# 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 2026-06-02 | *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

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  "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" : "2026-06-02T12:44:46+00:00",
  "publisher" : "IKNL",
  "contact" : [{
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    },
    {
      "system" : "email",
      "value" : "info@iknl.nl"
    }]
  }],
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  "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",
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      "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",
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      "item" : [{
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        "text" : "Voornamen",
        "type" : "string",
        "required" : false,
        "repeats" : false
      },
      {
        "linkId" : "969",
        "text" : "Voorvoegsels",
        "type" : "string",
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        "repeats" : false
      },
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        "type" : "string",
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        "repeats" : false
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    },
    {
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      "text" : "Functie (Specialisme)",
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      "required" : false,
      "repeats" : false,
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          "display" : "Arts"
        }
      },
      {
        "valueCoding" : {
          "system" : "http://fhir.nl/fhir/NamingSystem/uzi-rolcode",
          "code" : "01.015",
          "display" : "Huisarts"
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      },
      {
        "valueCoding" : {
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          "code" : "01.047",
          "display" : "Specialist ouderengeneeskunde"
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      },
      {
        "valueCoding" : {
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          "code" : "30.000",
          "display" : "Verpleegkundige"
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      },
      {
        "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"
        }
      }]
    }]
  },
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    "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" : "boolean",
      "required" : false,
      "repeats" : false,
      "item" : [{
        "linkId" : "1407",
        "text" : "Toelichting",
        "type" : "string",
        "required" : false,
        "repeats" : false
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    },
    {
      "linkId" : "29",
      "text" : "Bij wilsonbekwaamheid m.b.t. medische behandelbeslissingen is/wordt de wettelijke vertegenwoordiger:",
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        "prefix" : "a)",
        "text" : "Naam wettelijk vertegenwoordiger",
        "type" : "group",
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        "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" : [{
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                "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1",
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                "display" : "Land Line"
              }
            },
            {
              "valueCoding" : {
                "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1",
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                "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",
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                "display" : "Telefoonnummer thuis"
              }
            },
            {
              "valueCoding" : {
                "system" : "http://terminology.hl7.org/CodeSystem/v3-AddressUse",
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                "display" : "Tijdelijk telefoonnummer"
              }
            },
            {
              "valueCoding" : {
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                "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",
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            "repeats" : false,
            "answerOption" : [{
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            },
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              "valueCoding" : {
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            }]
          }]
        }]
      },
      {
        "linkId" : "982",
        "prefix" : "c)",
        "text" : "Relatie tot patiënt (1)",
        "type" : "choice",
        "required" : false,
        "repeats" : true,
        "answerOption" : [{
          "valueCoding" : {
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            "display" : "Wettelijke vertegenwoordiger"
          },
          "initialSelected" : true
        },
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            "display" : "Eerste relatie/contactpersoon"
          }
        },
        {
          "valueCoding" : {
            "system" : "http://snomed.info/sct",
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        },
        {
          "valueCoding" : {
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            "display" : "Curator (juridisch)"
          }
        },
        {
          "valueCoding" : {
            "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.22.472",
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            "display" : "Mentor"
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        },
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            "display" : "Partner"
          }
        },
        {
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          "valueCoding" : {
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            "display" : "Vader"
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        },
        {
          "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"
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        },
        {
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            "code" : "BRO",
            "display" : "Broer"
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        },
        {
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
            "code" : "SIS",
            "display" : "Zuster"
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        },
        {
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
            "code" : "OTH",
            "display" : "Anders"
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        }],
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        "linkId" : "984",
        "prefix" : "d)",
        "text" : "Is de wettelijk vertegenwoordiger ook de eerste contactpersoon?",
        "type" : "boolean",
        "required" : false,
        "repeats" : false
      },
      {
        "linkId" : "53",
        "prefix" : "e)",
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          "answerBoolean" : false
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          "repeats" : false
        },
        {
          "linkId" : "986",
          "text" : "Voorvoegsels",
          "type" : "string",
          "required" : false,
          "repeats" : false
        },
        {
          "linkId" : "987",
          "text" : "Achternaam",
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          "repeats" : false
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      },
      {
        "linkId" : "61",
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          "operator" : "=",
          "answerBoolean" : false
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        "enableBehavior" : "any",
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        "item" : [{
          "linkId" : "62",
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          "type" : "group",
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          "item" : [{
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            "type" : "string",
            "required" : false,
            "repeats" : false
          },
          {
            "linkId" : "989",
            "text" : "TelecomType",
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                "display" : "Land Line"
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            },
            {
              "valueCoding" : {
                "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1",
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                "display" : "Fax"
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            },
            {
              "valueCoding" : {
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                "display" : "Mobiel telefoonnummer"
              }
            },
            {
              "valueCoding" : {
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                "code" : "PG",
                "display" : "Pieper"
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            }]
          },
          {
            "linkId" : "990",
            "text" : "NummerSoort",
            "type" : "choice",
            "required" : false,
            "repeats" : false,
            "answerOption" : [{
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            },
            {
              "valueCoding" : {
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            },
            {
              "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" : "=",
          "answerBoolean" : false
        }],
        "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" : "=",
          "answerBoolean" : false
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        "enableBehavior" : "any",
        "required" : false,
        "repeats" : false,
        "answerOption" : [{
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            "code" : "DOMPART",
            "display" : "Partner"
          }
        },
        {
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
            "code" : "HUSB",
            "display" : "Echtgenoot"
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        },
        {
          "valueCoding" : {
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            "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"
          }
        },
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      "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" : "boolean",
      "required" : false,
      "repeats" : false
    },
    {
      "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"
        }
      }]
    }]
  }]
}

```
