctly if they see it, but many (though *not all*) specifications and/or applications ensure that Patient.active will never be false, and so it will never be populated e.g. MedMij in Netherlands prohibits use of Patient.active, and explains that it is never false.
property:
  code:
    v: qualifier
  value: Code
    v: SHALL
property:
  code:
    v: parent
  value: Code
    v: explain

code:
  v: SHOULD:explain
display:
  v: SHOULD populate or document irrelevance
definition:
  v: Documentation applicable to Conformant applications SHOULD explain how this element is handled. Notes: this is really a rule about specifications, implying that another specification (which might be application documentation) either makes this element `populate`, or explains how the use cases that involve this element do not arise, or how they are handled. An example: IPA marks Patient.active must-handle and must-explain. Client applications must process Patient.active correctly if they see it, but many (though *not all*) specifications and/or applications ensure that Patient.active will never be false, and so it will never be populated e.g. MedMij in Netherlands prohibits use of Patient.active, and explains that it is never false.
property:
  code:
    v: qualifier
  value: Code
    v: SHOULD
property:
  code:
    v: parent
  value: Code
    v: explain

code:
  v: SHALL:persist
display:
  v: SHALL persist
definition:
  v: Conformant applications SHALL ensure that the value for this element is stored in a persistent data store. Notes: Exactly what the data store is not specified, nor how long it is stored for, but it is understood that the same value will be available in later exchanges
property:
  code:
    v: qualifier
  value: Code
    v: SHALL
property:
  code:
    v: parent
  value: Code
    v: persist

code:
  v: SHOULD:persist
display:
  v: SHOULD persist
definition:
  v: Conformant applications SHOULD ensure that the value for this element is stored in a persistent data store. Notes: Exactly what the data store is not specified, nor how long it is stored for, but it is understood that the same value will be available in later exchanges
property:
  code:
    v: qualifier
  value: Code
    v: SHOULD
property:
  code:
    v: parent
  value: Code
    v: persist

code:
  v: MAY:persist
display:
  v: MAY persist
definition:
  v: Conformant applications MAY ensure that the value for this element is stored in a persistent data store. Notes: Exactly what the data store is not specified, nor how long it is stored for, but it is understood that the same value will be available in later exchanges
property:
  code:
    v: qualifier
  value: Code
    v: MAY
property:
  code:
    v: parent
  value: Code
    v: persist

code:
  v: SHALL:no-alter
display:
  v: SHALL not alter
definition:
  v: Conformant applications SHALL ensure that this element does not change between receiving and transfer. Notes: This does not mean that the element value cannot change, only that changing the element value for an element marked with this obligation moves an application from being an exchanger to a Consumer and a Producer, and those obligations apply
property:
  code:
    v: qualifier
  value: Code
    v: SHALL
property:
  code:
    v: parent
  value: Code
    v: no-alter
property:
  code:
    v: converse
  value: Code
    v: MAY:alter

code:
  v: SHOULD:no-alter
display:
  v: SHOULD not alter
definition:
  v: Conformant applications SHOULD ensure that this element does not change between receiving and transfer. Notes: This does not mean that the element value cannot change, only that changing the element value for an element marked with this obligation moves an application from being an exchanger to a Consumer and a Producer, and those obligations apply
property:
  code:
    v: qualifier
  value: Code
    v: SHOULD
property:
  code:
    v: parent
  value: Code
    v: no-alter
property:
  code:
    v: converse
  value: Code
    v: MAY:alter

code:
  v: MAY:alter
display:
  v: MAY alter
definition:
  v: Conformant applications MAY choose to alter this element value. Notes: this is really a null-statement - it's the default rule for an application. It's defined here to allow a specification to be explicit that it isn't conveying obligations for resource producers
property:
  code:
    v: qualifier
  value: Code
    v: MAY
property:
  code:
    v: parent
  value: Code
    v: ResourceExchangerObligations
property:
  code:
    v: converse
  value: Code
    v: no-alter

code:
  v: SHALL:no-error
display:
  v: SHALL not error if present
definition:
  v: Conformant applications SHALL accept resources containing any valid value for the element without error. Notes: Applications are still able to inform the user that a value cannot be processed correctly and may ignore the data, but applications aren't able to reject an instance merely because the element is present (which would be allowed for elements that do not have this obligation). A system MAY raise an error if the value provided is not valid or violates specific business rules. This obligation also applies to elements that only contain an extension in place of a value where (or equivalent), should either of these be allowed on the consumer obligations
property:
  code:
    v: qualifier
  value: Code
    v: SHALL
property:
  code:
    v: parent
  value: Code
    v: no-error

code:
  v: SHOULD:no-error
display:
  v: SHOULD not error if present
definition:
  v: Conformant applications SHOULD accept resources containing any valid value for the element without error. Notes: Applications are still able to inform the user that a value cannot be processed correctly and may ignore the data, but applications aren't able to reject an instance merely because the element is present (which would be allowed for elements that do not have this obligation). A system MAY raise an error if the value provided is not valid or violates specific business rules. This obligation also applies to elements that only contain an extension in place of a value where (or equivalent), should either of these be allowed on the consumer obligations
property:
  code:
    v: qualifier
  value: Code
    v: SHOULD
property:
  code:
    v: parent
  value: Code
    v: no-error

code:
  v: SHALL:reject-invalid
display:
  v: SHALL reject invalid
definition:
  v: Conformant applications SHALL check that values for this element meet all data constraints asserted within the profile declaring this obligation. If validity issues are found, the system SHALL not accept the instance. Notes: This applies to validating the element with the obligation, but not resources referenced by it.
property:
  code:
    v: qualifier
  value: Code
    v: SHALL
property:
  code:
    v: parent
  value: Code
    v: reject-invalid
property:
  code:
    v: converse
  value: Code
    v: accept-invalid

code:
  v: SHOULD:reject-invalid
display:
  v: SHOULD reject invalid
definition:
  v: Conformant applications SHOULD check that values for this element meet all data constraints asserted within the profile declaring this obligation. If validity issues are found, the system SHOULD not accept the instance. Notes: This applies to validating the element with the obligation, but not resources referenced by it.
property:
  code:
    v: qualifier
  value: Code
    v: SHOULD
property:
  code:
    v: parent
  value: Code
    v: reject-invalid
property:
  code:
    v: converse
  value: Code
    v: accept-invalid

code:
  v: SHALL:accept-invalid
display:
  v: SHALL accept invalid
definition:
  v: Conformant applications SHALL accept data that does not meet all data constraints asserted within the profile declaring this obligation. This applies to non-valid constraints, not to non-valid syntax or failure to meet base resource validity expectations. Typically used when a system needs to be able to handle data that does not adhere to desired expectations (legacy data, test data, data undergoing authorship that is not yet complete, etc.)
property:
  code:
    v: qualifier
  value: Code
    v: SHALL
property:
  code:
    v: parent
  value: Code
    v: accept-invalid
property:
  code:
    v: converse
  value: Code
    v: reject-invalid

code:
  v: SHOULD:accept-invalid
display:
  v: SHOULD accept invalid
definition:
  v: Conformant applications SHOULD accept data that does not meet all data constraints asserted within the profile declaring this obligation. This applies to non-valid constraints, not to non-valid syntax or failure to meet base resource validity expectations. Typically used when a system ought to be able to handle data that does not adhere to desired expectations (legacy data, test data, data undergoing authorship that is not yet complete, etc.)
property:
  code:
    v: qualifier
  value: Code
    v: SHOULD
property:
  code:
    v: parent
  value: Code
    v: accept-invalid
property:
  code:
    v: converse
  value: Code
    v: reject-invalid

code:
  v: SHALL:handle
display:
  v: SHALL correctly handle
definition:
  v: Conformant applications SHALL handle the meaning of this element correctly. Notes: this rule is vague in that doesn't specify any particular handling of the element. But it's important because an application that ignores this element is non-conformant. A good example would be a status code of 'entered-in-error' - how exactly a Resource Consumer handles this depends on the use case etc., but the application can never simply ignore such a status code. Note that whether the resource or information from it is stored for later use is irrelevant - when the resource or information in it is processed, the consequences of the element are considered. That may mean not retaining the information for later use, or informing the user, etc. Typically, this obligation marks that there are known patient safety issues that can arise if the element is ignored. Implementers should pay particular attention to the possible range of values for the element from a safety perspective.
property:
  code:
    v: qualifier
  value: Code
    v: SHALL
property:
  code:
    v: parent
  value: Code
    v: handle

code:
  v: SHOULD:handle
display:
  v: SHOULD correctly handle
definition:
  v: Conformant applications SHOULD handle the meaning of this element correctly. Notes: this rule is vague in that doesn't specify any particular handling of the element. But it's important because an application that ignores this element is non-conformant. A good example would be a status code of 'entered-in-error' - how exactly a Resource Consumer handles this depends on the use case etc., but the application can never simply ignore such a status code. Note that whether the resource or information from it is stored for later use is irrelevant - when the resource or information in it is processed, the consequences of the element are considered. That may mean not retaining the information for later use, or informing the user, etc. Typically, this obligation marks that there are known patient safety issues that can arise if the element is ignored. Implementers should pay particular attention to the possible range of values for the element from a safety perspective.
property:
  code:
    v: qualifier
  value: Code
    v: SHOULD
property:
  code:
    v: parent
  value: Code
    v: handle

code:
  v: SHALL:display
display:
  v: SHALL display
definition:
  v: Conformant applications SHALL display the value of this element when presenting the data from the resource to a human user. Notes: exactly how it is displayed is not specified, but it means that a human looking at the content of the resource is made aware of the value of the element so that they can consider the meaning of the resource
property:
  code:
    v: qualifier
  value: Code
    v: SHALL
property:
  code:
    v: parent
  value: Code
    v: SHALL:handle
property:
  code:
    v: parent
  value: Code
    v: display
property:
  code:
    v: security-dependent
  value: Boolean
    v: true

code:
  v: SHOULD:display
display:
  v: SHOULD display
definition:
  v: Conformant applications SHOULD display the value of this element when presenting the data from the resource to a human user. Notes: exactly how it is displayed is not specified, but it means that a human looking at the content of the resource is made aware of the value of the element so that they can consider the meaning of the resource
property:
  code:
    v: qualifier
  value: Code
    v: SHOULD
property:
  code:
    v: parent
  value: Code
    v: SHOULD:handle
property:
  code:
    v: parent
  value: Code
    v: display
property:
  code:
    v: security-dependent
  value: Boolean
    v: true

code:
  v: MAY:display
display:
  v: MAY display
definition:
  v: Conformant applications MAY display the value of this element when presenting the data from the resource to a human user. Notes: exactly how it is displayed is not specified, but it means that a human looking at the content of the resource is made aware of the value of the element so that they can consider the meaning of the resource
property:
  code:
    v: qualifier
  value: Code
    v: MAY
property:
  code:
    v: parent
  value: Code
    v: display
property:
  code:
    v: security-dependent
  value: Boolean
    v: true

code:
  v: SHALL:process
display:
  v: SHALL process
definition:
  v: Conformant applications SHALL consider the value of this element when processing the resource as specified by the IG. Notes: this implies that the IG that specifies this obligation provides details about what processing is to be performed, and the obligation specifially relates to the processing specified in the IG of any [ElementDefinition.valueAlternatives](http://hl7.org/fhir/R5/elementdefinition-definitions.html#ElementDefinition.valueAlternatives) extensions as well as the value (or other extensions explicitly declared beneath the element in the profile containing the obligation. Examples might include consideration in decision support, consideration in claims evaluation, etc.
property:
  code:
    v: qualifier
  value: Code
    v: SHALL
property:
  code:
    v: parent
  value: Code
    v: SHALL:handle
property:
  code:
    v: parent
  value: Code
    v: process
property:
  code:
    v: security-dependent
  value: Boolean
    v: true

code:
  v: SHOULD:process
display:
  v: SHOULD process
definition:
  v: Conformant applications SHOULD consider the value of this element when processing the resource as specified by the IG. Notes: this implies that the IG that specifies this obligation provides details about what processing is to be performed, and the obligation specifially relates to the processing specified in the IG of any [ElementDefinition.valueAlternatives](http://hl7.org/fhir/R5/elementdefinition-definitions.html#ElementDefinition.valueAlternatives) extensions as well as the value (or other extensions explicitly declared beneath the element in the profile containing the obligation. Examples might include consideration in decision support, consideration in claims evaluation, etc.
property:
  code:
    v: qualifier
  value: Code
    v: SHOULD
property:
  code:
    v: parent
  value: Code
    v: SHOULD:handle
property:
  code:
    v: parent
  value: Code
    v: process
property:
  code:
    v: security-dependent
  value: Boolean
    v: true

code:
  v: MAY:process
display:
  v: MAY process
definition:
  v: Conformant applications MAY consider the value of this element when processing the resource as specified by the IG. Notes: this implies that the IG that specifies this obligation provides details about what processing is to be performed, and the obligation specifially relates to the processing specified in the IG of any [ElementDefinition.valueAlternatives](http://hl7.org/fhir/R5/elementdefinition-definitions.html#ElementDefinition.valueAlternatives) extensions as well as the value (or other extensions explicitly declared beneath the element in the profile containing the obligation. Examples might include consideration in decision support, consideration in claims evaluation, etc.
property:
  code:
    v: qualifier
  value: Code
    v: MAY
property:
  code:
    v: parent
  value: Code
    v: process
property:
  code:
    v: security-dependent
  value: Boolean
    v: true

code:
  v: SHALL:print
display:
  v: SHALL print
definition:
  v: Conformant applications SHALL print the value of this element somewhere. Notes: The form of the printing is not specified. A profile using this value SHALL explain the nature of the printing requirement somehow
property:
  code:
    v: qualifier
  value: Code
    v: SHALL
property:
  code:
    v: parent
  value: Code
    v: SHALL:handle
property:
  code:
    v: parent
  value: Code
    v: print
property:
  code:
    v: security-dependent
  value: Boolean
    v: true

code:
  v: SHOULD:print
display:
  v: SHOULD print
definition:
  v: Conformant applications SHOULD print the value of this element somewhere. Notes: The form of the printing is not specified. A profile using this value SHALL explain the nature of the printing requirement somehow
property:
  code:
    v: qualifier
  value: Code
    v: SHOULD
property:
  code:
    v: parent
  value: Code
    v: SHOULD:handle
property:
  code:
    v: parent
  value: Code
    v: print
property:
  code:
    v: security-dependent
  value: Boolean
    v: true

code:
  v: MAY:print
display:
  v: MAY print
definition:
  v: Conformant applications MAY print the value of this element somewhere. Notes: The form of the printing is not specified. A profile using this value SHALL explain the nature of the printing requirement somehow
property:
  code:
    v: qualifier
  value: Code
    v: MAY
property:
  code:
    v: parent
  value: Code
    v: print
property:
  code:
    v: security-dependent
  value: Boolean
    v: true

code:
  v: SHALL:ignore
display:
  v: SHALL ignore
definition:
  v: Conformant applications SHALL not make any use of the value of this element if received.
property:
  code:
    v: qualifier
  value: Code
    v: SHALL
property:
  code:
    v: parent
  value: Code
    v: ignore
property:
  code:
    v: converse
  value: Code
    v: handle

code:
  v: SHOULD:ignore
display:
  v: SHOULD ignore
definition:
  v: Conformant applications SHOULD not make any use of the value of this element if received.
property:
  code:
    v: qualifier
  value: Code
    v: SHOULD
property:
  code:
    v: parent
  value: Code
    v: ignore
property:
  code:
    v: converse
  value: Code
    v: handle

code:
  v: MAY:ignore
display:
  v: MAY ignore
definition:
  v: Conformant applications MAY not make any use of the value of this element if received. This is a null statement and is the default behavior or consuming systems if other obligations are not specified.
property:
  code:
    v: qualifier
  value: Code
    v: MAY
property:
  code:
    v: parent
  value: Code
    v: ignore
property:
  code:
    v: converse
  value: Code
    v: handle

code:
  v: v2-re
display:
  v: V2 RE (required but may be empty)
definition:
  v: RE as defined in chapter 2 of the v2 specification
property:
  code:
    v: parent
  value: Code
    v: SHALL:able-to-populate
property:
  code:
    v: parent
  value: Code
    v: SHALL:display
property:
  code:
    v: parent
  value: Code
    v: SHOULD:persist
property:
  code:
    v: parent
  value: Code
    v: SHOULD:populate
property:
  code:
    v: parent
  value: Code
    v: SHALL:no-error

code:
  v: ihe-r2
display:
  v: IHE R2
definition:
  v: R2 as defined in IHE Appendix Z
property:
  code:
    v: parent
  value: Code
    v: SHALL:populate
property:
  code:
    v: parent
  value: Code
    v: MAY:ignore
property:
  code:
    v: parent
  value: Code
    v: SHALL:no-error

code:
  v: std
display:
  v: Standard obligations
definition:
  v: The standard recommended set of obligations for IGs to use unless they know they want something different. Note that the standard codes don't include use-dar, use-dar-nf, use-dar-if-allowed / use-reason - that gets put on specific elements that justify this handling
property:
  code:
    v: parent
  value: Code
    v: SHALL:populate
property:
  code:
    v: parent
  value: Code
    v: SHALL:display
property:
  code:
    v: parent
  value: Code
    v: SHALL:no-error