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HdBe-LegalSituation

WARNING This page contains a draft CBB, as raw output from the zib export and automatic conversion to CBB. It requires thorough review and adaption to the Belgian realm. This CBB is merely added for informative use.

CBB	Description	Status
HdBe-LegalSituation	A legal situation can concern a legal status and/or representation. The legal status indicates the basis on which the patient is staying in a healthcare organization. This can be either voluntary or involuntary, however the legal status is always determined by a judge. Representation is important in situations where a person is legally not competent to give permission and/or factually (partly) incapable of doing so. A representative supports and takes decisions in the interest of the representee when they cannot do so themselves (temporarily or permanently). Purpose Health professionals must be aware of the existence of a legal status or representation because this in part determines what type of care can be provided to the patient. For example, a supporting legal status can be required for using freedom restricting interventions. For a mentally incompetent patient, it must be clear that there is a representative for further decision-making: in this case, the health professional should follow the decision of the representative of the mentally incompetent patient, unless this is incompatible with the care of a good health professional. Evidence Base In version 2.0, the new legal statuses resulting from the new legislation on involuntary / compulsory care have been added to the LegalStatus value list. In version 1.0 this list was based on the Vektis value list LegalStatus. However, this list is no longer maintained. That is why the value lists in the new version are based on an internal Nictiz codesystem. Instructions In case of an intervention, a distinction is made between seclusion and separation. For the purpose of unambiguous recording, the following definitions are used: Seclusion: Seclusion is the confinement of a patient for care, nursing and treatment in a specially designated seclusion room. A seclusion room is generally a bare single room with only a bed, sometimes with a table, a chair, a wardrobe and occasionally washing facilities. Seclusion may not take place in the "own" bedroom. Separation: Separation is the confinement of a patient in a specially designated enclosed space that has been approved as a separation residence; for several years now the term Extra Secure Room (EBK) has been used for this. The separation space is a specially equipped room, with a mattress or riveted bed and mostly without furniture. Separation should be applied with great caution. The risks of harmful side effects of separation, such as anxiety and stress, are significant. Also in the context of safety, separation should be avoided as much as possible and alternatives should be sought to avert the danger.	draft

CBB

Description

Status

HdBe-LegalSituation

A legal situation can concern a legal status and/or representation.

The legal status indicates the basis on which the patient is staying in a healthcare organization. This can be either voluntary or involuntary, however the legal status is always determined by a judge.

Representation is important in situations where a person is legally not competent to give permission and/or factually (partly) incapable of doing so. A representative supports and takes decisions in the interest of the representee when they cannot do so themselves (temporarily or permanently).

Purpose

Health professionals must be aware of the existence of a legal status or representation because this in part determines what type of care can be provided to the patient. For example, a supporting legal status can be required for using freedom restricting interventions. For a mentally incompetent patient, it must be clear that there is a representative for further decision-making: in this case, the health professional should follow the decision of the representative of the mentally incompetent patient, unless this is incompatible with the care of a good health professional.

Evidence Base

In version 2.0, the new legal statuses resulting from the new legislation on involuntary / compulsory care have been added to the LegalStatus value list. In version 1.0 this list was based on the Vektis value list LegalStatus. However, this list is no longer maintained. That is why the value lists in the new version are based on an internal Nictiz codesystem.

Instructions

In case of an intervention, a distinction is made between seclusion and separation. For the purpose of unambiguous recording, the following definitions are used:

Seclusion: Seclusion is the confinement of a patient for care, nursing and treatment in a specially designated seclusion room. A seclusion room is generally a bare single room with only a bed, sometimes with a table, a chair, a wardrobe and occasionally washing facilities. Seclusion may not take place in the "own" bedroom.

Separation: Separation is the confinement of a patient in a specially designated enclosed space that has been approved as a separation residence; for several years now the term Extra Secure Room (EBK) has been used for this. The separation space is a specially equipped room, with a mattress or riveted bed and mostly without furniture. Separation should be applied with great caution. The risks of harmful side effects of separation, such as anxiety and stress, are significant. Also in the context of safety, separation should be avoided as much as possible and alternatives should be sought to avert the danger.

draft

LegalSituation			LegalSituation	Element id LegalSituation Short description LegalSituation Definition Root concept of the LegalSituation information model. This root concept contains all data elements of the LegalSituation information model. Data type LegalSituation Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
id		0..1	string	There are no (further) constraints on this element Element id LegalSituation.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id LegalSituation.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
LegalStatus		0..*	CodeableConceptBinding	Element id LegalSituation.LegalStatus Short description LegalStatus Definition The legal status that applies to the patient. The legal status indicates the basis on which the patient is staying in a healthcare organization. This can be either voluntary or involuntary, however the legal status is always determined by a judge. A patient can also receive healthcare based on a forensic status. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding LegalStatus codes LegalStatus (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
Representation		0..*	CodeableConceptBinding	Element id LegalSituation.Representation Short description Representation Definition In some situations, a person is legally not competent to give permission and/or factually (partly) incapable of doing so. A representative supports and takes decisions in the interest of the representee when they cannot do so themselves (temporarily or permanently). The representative should involve the patient as much as possible in the fulfillment of their tasks and the factual capability of the patient must be honored as much as possible. The Wgbo (Dutch law) determines who are able to become representatives as well as an enforced order. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding Representation codes Representation (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
DateStart		0..1	dateTime	Element id LegalSituation.DateStart Short description DateStart Definition The date on which the legal situation of the patient starts. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
DateStop		0..1	dateTime	Element id LegalSituation.DateStop Short description DateStop Definition The date on which the legal situation of the patient ends. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a

LegalSituation		0..*
LegalSituation.LegalStatus	CodeableConcept	0..*
LegalSituation.Representation	CodeableConcept	0..*
LegalSituation.DateStart	dateTime	0..1
LegalSituation.DateStop	dateTime	0..1

LegalSituation
Definition	Root concept of the LegalSituation information model. This root concept contains all data elements of the LegalSituation information model.
Cardinality	0...*
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
LegalSituation.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...1
Type	string
Mappings	rim: n/a
LegalSituation.extension
Definition	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.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	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.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a rim: N/A
LegalSituation.LegalStatus
Definition	The legal status that applies to the patient. The legal status indicates the basis on which the patient is staying in a healthcare organization. This can be either voluntary or involuntary, however the legal status is always determined by a judge. A patient can also receive healthcare based on a forensic status.
Cardinality	0...*
Type	CodeableConcept
Binding	LegalStatus codes LegalStatus (required)
Comments	Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
LegalSituation.Representation
Definition	In some situations, a person is legally not competent to give permission and/or factually (partly) incapable of doing so. A representative supports and takes decisions in the interest of the representee when they cannot do so themselves (temporarily or permanently). The representative should involve the patient as much as possible in the fulfillment of their tasks and the factual capability of the patient must be honored as much as possible. The Wgbo (Dutch law) determines who are able to become representatives as well as an enforced order.
Cardinality	0...*
Type	CodeableConcept
Binding	Representation codes Representation (required)
Comments	Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
LegalSituation.DateStart
Definition	The date on which the legal situation of the patient starts.
Cardinality	0...1
Type	dateTime
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
LegalSituation.DateStop
Definition	The date on which the legal situation of the patient ends.
Cardinality	0...1
Type	dateTime
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a

Example instances

[CBB name]
[Concept name ]	[example value]

// example of NameInformation

## Example instances

| NameInformation      |                   |
|----------------------|-------------------|
| FirstNames | Johanna Petronella Maria   
| Initials | J.P.M. 
| GivenName | Jo 
| NameUsage | Geslachtsnaam partner gevolgd door eigen geslachtsnaam
| LastName.Prefix | van
| LastName.LastName | Putten
| LastNamePartner.PartnerPrefix | van der
| LastNamePartner.PartnerLastName | Giessen
| Titles |

zib [zib name + version](https://zibs.nl/wiki/[zib name + version(release)]) difference

Concept	Category	Description
`[element.path]`	[category of change]	[Description of change]([Reference to ticket/issue/zulip chat using MarkDown link])

Terminology Bindings

Path	Name	Strength	URL
LegalStatus	LegalStatus	required	https://fhir.healthdata.be/ValueSet/LegalStatus
Representation	Representation	required	https://fhir.healthdata.be/ValueSet/Representation