Advance Care Planning (PZP)
1.0.0-rc1 - 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-rc1 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

## Resource Profile: AdvanceDirective

Official URL: https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ACP-AdvanceDirective | Version: 1.0.0-rc1
Draft as of 2025-10-31 | Computable Name: ACPAdvanceDirective
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.

A verbal or written description of the patient’s wishes with regard to future medical action or end of their life. A living will is mainly used for situations in which the patient is no longer able to speak about these decisions with their healthcare provider. Based on nl-core-AdvanceDirective and HCIM AdvanceDirective.

Usages:

- Refer to this Profile: TreatmentDirective
- Examples for this Profile: Consent/P2-ACP-AdvanceDirective

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

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

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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Consent | C | 0..* | NlcoreAdvanceDirective | AdvanceDirective Constraints: ppc-1, ppc-2, ppc-3, ppc-4, ppc-5
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  |  |  | Content/Rules for all slices
extension:disorder | O | 0..* | (Complex) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/ext-AdvanceDirective.Disorder Constraints: ext-1
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/ext-AdvanceDirective.Disorder"
value[x] |  | 0..1 | Reference(nl core Problem) | Disorder
extension:comment | O | 0..1 | (Complex) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/ext-Comment Constraints: ext-1
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/ext-Comment"
value[x] |  | 0..1 | string | Comment
extension:encounter |  | 0..1 | (Complex) | ext Encounter Reference URL: https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ext-EncounterReference Constraints: ext-1
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ext-EncounterReference"
value[x] |  | 0..1 | Reference(Encounter(1.0.0-rc1)) | Encounter
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored Constraints: ext-1
status | ?!Σ | 1..1 | code | draft | proposed | active | rejected | inactive | entered-in-error Binding: ConsentState (required): Indicates the state of the consent.
scope | ?!Σ | 1..1 | CodeableConcept | Which of the four areas this resource covers (extensible) Binding: ConsentScopeCodes (extensible): The four anticipated uses for the Consent Resource. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/consentscope
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: adr
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
Slices for category | Σ | 1..* | CodeableConcept | Classification of the consent statement - for indexing/retrieval Slice: Unordered, Open by value:$this Binding: ConsentCategoryCodes (extensible): A classification of the type of consents found in a consent statement.
category:advanceDirectiveCode | Σ | 1..1 | CodeableConcept | Classification of the consent statement - for indexing/retrieval Binding: ConsentCategoryCodes (extensible): A classification of the type of consents found in a consent statement. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/consentcategorycodes
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: acd
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
patient | O Σ | 0..1 | Reference(Patient(1.0.0-rc1)) | Who the consent applies to
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
dateTime | O Σ | 0..1 | dateTime | LivingWillDate
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Slices for source[x] | Σ | 0..1 |  | Source from which this consent is taken Slice: Unordered, Closed by type:$this
sourceAttachment |  |  | Attachment |
sourceReference |  |  | Reference(Consent | DocumentReference | Contract | QuestionnaireResponse) |
source[x]:sourceAttachment | O Σ | 0..1 | Attachment | LivingWillDocument
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Consent.status | Base | required | ConsentState | 📍4.0.1 | FHIR Std.
Consent.scope | Base | extensible | Consent Scope Codes | 📍4.0.1 | FHIR Std.
Consent.category | Base | extensible | Consent Category Codes | 📍4.0.1 | FHIR Std.
Consent.category:advanceDirectiveCode | Base | extensible | Consent Category Codes | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Consent | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Consent | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | Consent | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | Consent | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Consent | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | Consent.implicitRules, Consent.extension:disorder, Consent.extension:disorder.value[x], Consent.extension:comment, Consent.extension:comment.value[x], Consent.extension:encounter, Consent.extension:encounter.value[x], Consent.modifierExtension, Consent.status, Consent.scope, Consent.category, Consent.category:advanceDirectiveCode, Consent.patient, Consent.dateTime, Consent.source[x], Consent.source[x]:sourceAttachment | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | Consent.extension:disorder, Consent.extension:comment, Consent.extension:encounter, Consent.modifierExtension | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
ppc-1 | error | Consent | Either a Policy or PolicyRule | `policy.exists() or policyRule.exists()`
ppc-2 | error | Consent | IF Scope=privacy, there must be a patient | `patient.exists() or scope.coding.where(system='something' and code='patient-privacy').exists().not()`
ppc-3 | error | Consent | IF Scope=research, there must be a patient | `patient.exists() or scope.coding.where(system='something' and code='research').exists().not()`
ppc-4 | error | Consent | IF Scope=adr, there must be a patient | `patient.exists() or scope.coding.where(system='something' and code='adr').exists().not()`
ppc-5 | error | Consent | IF Scope=treatment, there must be a patient | `patient.exists() or scope.coding.where(system='something' and code='treatment').exists().not()`

This structure is derived from NlcoreAdvanceDirective

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Consent |  | 0..* | NlcoreAdvanceDirective | AdvanceDirective
Slices for extension |  |  |  | Content/Rules for all slices
extension:disorder | O | 0..* | ExtAdvanceDirectiveDisorder | Optional Extensions Element
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
value[x] |  | 0..1 | Reference(nl core Problem) | Disorder
extension:comment | O | 0..1 | ExtComment | Optional Extensions Element
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
value[x] |  | 0..1 | string | Comment
extension:encounter |  | 0..1 | (Complex) | ext Encounter Reference URL: https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ext-EncounterReference
value[x] |  | 0..1 | Reference(Encounter(1.0.0-rc1)) | Encounter
patient | O | 0..1 | Reference(Patient(1.0.0-rc1)) | Who the consent applies to
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
dateTime | O | 0..1 | dateTime | LivingWillDate
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Slices for source[x] |  |  |  | Content/Rules for all slices
source[x]:sourceAttachment | O | 0..1 | Attachment | LivingWillDocument
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
provision |  |  |  |
Slices for actor |  |  |  | Content/Rules for all slices
actor:representative |  | 0..1 | BackboneElement | Who|what controlled by this rule (or group, by role)
reference | O | 1..1 | Reference(Device | Group | CareTeam | Organization | Patient | Practitioner | RelatedPerson | PractitionerRole | nl core ContactPerson) | Representative
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
code | O | 0..1 | CodeableConcept | LivingWillType
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Consent | C | 0..* | NlcoreAdvanceDirective | AdvanceDirective Constraints: ppc-1, ppc-2, ppc-3, ppc-4, ppc-5
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
extension:disorder | O | 0..* | (Complex) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/ext-AdvanceDirective.Disorder Constraints: ext-1
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/ext-AdvanceDirective.Disorder"
value[x] |  | 0..1 | Reference(nl core Problem) | Disorder
extension:comment | O | 0..1 | (Complex) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/ext-Comment Constraints: ext-1
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/ext-Comment"
value[x] |  | 0..1 | string | Comment
extension:encounter |  | 0..1 | (Complex) | ext Encounter Reference URL: https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ext-EncounterReference 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 | "https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ext-EncounterReference"
value[x] |  | 0..1 | Reference(Encounter(1.0.0-rc1)) | Encounter
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored Constraints: ext-1
identifier | Σ | 0..* | Identifier | Identifier for this record (external references) Example General: {"system":"urn:ietf:rfc:3986","value":"Local eCMS identifier"}
status | ?!Σ | 1..1 | code | draft | proposed | active | rejected | inactive | entered-in-error Binding: ConsentState (required): Indicates the state of the consent.
scope | ?!Σ | 1..1 | CodeableConcept | Which of the four areas this resource covers (extensible) Binding: ConsentScopeCodes (extensible): The four anticipated uses for the Consent Resource. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/consentscope
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: adr
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
Slices for category | Σ | 1..* | CodeableConcept | Classification of the consent statement - for indexing/retrieval Slice: Unordered, Open by value:$this Binding: ConsentCategoryCodes (extensible): A classification of the type of consents found in a consent statement.
category:advanceDirectiveCode | Σ | 1..1 | CodeableConcept | Classification of the consent statement - for indexing/retrieval Binding: ConsentCategoryCodes (extensible): A classification of the type of consents found in a consent statement. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/consentcategorycodes
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: acd
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
patient | O Σ | 0..1 | Reference(Patient(1.0.0-rc1)) | Who the consent applies to
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
dateTime | O Σ | 0..1 | dateTime | LivingWillDate
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
performer | Σ | 0..* | Reference(Organization | Patient | Practitioner | RelatedPerson | PractitionerRole) | Who is agreeing to the policy and rules
organization | Σ | 0..* | Reference(Organization) | Custodian of the consent
Slices for source[x] | Σ | 0..1 |  | Source from which this consent is taken Slice: Unordered, Closed by type:$this
sourceAttachment |  |  | Attachment |
sourceReference |  |  | Reference(Consent | DocumentReference | Contract | QuestionnaireResponse) |
source[x]:sourceAttachment | O Σ | 0..1 | Attachment | LivingWillDocument
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
policy |  | 0..* | BackboneElement | Policies covered by this consent
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Constraints: ext-1
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized Constraints: ext-1
authority | C | 0..1 | uri | Enforcement source for policy
uri | C | 0..1 | uri | Specific policy covered by this consent
policyRule | Σ C | 0..1 | CodeableConcept | Regulation that this consents to Binding: ConsentPolicyRuleCodes (extensible): Regulatory policy examples.
verification | Σ | 0..* | BackboneElement | Consent Verified by patient or family
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Constraints: ext-1
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized Constraints: ext-1
verified | Σ | 1..1 | boolean | Has been verified
verifiedWith |  | 0..1 | Reference(Patient | RelatedPerson) | Person who verified
verificationDate |  | 0..1 | dateTime | When consent verified
provision | Σ | 0..1 | BackboneElement | Constraints to the base Consent.policyRule
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Constraints: ext-1
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized Constraints: ext-1
type | Σ | 0..1 | code | deny | permit Binding: ConsentProvisionType (required): How a rule statement is applied, such as adding additional consent or removing consent.
period | Σ | 0..1 | Period | Timeframe for this rule
Slices for actor |  | 0..* | BackboneElement | Who|what controlled by this rule (or group, by role) Slice: Unordered, Open by value:role
actor:All Slices |  |  |  | Content/Rules for all slices
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Constraints: ext-1
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized Constraints: ext-1
role |  | 1..1 | CodeableConcept | How the actor is involved Binding: SecurityRoleType (extensible): How an actor is involved in the consent considerations.
reference |  | 1..1 | Reference(Device | Group | CareTeam | Organization | Patient | Practitioner | RelatedPerson | PractitionerRole) | Resource for the actor (or group, by role)
actor:representative |  | 0..1 | BackboneElement | Who|what controlled by this rule (or group, by role)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Constraints: ext-1
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized Constraints: ext-1
role |  | 1..1 | CodeableConcept | How the actor is involved Binding: SecurityRoleType (extensible): How an actor is involved in the consent considerations. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-RoleCode
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: RESPRSN
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
reference | O | 1..1 | Reference(Device | Group | CareTeam | Organization | Patient | Practitioner | RelatedPerson | PractitionerRole | nl core ContactPerson) | Representative
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
action | Σ | 0..* | CodeableConcept | Actions controlled by this rule Binding: ConsentActionCodes (example): Detailed codes for the consent action.
securityLabel | Σ | 0..* | Coding | Security Labels that define affected resources Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
purpose | Σ | 0..* | Coding | Context of activities covered by this rule Binding: PurposeOfUse (3.1.0) (extensible): What purposes of use are controlled by this exception. If more than one label is specified, operations must have all the specified labels.
class | Σ | 0..* | Coding | e.g. Resource Type, Profile, CDA, etc. Binding: ConsentContentClass (extensible): The class (type) of information a consent rule covers.
code | O Σ | 0..1 | CodeableConcept | LivingWillType Binding: WilsverklaringTypeCodelijst (2020-09-01T00:00:00) (required): If this code is found in an instance, then the exception applies.
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
dataPeriod | Σ | 0..1 | Period | Timeframe for data controlled by this rule
data | Σ | 0..* | BackboneElement | Data controlled by this rule
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Constraints: ext-1
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized Constraints: ext-1
meaning | Σ | 1..1 | code | instance | related | dependents | authoredby Binding: ConsentDataMeaning (required): How a resource reference is interpreted when testing consent restrictions.
reference | Σ | 1..1 | Reference(Resource) | The actual data reference
provision |  | 0..* | See provision (Consent) | Nested Exception Rules
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Consent.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Consent.status | Base | required | ConsentState | 📍4.0.1 | FHIR Std.
Consent.scope | Base | extensible | Consent Scope Codes | 📍4.0.1 | FHIR Std.
Consent.category | Base | extensible | Consent Category Codes | 📍4.0.1 | FHIR Std.
Consent.category:advanceDirectiveCode | Base | extensible | Consent Category Codes | 📍4.0.1 | FHIR Std.
Consent.policyRule | Base | extensible | Consent PolicyRule Codes | 📍4.0.1 | FHIR Std.
Consent.provision.type | Base | required | ConsentProvisionType | 📍4.0.1 | FHIR Std.
Consent.provision.actor.​role | Base | extensible | SecurityRoleType | 📍4.0.1 | FHIR Std.
Consent.provision.actor:representative.​role | Base | extensible | SecurityRoleType | 📍4.0.1 | FHIR Std.
Consent.provision.action | Base | example | Consent Action Codes | 📍4.0.1 | FHIR Std.
Consent.provision.securityLabel | Base | extensible | SecurityLabels | 📍4.0.1 | FHIR Std.
Consent.provision.purpose | Base | extensible | PurposeOfUse | 📍3.1.0 | THO v6.5
Consent.provision.class | Base | extensible | Consent Content Class | 📍4.0.1 | FHIR Std.
Consent.provision.code | Base | required | WilsverklaringTypeCodelijst | 📍2020-09-01T00:00:00 | FHIR implementation of zibs 2020 v0.12
Consent.provision.data.​meaning | Base | required | ConsentDataMeaning | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Consent | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Consent | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | Consent | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | Consent | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Consent | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | Consent.meta, Consent.implicitRules, Consent.language, Consent.text, Consent.extension, Consent.extension:disorder, Consent.extension:disorder.extension, Consent.extension:disorder.value[x], Consent.extension:comment, Consent.extension:comment.extension, Consent.extension:comment.value[x], Consent.extension:encounter, Consent.extension:encounter.value[x], Consent.modifierExtension, Consent.identifier, Consent.status, Consent.scope, Consent.category, Consent.category:advanceDirectiveCode, Consent.patient, Consent.dateTime, Consent.performer, Consent.organization, Consent.source[x], Consent.source[x]:sourceAttachment, Consent.policy, Consent.policy.extension, Consent.policy.modifierExtension, Consent.policy.authority, Consent.policy.uri, Consent.policyRule, Consent.verification, Consent.verification.extension, Consent.verification.modifierExtension, Consent.verification.verified, Consent.verification.verifiedWith, Consent.verification.verificationDate, Consent.provision, Consent.provision.extension, Consent.provision.modifierExtension, Consent.provision.type, Consent.provision.period, Consent.provision.actor, Consent.provision.actor.extension, Consent.provision.actor.modifierExtension, Consent.provision.actor.role, Consent.provision.actor.reference, Consent.provision.actor:representative, Consent.provision.actor:representative.extension, Consent.provision.actor:representative.modifierExtension, Consent.provision.actor:representative.role, Consent.provision.actor:representative.reference, Consent.provision.action, Consent.provision.securityLabel, Consent.provision.purpose, Consent.provision.class, Consent.provision.code, Consent.provision.dataPeriod, Consent.provision.data, Consent.provision.data.extension, Consent.provision.data.modifierExtension, Consent.provision.data.meaning, Consent.provision.data.reference, Consent.provision.provision | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | Consent.extension, Consent.extension:disorder, Consent.extension:disorder.extension, Consent.extension:comment, Consent.extension:comment.extension, Consent.extension:encounter, Consent.modifierExtension, Consent.policy.extension, Consent.policy.modifierExtension, Consent.verification.extension, Consent.verification.modifierExtension, Consent.provision.extension, Consent.provision.modifierExtension, Consent.provision.actor.extension, Consent.provision.actor.modifierExtension, Consent.provision.actor:representative.extension, Consent.provision.actor:representative.modifierExtension, Consent.provision.data.extension, Consent.provision.data.modifierExtension | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
ppc-1 | error | Consent | Either a Policy or PolicyRule | `policy.exists() or policyRule.exists()`
ppc-2 | error | Consent | IF Scope=privacy, there must be a patient | `patient.exists() or scope.coding.where(system='something' and code='patient-privacy').exists().not()`
ppc-3 | error | Consent | IF Scope=research, there must be a patient | `patient.exists() or scope.coding.where(system='something' and code='research').exists().not()`
ppc-4 | error | Consent | IF Scope=adr, there must be a patient | `patient.exists() or scope.coding.where(system='something' and code='adr').exists().not()`
ppc-5 | error | Consent | IF Scope=treatment, there must be a patient | `patient.exists() or scope.coding.where(system='something' and code='treatment').exists().not()`

This structure is derived from NlcoreAdvanceDirective

Summary

Structures

This structure refers to these other structures:

- Encounter (https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ACP-Encounter|1.0.0-rc1)
- Patient (https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ACP-Patient|1.0.0-rc1)

Extensions

This structure refers to these extensions:

- https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ext-EncounterReference|1.0.0-rc1

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Consent | C | 0..* | NlcoreAdvanceDirective | AdvanceDirective Constraints: ppc-1, ppc-2, ppc-3, ppc-4, ppc-5
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  |  |  | Content/Rules for all slices
extension:disorder | O | 0..* | (Complex) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/ext-AdvanceDirective.Disorder Constraints: ext-1
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/ext-AdvanceDirective.Disorder"
value[x] |  | 0..1 | Reference(nl core Problem) | Disorder
extension:comment | O | 0..1 | (Complex) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/ext-Comment Constraints: ext-1
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/ext-Comment"
value[x] |  | 0..1 | string | Comment
extension:encounter |  | 0..1 | (Complex) | ext Encounter Reference URL: https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ext-EncounterReference Constraints: ext-1
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ext-EncounterReference"
value[x] |  | 0..1 | Reference(Encounter(1.0.0-rc1)) | Encounter
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored Constraints: ext-1
status | ?!Σ | 1..1 | code | draft | proposed | active | rejected | inactive | entered-in-error Binding: ConsentState (required): Indicates the state of the consent.
scope | ?!Σ | 1..1 | CodeableConcept | Which of the four areas this resource covers (extensible) Binding: ConsentScopeCodes (extensible): The four anticipated uses for the Consent Resource. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/consentscope
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: adr
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
Slices for category | Σ | 1..* | CodeableConcept | Classification of the consent statement - for indexing/retrieval Slice: Unordered, Open by value:$this Binding: ConsentCategoryCodes (extensible): A classification of the type of consents found in a consent statement.
category:advanceDirectiveCode | Σ | 1..1 | CodeableConcept | Classification of the consent statement - for indexing/retrieval Binding: ConsentCategoryCodes (extensible): A classification of the type of consents found in a consent statement. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/consentcategorycodes
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: acd
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
patient | O Σ | 0..1 | Reference(Patient(1.0.0-rc1)) | Who the consent applies to
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
dateTime | O Σ | 0..1 | dateTime | LivingWillDate
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Slices for source[x] | Σ | 0..1 |  | Source from which this consent is taken Slice: Unordered, Closed by type:$this
sourceAttachment |  |  | Attachment |
sourceReference |  |  | Reference(Consent | DocumentReference | Contract | QuestionnaireResponse) |
source[x]:sourceAttachment | O Σ | 0..1 | Attachment | LivingWillDocument
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Consent.status | Base | required | ConsentState | 📍4.0.1 | FHIR Std.
Consent.scope | Base | extensible | Consent Scope Codes | 📍4.0.1 | FHIR Std.
Consent.category | Base | extensible | Consent Category Codes | 📍4.0.1 | FHIR Std.
Consent.category:advanceDirectiveCode | Base | extensible | Consent Category Codes | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Consent | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Consent | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | Consent | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | Consent | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Consent | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | Consent.implicitRules, Consent.extension:disorder, Consent.extension:disorder.value[x], Consent.extension:comment, Consent.extension:comment.value[x], Consent.extension:encounter, Consent.extension:encounter.value[x], Consent.modifierExtension, Consent.status, Consent.scope, Consent.category, Consent.category:advanceDirectiveCode, Consent.patient, Consent.dateTime, Consent.source[x], Consent.source[x]:sourceAttachment | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | Consent.extension:disorder, Consent.extension:comment, Consent.extension:encounter, Consent.modifierExtension | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
ppc-1 | error | Consent | Either a Policy or PolicyRule | `policy.exists() or policyRule.exists()`
ppc-2 | error | Consent | IF Scope=privacy, there must be a patient | `patient.exists() or scope.coding.where(system='something' and code='patient-privacy').exists().not()`
ppc-3 | error | Consent | IF Scope=research, there must be a patient | `patient.exists() or scope.coding.where(system='something' and code='research').exists().not()`
ppc-4 | error | Consent | IF Scope=adr, there must be a patient | `patient.exists() or scope.coding.where(system='something' and code='adr').exists().not()`
ppc-5 | error | Consent | IF Scope=treatment, there must be a patient | `patient.exists() or scope.coding.where(system='something' and code='treatment').exists().not()`

Differential View

This structure is derived from NlcoreAdvanceDirective

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Consent |  | 0..* | NlcoreAdvanceDirective | AdvanceDirective
Slices for extension |  |  |  | Content/Rules for all slices
extension:disorder | O | 0..* | ExtAdvanceDirectiveDisorder | Optional Extensions Element
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
value[x] |  | 0..1 | Reference(nl core Problem) | Disorder
extension:comment | O | 0..1 | ExtComment | Optional Extensions Element
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
value[x] |  | 0..1 | string | Comment
extension:encounter |  | 0..1 | (Complex) | ext Encounter Reference URL: https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ext-EncounterReference
value[x] |  | 0..1 | Reference(Encounter(1.0.0-rc1)) | Encounter
patient | O | 0..1 | Reference(Patient(1.0.0-rc1)) | Who the consent applies to
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
dateTime | O | 0..1 | dateTime | LivingWillDate
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Slices for source[x] |  |  |  | Content/Rules for all slices
source[x]:sourceAttachment | O | 0..1 | Attachment | LivingWillDocument
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
provision |  |  |  |
Slices for actor |  |  |  | Content/Rules for all slices
actor:representative |  | 0..1 | BackboneElement | Who|what controlled by this rule (or group, by role)
reference | O | 1..1 | Reference(Device | Group | CareTeam | Organization | Patient | Practitioner | RelatedPerson | PractitionerRole | nl core ContactPerson) | Representative
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
code | O | 0..1 | CodeableConcept | LivingWillType
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Consent | C | 0..* | NlcoreAdvanceDirective | AdvanceDirective Constraints: ppc-1, ppc-2, ppc-3, ppc-4, ppc-5
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
extension:disorder | O | 0..* | (Complex) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/ext-AdvanceDirective.Disorder Constraints: ext-1
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/ext-AdvanceDirective.Disorder"
value[x] |  | 0..1 | Reference(nl core Problem) | Disorder
extension:comment | O | 0..1 | (Complex) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/ext-Comment Constraints: ext-1
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/ext-Comment"
value[x] |  | 0..1 | string | Comment
extension:encounter |  | 0..1 | (Complex) | ext Encounter Reference URL: https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ext-EncounterReference 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 | "https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ext-EncounterReference"
value[x] |  | 0..1 | Reference(Encounter(1.0.0-rc1)) | Encounter
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored Constraints: ext-1
identifier | Σ | 0..* | Identifier | Identifier for this record (external references) Example General: {"system":"urn:ietf:rfc:3986","value":"Local eCMS identifier"}
status | ?!Σ | 1..1 | code | draft | proposed | active | rejected | inactive | entered-in-error Binding: ConsentState (required): Indicates the state of the consent.
scope | ?!Σ | 1..1 | CodeableConcept | Which of the four areas this resource covers (extensible) Binding: ConsentScopeCodes (extensible): The four anticipated uses for the Consent Resource. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/consentscope
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: adr
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
Slices for category | Σ | 1..* | CodeableConcept | Classification of the consent statement - for indexing/retrieval Slice: Unordered, Open by value:$this Binding: ConsentCategoryCodes (extensible): A classification of the type of consents found in a consent statement.
category:advanceDirectiveCode | Σ | 1..1 | CodeableConcept | Classification of the consent statement - for indexing/retrieval Binding: ConsentCategoryCodes (extensible): A classification of the type of consents found in a consent statement. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/consentcategorycodes
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: acd
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
patient | O Σ | 0..1 | Reference(Patient(1.0.0-rc1)) | Who the consent applies to
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
dateTime | O Σ | 0..1 | dateTime | LivingWillDate
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
performer | Σ | 0..* | Reference(Organization | Patient | Practitioner | RelatedPerson | PractitionerRole) | Who is agreeing to the policy and rules
organization | Σ | 0..* | Reference(Organization) | Custodian of the consent
Slices for source[x] | Σ | 0..1 |  | Source from which this consent is taken Slice: Unordered, Closed by type:$this
sourceAttachment |  |  | Attachment |
sourceReference |  |  | Reference(Consent | DocumentReference | Contract | QuestionnaireResponse) |
source[x]:sourceAttachment | O Σ | 0..1 | Attachment | LivingWillDocument
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
policy |  | 0..* | BackboneElement | Policies covered by this consent
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Constraints: ext-1
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized Constraints: ext-1
authority | C | 0..1 | uri | Enforcement source for policy
uri | C | 0..1 | uri | Specific policy covered by this consent
policyRule | Σ C | 0..1 | CodeableConcept | Regulation that this consents to Binding: ConsentPolicyRuleCodes (extensible): Regulatory policy examples.
verification | Σ | 0..* | BackboneElement | Consent Verified by patient or family
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Constraints: ext-1
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized Constraints: ext-1
verified | Σ | 1..1 | boolean | Has been verified
verifiedWith |  | 0..1 | Reference(Patient | RelatedPerson) | Person who verified
verificationDate |  | 0..1 | dateTime | When consent verified
provision | Σ | 0..1 | BackboneElement | Constraints to the base Consent.policyRule
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Constraints: ext-1
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized Constraints: ext-1
type | Σ | 0..1 | code | deny | permit Binding: ConsentProvisionType (required): How a rule statement is applied, such as adding additional consent or removing consent.
period | Σ | 0..1 | Period | Timeframe for this rule
Slices for actor |  | 0..* | BackboneElement | Who|what controlled by this rule (or group, by role) Slice: Unordered, Open by value:role
actor:All Slices |  |  |  | Content/Rules for all slices
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Constraints: ext-1
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized Constraints: ext-1
role |  | 1..1 | CodeableConcept | How the actor is involved Binding: SecurityRoleType (extensible): How an actor is involved in the consent considerations.
reference |  | 1..1 | Reference(Device | Group | CareTeam | Organization | Patient | Practitioner | RelatedPerson | PractitionerRole) | Resource for the actor (or group, by role)
actor:representative |  | 0..1 | BackboneElement | Who|what controlled by this rule (or group, by role)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Constraints: ext-1
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized Constraints: ext-1
role |  | 1..1 | CodeableConcept | How the actor is involved Binding: SecurityRoleType (extensible): How an actor is involved in the consent considerations. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-RoleCode
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: RESPRSN
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
reference | O | 1..1 | Reference(Device | Group | CareTeam | Organization | Patient | Practitioner | RelatedPerson | PractitionerRole | nl core ContactPerson) | Representative
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
action | Σ | 0..* | CodeableConcept | Actions controlled by this rule Binding: ConsentActionCodes (example): Detailed codes for the consent action.
securityLabel | Σ | 0..* | Coding | Security Labels that define affected resources Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
purpose | Σ | 0..* | Coding | Context of activities covered by this rule Binding: PurposeOfUse (3.1.0) (extensible): What purposes of use are controlled by this exception. If more than one label is specified, operations must have all the specified labels.
class | Σ | 0..* | Coding | e.g. Resource Type, Profile, CDA, etc. Binding: ConsentContentClass (extensible): The class (type) of information a consent rule covers.
code | O Σ | 0..1 | CodeableConcept | LivingWillType Binding: WilsverklaringTypeCodelijst (2020-09-01T00:00:00) (required): If this code is found in an instance, then the exception applies.
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
dataPeriod | Σ | 0..1 | Period | Timeframe for data controlled by this rule
data | Σ | 0..* | BackboneElement | Data controlled by this rule
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Constraints: ext-1
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized Constraints: ext-1
meaning | Σ | 1..1 | code | instance | related | dependents | authoredby Binding: ConsentDataMeaning (required): How a resource reference is interpreted when testing consent restrictions.
reference | Σ | 1..1 | Reference(Resource) | The actual data reference
provision |  | 0..* | See provision (Consent) | Nested Exception Rules
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Consent.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Consent.status | Base | required | ConsentState | 📍4.0.1 | FHIR Std.
Consent.scope | Base | extensible | Consent Scope Codes | 📍4.0.1 | FHIR Std.
Consent.category | Base | extensible | Consent Category Codes | 📍4.0.1 | FHIR Std.
Consent.category:advanceDirectiveCode | Base | extensible | Consent Category Codes | 📍4.0.1 | FHIR Std.
Consent.policyRule | Base | extensible | Consent PolicyRule Codes | 📍4.0.1 | FHIR Std.
Consent.provision.type | Base | required | ConsentProvisionType | 📍4.0.1 | FHIR Std.
Consent.provision.actor.​role | Base | extensible | SecurityRoleType | 📍4.0.1 | FHIR Std.
Consent.provision.actor:representative.​role | Base | extensible | SecurityRoleType | 📍4.0.1 | FHIR Std.
Consent.provision.action | Base | example | Consent Action Codes | 📍4.0.1 | FHIR Std.
Consent.provision.securityLabel | Base | extensible | SecurityLabels | 📍4.0.1 | FHIR Std.
Consent.provision.purpose | Base | extensible | PurposeOfUse | 📍3.1.0 | THO v6.5
Consent.provision.class | Base | extensible | Consent Content Class | 📍4.0.1 | FHIR Std.
Consent.provision.code | Base | required | WilsverklaringTypeCodelijst | 📍2020-09-01T00:00:00 | FHIR implementation of zibs 2020 v0.12
Consent.provision.data.​meaning | Base | required | ConsentDataMeaning | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Consent | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Consent | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | Consent | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | Consent | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Consent | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | Consent.meta, Consent.implicitRules, Consent.language, Consent.text, Consent.extension, Consent.extension:disorder, Consent.extension:disorder.extension, Consent.extension:disorder.value[x], Consent.extension:comment, Consent.extension:comment.extension, Consent.extension:comment.value[x], Consent.extension:encounter, Consent.extension:encounter.value[x], Consent.modifierExtension, Consent.identifier, Consent.status, Consent.scope, Consent.category, Consent.category:advanceDirectiveCode, Consent.patient, Consent.dateTime, Consent.performer, Consent.organization, Consent.source[x], Consent.source[x]:sourceAttachment, Consent.policy, Consent.policy.extension, Consent.policy.modifierExtension, Consent.policy.authority, Consent.policy.uri, Consent.policyRule, Consent.verification, Consent.verification.extension, Consent.verification.modifierExtension, Consent.verification.verified, Consent.verification.verifiedWith, Consent.verification.verificationDate, Consent.provision, Consent.provision.extension, Consent.provision.modifierExtension, Consent.provision.type, Consent.provision.period, Consent.provision.actor, Consent.provision.actor.extension, Consent.provision.actor.modifierExtension, Consent.provision.actor.role, Consent.provision.actor.reference, Consent.provision.actor:representative, Consent.provision.actor:representative.extension, Consent.provision.actor:representative.modifierExtension, Consent.provision.actor:representative.role, Consent.provision.actor:representative.reference, Consent.provision.action, Consent.provision.securityLabel, Consent.provision.purpose, Consent.provision.class, Consent.provision.code, Consent.provision.dataPeriod, Consent.provision.data, Consent.provision.data.extension, Consent.provision.data.modifierExtension, Consent.provision.data.meaning, Consent.provision.data.reference, Consent.provision.provision | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | Consent.extension, Consent.extension:disorder, Consent.extension:disorder.extension, Consent.extension:comment, Consent.extension:comment.extension, Consent.extension:encounter, Consent.modifierExtension, Consent.policy.extension, Consent.policy.modifierExtension, Consent.verification.extension, Consent.verification.modifierExtension, Consent.provision.extension, Consent.provision.modifierExtension, Consent.provision.actor.extension, Consent.provision.actor.modifierExtension, Consent.provision.actor:representative.extension, Consent.provision.actor:representative.modifierExtension, Consent.provision.data.extension, Consent.provision.data.modifierExtension | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
ppc-1 | error | Consent | Either a Policy or PolicyRule | `policy.exists() or policyRule.exists()`
ppc-2 | error | Consent | IF Scope=privacy, there must be a patient | `patient.exists() or scope.coding.where(system='something' and code='patient-privacy').exists().not()`
ppc-3 | error | Consent | IF Scope=research, there must be a patient | `patient.exists() or scope.coding.where(system='something' and code='research').exists().not()`
ppc-4 | error | Consent | IF Scope=adr, there must be a patient | `patient.exists() or scope.coding.where(system='something' and code='adr').exists().not()`
ppc-5 | error | Consent | IF Scope=treatment, there must be a patient | `patient.exists() or scope.coding.where(system='something' and code='treatment').exists().not()`

This structure is derived from NlcoreAdvanceDirective

Summary

Structures

This structure refers to these other structures:

- Encounter (https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ACP-Encounter|1.0.0-rc1)
- Patient (https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ACP-Patient|1.0.0-rc1)

Extensions

This structure refers to these extensions:

- https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ext-EncounterReference|1.0.0-rc1

Other representations of profile: CSV, Excel, Schematron