Advance Care Planning (PZP)
1.0.0-rc2 - trial-use

Advance Care Planning (PZP), published by IKNL. This guide is not an authorized publication; it is the continuous build for version 1.0.0-rc2 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/IKNL/PZP-FHIR-R4/ and changes regularly. See the Directory of published versions

## Extension: ext Patient.LegallyCapableMedicalTreatmentDecisions

Official URL: https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ext-Patient.LegallyCapableMedicalTreatmentDecisions | Version: 1.0.0-rc2
Draft as of 2026-06-02 | Computable Name: ExtPatientLegallyCapableMedicalTreatmentDecisions
Copyright/Legal: Copyright and related rights waived via CC0, https://creativecommons.org/publicdomain/zero/1.0/. This does not apply to information from third parties, for example a medical terminology system. The implementer alone is responsible for identifying and obtaining any necessary licenses or authorizations to utilize third party IP in connection with the specification or otherwise.

An extension to indicate the patient's legal capability regarding medical treatment decisions, and to provide a comment on this capability.

This extension is based on the extension FreedomRestrictingIntervention.LegallyCapable, but is adapted for the ACP context by allowing its use on the Patient resource and specifying its application to treatment decisions.

Context of Use

This extension may be used on the following element(s)

- Element ID: `Patient`

Usage info

Usages:

- Use this Extension: ACP Patient
- Examples for this Extension: Patient/ACP-Patient-HendrikHartman-Pat1 and Patient/ACP-Patient-SamiraVanDerSluijs-Pat2

You can also check for usages in the FHIR IG Statistics

### Formal Views of Extension Content

Description of Profiles, Differentials, Snapshots, and how the XML and JSON presentations work.

- Differential Table
- Snapshot Table
- Statistics/References
- All

This structure is derived from Extension

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..* | Extension(4.0.1) | ext Patient.LegallyCapableMedicalTreatmentDecisions
Slices for extension |  |  |  | Content/Rules for all slices
extension:legallyCapable |  | 0..1 | Extension | Extension
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "legallyCapable"
value[x] |  | 0..1 | boolean | LegallyCapable
extension:legallyCapableComment |  | 0..1 | Extension | Extension
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "legallyCapableComment"
value[x] |  | 0..1 | string | LegallyCapableComment
url |  | 1..1 | uri | "https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ext-Patient.LegallyCapableMedicalTreatmentDecisions"
value[x] |  | 0..0 |  | Value of extension
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..* | Extension(4.0.1) | ext Patient.LegallyCapableMedicalTreatmentDecisions Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
extension:legallyCapable |  | 0..1 | Extension | Extension Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "legallyCapable"
value[x] |  | 0..1 | boolean | LegallyCapable
extension:legallyCapableComment |  | 0..1 | Extension | Extension Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "legallyCapableComment"
value[x] |  | 0..1 | string | LegallyCapableComment
url |  | 1..1 | uri | "https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ext-Patient.LegallyCapableMedicalTreatmentDecisions"
Documentation for this format

This structure is derived from Extension

Summary

Complex Extension: An extension to indicate the patient's legal capability regarding medical treatment decisions, and to provide a comment on this capability.

- legallyCapable: boolean: An Extension
- legallyCapableComment: string: An Extension

Differential View

This structure is derived from Extension

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..* | Extension(4.0.1) | ext Patient.LegallyCapableMedicalTreatmentDecisions
Slices for extension |  |  |  | Content/Rules for all slices
extension:legallyCapable |  | 0..1 | Extension | Extension
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "legallyCapable"
value[x] |  | 0..1 | boolean | LegallyCapable
extension:legallyCapableComment |  | 0..1 | Extension | Extension
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "legallyCapableComment"
value[x] |  | 0..1 | string | LegallyCapableComment
url |  | 1..1 | uri | "https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ext-Patient.LegallyCapableMedicalTreatmentDecisions"
value[x] |  | 0..0 |  | Value of extension
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..* | Extension(4.0.1) | ext Patient.LegallyCapableMedicalTreatmentDecisions Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
extension:legallyCapable |  | 0..1 | Extension | Extension Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "legallyCapable"
value[x] |  | 0..1 | boolean | LegallyCapable
extension:legallyCapableComment |  | 0..1 | Extension | Extension Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "legallyCapableComment"
value[x] |  | 0..1 | string | LegallyCapableComment
url |  | 1..1 | uri | "https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ext-Patient.LegallyCapableMedicalTreatmentDecisions"
Documentation for this format

This structure is derived from Extension

Summary

Complex Extension: An extension to indicate the patient's legal capability regarding medical treatment decisions, and to provide a comment on this capability.

- legallyCapable: boolean: An Extension
- legallyCapableComment: string: An Extension

Other representations of profile: CSV, Excel, Schematron

#### Constraints

Id | Grade | Path(s) | Description | Expression
ele-1 | error | Extension, Extension.extension, Extension.extension:legallyCapable, Extension.extension:legallyCapable.value[x], Extension.extension:legallyCapableComment, Extension.extension:legallyCapableComment.value[x] | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | Extension, Extension.extension, Extension.extension:legallyCapable, Extension.extension:legallyCapableComment | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`