<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="individual-pronouns-ca-core" />
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-type-characteristics">
    <valueCode value="can-bind" />
  </extension>
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
    <valueCode value="trial-use" />
  </extension>
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
    <valueInteger value="2" />
  </extension>
  <url value="http://fhir.infoway-inforoute.ca/ca-ext/StructureDefinition/individualPronouns" />
  <version value="1.1.0" />
  <name value="Pronouns" />
  <title value="Individual Pronouns" />
  <status value="draft" />
  <experimental value="false" />
  <date value="2024-03-15" />
  <publisher value="Canada Health Infoway" />
  <contact>
    <name value="National Standards Release Centre" />
    <telecom>
      <system value="url" />
      <value value="http://www.infoway-inforoute.ca" />
    </telecom>
    <telecom>
      <system value="email" />
      <value value="standards@infoway-inforoute.ca" />
    </telecom>
  </contact>
  <description value="The pronouns to use when referring to an individual in verbal or written communication. This extension is published in this guide to pre-adopt an extension published in R5 and re-profile it further through CA Core+ project. This extension is an R4 (4.0.1) conversion and re-profiling of the canonical extension published in the R5 [FHIR Extensions Pack](http://hl7.org/fhir/extensions/5.1.0-snapshot1/StructureDefinition-individual-pronouns.html)." />
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166" />
      <code value="CA" />
    </coding>
  </jurisdiction>
  <copyright value="Copyright © 2025+ Canada Health Infoway. All rights reserved. [Terms of Use and License Agreements](https://ic.infoway-inforoute.ca/en/about/tou). [Privacy Policy](https://www.infoway-inforoute.ca/en/legal/privacy-policy)." />
  <fhirVersion value="4.0.1" />
  <mapping>
    <identity value="CACDI" />
    <name value="Canadian Core Data for Interoperability (CACDI)" />
  </mapping>
  <kind value="complex-type" />
  <abstract value="false" />
  <context>
    <type value="element" />
    <expression value="Patient" />
  </context>
  <context>
    <type value="element" />
    <expression value="RelatedPerson" />
  </context>
  <context>
    <type value="element" />
    <expression value="Person" />
  </context>
  <context>
    <type value="element" />
    <expression value="Practitioner" />
  </context>
  <type value="Extension" />
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/individual-pronouns" />
  <derivation value="constraint" />
  <snapshot>
    <element id="Extension">
      <path value="Extension" />
      <short value="The pronouns to use when communicating about an individual." />
      <definition value="The pronouns to use when referring to an individual in verbal or written communication." />
      <comment value="This extension has been re-profiled by the CA Core+ project for use in Canada. It currently provides the mapping details to the pan-Canadian Health Data Content Framework (pCHDCF) concept 'Pronouns'. This pCHDCF concept is still under development and as such does not have further constraints or terminology recommendations at the time of this release" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
      <mapping>
        <identity value="CACDI" />
        <map value="Personal Pronouns" />
      </mapping>
    </element>
    <element id="Extension.id">
      <path value="Extension.id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="Extension.extension">
      <path value="Extension.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Extension.extension.id">
      <path value="Extension.extension.id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="Extension.extension.extension">
      <path value="Extension.extension.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Extension.extension.url">
      <path value="Extension.extension.url" />
      <representation value="xmlAttr" />
      <short value="identifies the meaning of the extension" />
      <definition value="Source of the definition for the extension code - a logical name or a URL." />
      <comment value="The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Extension.url" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="uri" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Extension.extension.value[x]">
      <path value="Extension.extension.value[x]" />
      <slicing>
        <discriminator>
          <type value="type" />
          <path value="$this" />
        </discriminator>
        <ordered value="false" />
        <rules value="open" />
      </slicing>
      <short value="Value of extension" />
      <definition value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list)." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Extension.value[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="base64Binary" />
      </type>
      <type>
        <code value="boolean" />
      </type>
      <type>
        <code value="canonical" />
      </type>
      <type>
        <code value="code" />
      </type>
      <type>
        <code value="date" />
      </type>
      <type>
        <code value="dateTime" />
      </type>
      <type>
        <code value="decimal" />
      </type>
      <type>
        <code value="id" />
      </type>
      <type>
        <code value="instant" />
      </type>
      <type>
        <code value="integer" />
      </type>
      <type>
        <code value="markdown" />
      </type>
      <type>
        <code value="oid" />
      </type>
      <type>
        <code value="positiveInt" />
      </type>
      <type>
        <code value="string" />
      </type>
      <type>
        <code value="time" />
      </type>
      <type>
        <code value="unsignedInt" />
      </type>
      <type>
        <code value="uri" />
      </type>
      <type>
        <code value="url" />
      </type>
      <type>
        <code value="uuid" />
      </type>
      <type>
        <code value="Address" />
      </type>
      <type>
        <code value="Age" />
      </type>
      <type>
        <code value="Annotation" />
      </type>
      <type>
        <code value="Attachment" />
      </type>
      <type>
        <code value="CodeableConcept" />
      </type>
      <type>
        <code value="Coding" />
      </type>
      <type>
        <code value="ContactPoint" />
      </type>
      <type>
        <code value="Count" />
      </type>
      <type>
        <code value="Distance" />
      </type>
      <type>
        <code value="Duration" />
      </type>
      <type>
        <code value="HumanName" />
      </type>
      <type>
        <code value="Identifier" />
      </type>
      <type>
        <code value="Money" />
      </type>
      <type>
        <code value="Period" />
      </type>
      <type>
        <code value="Quantity" />
      </type>
      <type>
        <code value="Range" />
      </type>
      <type>
        <code value="Ratio" />
      </type>
      <type>
        <code value="Reference" />
      </type>
      <type>
        <code value="SampledData" />
      </type>
      <type>
        <code value="Signature" />
      </type>
      <type>
        <code value="Timing" />
      </type>
      <type>
        <code value="ContactDetail" />
      </type>
      <type>
        <code value="Contributor" />
      </type>
      <type>
        <code value="DataRequirement" />
      </type>
      <type>
        <code value="Expression" />
      </type>
      <type>
        <code value="ParameterDefinition" />
      </type>
      <type>
        <code value="RelatedArtifact" />
      </type>
      <type>
        <code value="TriggerDefinition" />
      </type>
      <type>
        <code value="UsageContext" />
      </type>
      <type>
        <code value="Dosage" />
      </type>
      <type>
        <code value="Meta" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Extension.extension.value[x]:valueCodeableConcept">
      <path value="Extension.extension.value[x]" />
      <sliceName value="valueCodeableConcept" />
      <short value="Value of extension" />
      <definition value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list)." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Extension.value[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <binding>
        <strength value="preferred" />
        <valueSet value="https://fhir.infoway-inforoute.ca/ValueSet/pronouns" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Extension.extension:value">
      <path value="Extension.extension" />
      <sliceName value="value" />
      <short value="The individual's pronouns" />
      <definition value="The pronouns to use when referring to an individual in verbal or written communication." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Extension.extension:value.id">
      <path value="Extension.extension.id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="Extension.extension:value.extension">
      <path value="Extension.extension.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Extension.extension:value.url">
      <path value="Extension.extension.url" />
      <representation value="xmlAttr" />
      <short value="identifies the meaning of the extension" />
      <definition value="Source of the definition for the extension code - a logical name or a URL." />
      <comment value="The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Extension.url" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <fixedUri value="value" />
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Extension.extension:value.value[x]">
      <path value="Extension.extension.value[x]" />
      <short value="Value of extension" />
      <definition value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list)." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Extension.value[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Pronouns" />
        </extension>
        <strength value="example" />
        <valueSet value="http://terminology.hl7.org/ValueSet/pronouns" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Extension.extension:period">
      <path value="Extension.extension" />
      <sliceName value="period" />
      <short value="When the pronouns apply to the individual" />
      <definition value="The time period during which the pronouns apply to the individual" />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Extension.extension:period.id">
      <path value="Extension.extension.id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="Extension.extension:period.extension">
      <path value="Extension.extension.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Extension.extension:period.url">
      <path value="Extension.extension.url" />
      <representation value="xmlAttr" />
      <short value="identifies the meaning of the extension" />
      <definition value="Source of the definition for the extension code - a logical name or a URL." />
      <comment value="The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Extension.url" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <fixedUri value="period" />
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Extension.extension:period.value[x]">
      <path value="Extension.extension.value[x]" />
      <short value="Value of extension" />
      <definition value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list)." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Extension.value[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Period" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Extension.extension:period.value[x].id">
      <path value="Extension.extension.value[x].id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="Extension.extension:period.value[x].extension">
      <path value="Extension.extension.value[x].extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Extension.extension:period.value[x].start">
      <path value="Extension.extension.value[x].start" />
      <short value="Starting time with inclusive boundary" />
      <definition value="The start of the period. The boundary is inclusive." />
      <comment value="If the low element is missing, the meaning is that the low boundary is not known." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Period.start" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="dateTime" />
      </type>
      <condition value="ele-1" />
      <condition value="per-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="DR.1" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./low" />
      </mapping>
      <mapping>
        <identity value="CACDI" />
        <map value="Person Pronoun Effective Date (Recommended)" />
      </mapping>
    </element>
    <element id="Extension.extension:period.value[x].end">
      <path value="Extension.extension.value[x].end" />
      <short value="End time with inclusive boundary, if not ongoing" />
      <definition value="The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time." />
      <comment value="The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Period.end" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="dateTime" />
      </type>
      <meaningWhenMissing value="If the end of the period is missing, it means that the period is ongoing" />
      <condition value="ele-1" />
      <condition value="per-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="DR.2" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./high" />
      </mapping>
      <mapping>
        <identity value="CACDI" />
        <map value="Person Pronoun Expiry Date (Recommended)" />
      </mapping>
    </element>
    <element id="Extension.extension:comment">
      <path value="Extension.extension" />
      <sliceName value="comment" />
      <short value="Explaination about the use of the pronouns" />
      <definition value="Text to further explain the use of the specified pronouns" />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Extension.extension:comment.id">
      <path value="Extension.extension.id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="Extension.extension:comment.extension">
      <path value="Extension.extension.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Extension.extension:comment.url">
      <path value="Extension.extension.url" />
      <representation value="xmlAttr" />
      <short value="identifies the meaning of the extension" />
      <definition value="Source of the definition for the extension code - a logical name or a URL." />
      <comment value="The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Extension.url" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <fixedUri value="comment" />
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Extension.extension:comment.value[x]">
      <path value="Extension.extension.value[x]" />
      <short value="Value of extension" />
      <definition value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list)." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Extension.value[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Extension.url">
      <path value="Extension.url" />
      <representation value="xmlAttr" />
      <short value="identifies the meaning of the extension" />
      <definition value="Source of the definition for the extension code - a logical name or a URL." />
      <comment value="The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Extension.url" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="uri" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <fixedUri value="http://hl7.org/fhir/StructureDefinition/individual-pronouns" />
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Extension.value[x]">
      <path value="Extension.value[x]" />
      <short value="Value of extension" />
      <definition value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list)." />
      <min value="0" />
      <max value="0" />
      <base>
        <path value="Extension.value[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="base64Binary" />
      </type>
      <type>
        <code value="boolean" />
      </type>
      <type>
        <code value="canonical" />
      </type>
      <type>
        <code value="code" />
      </type>
      <type>
        <code value="date" />
      </type>
      <type>
        <code value="dateTime" />
      </type>
      <type>
        <code value="decimal" />
      </type>
      <type>
        <code value="id" />
      </type>
      <type>
        <code value="instant" />
      </type>
      <type>
        <code value="integer" />
      </type>
      <type>
        <code value="markdown" />
      </type>
      <type>
        <code value="oid" />
      </type>
      <type>
        <code value="positiveInt" />
      </type>
      <type>
        <code value="string" />
      </type>
      <type>
        <code value="time" />
      </type>
      <type>
        <code value="unsignedInt" />
      </type>
      <type>
        <code value="uri" />
      </type>
      <type>
        <code value="url" />
      </type>
      <type>
        <code value="uuid" />
      </type>
      <type>
        <code value="Address" />
      </type>
      <type>
        <code value="Age" />
      </type>
      <type>
        <code value="Annotation" />
      </type>
      <type>
        <code value="Attachment" />
      </type>
      <type>
        <code value="CodeableConcept" />
      </type>
      <type>
        <code value="Coding" />
      </type>
      <type>
        <code value="ContactPoint" />
      </type>
      <type>
        <code value="Count" />
      </type>
      <type>
        <code value="Distance" />
      </type>
      <type>
        <code value="Duration" />
      </type>
      <type>
        <code value="HumanName" />
      </type>
      <type>
        <code value="Identifier" />
      </type>
      <type>
        <code value="Money" />
      </type>
      <type>
        <code value="Period" />
      </type>
      <type>
        <code value="Quantity" />
      </type>
      <type>
        <code value="Range" />
      </type>
      <type>
        <code value="Ratio" />
      </type>
      <type>
        <code value="Reference" />
      </type>
      <type>
        <code value="SampledData" />
      </type>
      <type>
        <code value="Signature" />
      </type>
      <type>
        <code value="Timing" />
      </type>
      <type>
        <code value="ContactDetail" />
      </type>
      <type>
        <code value="Contributor" />
      </type>
      <type>
        <code value="DataRequirement" />
      </type>
      <type>
        <code value="Expression" />
      </type>
      <type>
        <code value="ParameterDefinition" />
      </type>
      <type>
        <code value="RelatedArtifact" />
      </type>
      <type>
        <code value="TriggerDefinition" />
      </type>
      <type>
        <code value="UsageContext" />
      </type>
      <type>
        <code value="Dosage" />
      </type>
      <type>
        <code value="Meta" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element id="Extension">
      <path value="Extension" />
      <comment value="This extension has been re-profiled by the CA Core+ project for use in Canada. It currently provides the mapping details to the pan-Canadian Health Data Content Framework (pCHDCF) concept 'Pronouns'. This pCHDCF concept is still under development and as such does not have further constraints or terminology recommendations at the time of this release" />
      <mapping>
        <identity value="CACDI" />
        <map value="Personal Pronouns" />
      </mapping>
    </element>
    <element id="Extension.extension">
      <path value="Extension.extension" />
    </element>
    <element id="Extension.extension.extension">
      <path value="Extension.extension.extension" />
      <max value="0" />
    </element>
    <element id="Extension.extension.value[x]">
      <path value="Extension.extension.value[x]" />
      <slicing>
        <discriminator>
          <type value="type" />
          <path value="$this" />
        </discriminator>
        <ordered value="false" />
        <rules value="open" />
      </slicing>
    </element>
    <element id="Extension.extension.value[x]:valueCodeableConcept">
      <path value="Extension.extension.value[x]" />
      <sliceName value="valueCodeableConcept" />
      <min value="0" />
      <max value="1" />
      <type>
        <code value="CodeableConcept" />
      </type>
      <binding>
        <strength value="preferred" />
        <valueSet value="https://fhir.infoway-inforoute.ca/ValueSet/pronouns" />
      </binding>
    </element>
    <element id="Extension.extension:period">
      <path value="Extension.extension" />
      <sliceName value="period" />
    </element>
    <element id="Extension.extension:period.value[x].start">
      <path value="Extension.extension.value[x].start" />
      <mapping>
        <identity value="CACDI" />
        <map value="Person Pronoun Effective Date (Recommended)" />
      </mapping>
    </element>
    <element id="Extension.extension:period.value[x].end">
      <path value="Extension.extension.value[x].end" />
      <mapping>
        <identity value="CACDI" />
        <map value="Person Pronoun Expiry Date (Recommended)" />
      </mapping>
    </element>
  </differential>
</StructureDefinition>