HdBe-AdvanceDirective

Profile	Description	Status	URL
HdBe-AdvanceDirective	An AdvanceDirective is a verbal or written description of the patient’s wishes with regard to future medical action or end of their life. An advanceDirective is mainly used for situations in which the patient is no longer able to speak about these decisions with their healthcare provider.	draft	https://fhir.healthdata.be/StructureDefinition/HdBe-AdvanceDirective

Consent	I		Consent	Element Id Consent Short description AdvanceDirective Alternate names Wilsverklaring Definition A record of a healthcare consumer’s choices, which permits or denies identified recipient(s) or recipient role(s) to perform one or more actions within a given policy context, for specific purposes and periods of time. Comments Broadly, there are 3 key areas of consent for patients: Consent around sharing information (aka Privacy Consent Directive - Authorization to Collect, Use, or Disclose information), consent for specific treatment, or kinds of treatment, and general advance care directives. Data Type Consent Constraints dom-2:If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-4: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-3: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-6:A resource should have narrative for robust management text.`div`.exists() dom-5:If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` ppc-4:IF Scope=adr, there must be a patient `patient.exists() or scope.coding.where(system='something' and code='adr').exists().not()` ppc-5:IF Scope=treatment, there must be a patient `patient.exists() or scope.coding.where(system='something' and code='treatment').exists().not()` ppc-2:IF Scope=privacy, there must be a patient `patient.exists() or scope.coding.where(system='something' and code='patient-privacy').exists().not()` ppc-3:IF Scope=research, there must be a patient `patient.exists() or scope.coding.where(system='something' and code='research').exists().not()` ppc-1:Either a Policy or PolicyRule `policy.exists() or policyRule.exists()` Mappings rim:Entity. Role, or Act workflow:Event v2:CON rim:FinancialConsent zib-advancedirective-v3.1.1-2020EN:NL-CM:7.15.1 HdBe-AdvanceDirective:AdvanceDirective
extension	I	0..*	Extension	Element Id Consent.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 resource. 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) 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
disorder	I	0..*	Extension(Reference(HdBe Problem))	Element Id Consent.extension:disorder Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. 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(Reference(HdBe Problem)) Extension URL https://fhir.healthdata.be/StructureDefinition/ext-AdvanceDirective.Disorder 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
comment	I	0..1	Extension(string)	Element Id Consent.extension:comment Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. 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(string) Extension URL https://fhir.healthdata.be/StructureDefinition/ext-Comment 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
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id Consent.extension:comment.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments 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. Data Type System.String Fixed Value https://fhir.healthdata.be/StructureDefinition/ext-Comment Mappings rim:N/A
value[x]		0..1		Element Id Consent.extension:comment.value[x] Short description Comment Alternate names Toelichting Definition Comment on the living will: the form, such as a medallion, tattoo, etc., or where the living will can be found. Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A zib-advancedirective-v3.1.1-2020EN:NL-CM:7.15.6 HdBe-AdvanceDirective:AdvanceDirective.Comment
valueString			string	There are no (further) constraints on this element Data Type string
identifier	Σ	0..*	Identifier	There are no (further) constraints on this element Element Id Consent.identifier Short description Identifier for this record (external references) Definition Unique identifier for this copy of the Consent Statement. Comments This identifier identifies this copy of the consent. Where this identifier is also used elsewhere as the identifier for a consent record (e.g. a CDA consent document) then the consent details are expected to be the same. Data Type Identifier Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General { "system": "urn:ietf:rfc:3986", "value": "Local eCMS identifier" } Mappings rim:n/a v2:CX / EI (occasionally, more often EI maps to a resource id or a URL) rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd:Identifier workflow:Event.identifier w5:FiveWs.identifier rim:.id
status	Σ ?!	1..1	codeBinding	Element Id Consent.status Short description draft \| proposed \| active \| rejected \| inactive \| entered-in-error Definition Indicates the current state of this consent. Requirements The Consent Directive that is pointed to might be in various lifecycle states, e.g., a revoked Consent Directive. Comments This element has no functional counterpart in the CBB and cannot be implicitly mapped to other concepts. Unless a more appropriate status is recorded, it is assumed that only active Consent resources will be exchanged. Data Type code Binding Indicates the state of the consent. ConsentState (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a workflow:Event.status w5:FiveWs.status v2:HL7 Table 0498 - Consent Status rim:.statusCode
scope	Σ ?!	1..1	CodeableConceptBinding	Element Id Consent.scope Short description Which of the four areas this resource covers (extensible) Definition A selector of the type of consent being presented: ADR, Privacy, Treatment, Research. This list is now extensible. Comments At the moment of writing (02-11-2021) the adr code is incorrectly removed from the ConsentScopeCodes CodeSystem (http://terminology.hl7.org/CodeSystem/consentscope). This will be corrected within the R4 release of FHIR based on this tracker item: https://jira.hl7.org/browse/FHIR-34215. Data Type CodeableConcept Binding The four anticipated uses for the Consent Resource. ConsentScopeCodes (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/consentscope", "code": "adr" } ] } Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
category	Σ	1..*	CodeableConceptBinding	Element Id Consent.category Short description Classification of the consent statement - for indexing/retrieval Definition A classification of the type of consents found in the statement. This element supports indexing and retrieval of consent statements. 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 A classification of the type of consents found in a consent statement. ConsentCategoryCodes (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/consentcategorycodes", "code": "acd" } ] } Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD workflow:Event.code w5:FiveWs.class v2:HL7 Table 0497 - Consent Type rim:CNTRCT
patient	Σ I	0..1	Reference(Patient)	There are no (further) constraints on this element Element Id Consent.patient Short description Who the consent applies to Definition The patient/healthcare consumer to whom this consent applies. Comments Commonly, the patient the consent pertains to is the author, but for young and old people, it may be some other person. Data Type Reference(Patient) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Event.subject w5:FiveWs.subject[x] rim:Role w5:FiveWs.subject
dateTime	Σ	0..1	dateTime	Element Id Consent.dateTime Short description LivingWillDate Alternate names WilsverklaringDatum Definition The date on which the living will was recorded. Comments This is not the time of the original consent, but the time that this statement was made or derived. 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 workflow:Event.occurrence[x] w5:FiveWs.recorded v2:Field 13/ Consent Decision Date rim:FinancialConsent effectiveTime zib-advancedirective-v3.1.1-2020EN:NL-CM:7.15.7 HdBe-AdvanceDirective:AdvanceDirective.LivingWillDate
performer	Σ I	0..*	Reference(Organization \| Patient \| Practitioner \| RelatedPerson \| PractitionerRole)	There are no (further) constraints on this element Element Id Consent.performer Short description Who is agreeing to the policy and rules Alternate names consentor Definition Either the Grantor, which is the entity responsible for granting the rights listed in a Consent Directive or the Grantee, which is the entity responsible for complying with the Consent Directive, including any obligations or limitations on authorizations and enforcement of prohibitions. Comments Commonly, the patient the consent pertains to is the consentor, but particularly for young and old people, it may be some other person - e.g. a legal guardian. Data Type Reference(Organization \| Patient \| Practitioner \| RelatedPerson \| PractitionerRole) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Event.performer w5:FiveWs.actor v2:Field 24/ ConsenterID
organization	Σ I	0..*	Reference(Organization)	There are no (further) constraints on this element Element Id Consent.organization Short description Custodian of the consent Alternate names custodian Definition The organization that manages the consent, and the framework within which it is executed. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Organization) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Event.performer w5:FiveWs.witness
source[x]	Σ	0..1		Element Id Consent.source[x] Short description Source from which this consent is taken Definition The source on which this consent statement is based. The source might be a scanned original paper form, or a reference to a consent that links back to such a source, a reference to a document repository (e.g. XDS) that stores the original consent document. Comments The source can be contained inline (Attachment), referenced directly (Consent), referenced in a consent repository (DocumentReference), or simply by an identifier (Identifier), e.g. a CDA document id. Sliced: Unordered, Open, by $this(Type) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:Field 19 Informational Material Supplied Indicator
sourceReference			Reference(Consent \| DocumentReference \| Contract \| QuestionnaireResponse)	There are no (further) constraints on this element Data Type Reference(Consent \| DocumentReference \| Contract \| QuestionnaireResponse)
sourceAttachment	Σ	0..1	Attachment	Element Id Consent.source[x]:sourceAttachment Short description Source from which this consent is taken Definition The source on which this consent statement is based. The source might be a scanned original paper form, or a reference to a consent that links back to such a source, a reference to a document repository (e.g. XDS) that stores the original consent document. Comments The source can be contained inline (Attachment), referenced directly (Consent), referenced in a consent repository (DocumentReference), or simply by an identifier (Identifier), e.g. a CDA document id. Data Type Attachment Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:Field 19 Informational Material Supplied Indicator
contentType	Σ	0..1	codeBinding	There are no (further) constraints on this element Element Id Consent.source[x]:sourceAttachment.contentType Short description Mime type of the content, with charset etc. Definition Identifies the type of the data in the attachment and allows a method to be chosen to interpret or render the data. Includes mime type parameters such as charset where appropriate. Requirements Processors of the data need to be able to know how to interpret the data. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type code Binding The mime type of an attachment. Any valid mime type is allowed. Mime Types (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General text/plain; charset=UTF-8, image/png Mappings rim:n/a v2:ED.2+ED.3/RP.2+RP.3. Note conversion may be needed if old style values are being used rim:./mediaType, ./charset
language	Σ	0..1	codeBinding	There are no (further) constraints on this element Element Id Consent.source[x]:sourceAttachment.language Short description Human language of the content (BCP-47) Definition The human language of the content. The value can be any valid value according to BCP 47. Requirements Users need to be able to choose between the languages in a set of attachments. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type code Binding A human language. CommonLanguages (preferred) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General en-AU Mappings rim:n/a rim:./language
data		0..1	base64Binary	Element Id Consent.source[x]:sourceAttachment.data Short description LivingWillDocument Alternate names WilsverklaringDocument Definition Scanned source document with the living will and the patient's signature, such as a PDF. Requirements The data needs to able to be transmitted inline. Comments The base64-encoded data SHALL be expressed in the same character set as the base resource XML or JSON. Data Type base64Binary Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:ED.5 rim:./data zib-advancedirective-v3.1.1-2020EN:NL-CM:7.15.5 HdBe-AdvanceDirective:AdvanceDirective.LivingWillDocument
url	Σ	0..1	url	There are no (further) constraints on this element Element Id Consent.source[x]:sourceAttachment.url Short description Uri where the data can be found Definition A location where the data can be accessed. Requirements The data needs to be transmitted by reference. Comments If both data and url are provided, the url SHALL point to the same content as the data contains. Urls may be relative references or may reference transient locations such as a wrapping envelope using cid: though this has ramifications for using signatures. Relative URLs are interpreted relative to the service url, like a resource reference, rather than relative to the resource itself. If a URL is provided, it SHALL resolve to actual data. Data Type url Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General http://www.acme.com/logo-small.png Mappings rim:n/a v2:RP.1+RP.2 - if they refer to a URL (see v2.6) rim:./reference/literal
size	Σ	0..1	unsignedInt	There are no (further) constraints on this element Element Id Consent.source[x]:sourceAttachment.size Short description Number of bytes of content (if url provided) Definition The number of bytes of data that make up this attachment (before base64 encoding, if that is done). Requirements Representing the size allows applications to determine whether they should fetch the content automatically in advance, or refuse to fetch it at all. Comments The number of bytes is redundant if the data is provided as a base64binary, but is useful if the data is provided as a url reference. Data Type unsignedInt Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A (needs data type R3 proposal)
hash	Σ	0..1	base64Binary	There are no (further) constraints on this element Element Id Consent.source[x]:sourceAttachment.hash Short description Hash of the data (sha-1, base64ed) Definition The calculated hash of the data using SHA-1. Represented using base64. Requirements Included so that applications can verify that the contents of a location have not changed due to technical failures (e.g., storage rot, transport glitch, incorrect version). Comments The hash is calculated on the data prior to base64 encoding, if the data is based64 encoded. The hash is not intended to support digital signatures. Where protection against malicious threats a digital signature should be considered, see Provenance.signature for mechanism to protect a resource with a digital signature. Data Type base64Binary Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:.integrityCheck[parent::ED/integrityCheckAlgorithm="SHA-1"]
title	Σ	0..1	string	There are no (further) constraints on this element Element Id Consent.source[x]:sourceAttachment.title Short description Label to display in place of the data Definition A label or set of text to display in place of the data. Requirements Applications need a label to display to a human user in place of the actual data if the data cannot be rendered or perceived by the viewer. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General Official Corporate Logo Mappings rim:n/a rim:./title/data
creation	Σ	0..1	dateTime	There are no (further) constraints on this element Element Id Consent.source[x]:sourceAttachment.creation Short description Date attachment was first created Definition The date that the attachment was first created. Requirements This is often tracked as an integrity issue for use of the attachment. 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 rim:N/A (needs data type R3 proposal)
policy		0..*	BackboneElement	There are no (further) constraints on this element Element Id Consent.policy Short description Policies covered by this consent Definition The references to the policies that are included in this consent scope. Policies may be organizational, but are often defined jurisdictionally, or in law. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
authority	I	0..1	uri	There are no (further) constraints on this element Element Id Consent.policy.authority Short description Enforcement source for policy Definition Entity or Organization having regulatory jurisdiction or accountability for enforcing policies pertaining to Consent Directives. Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
uri	I	0..1	uri	Element Id Consent.policy.uri Short description Specific policy covered by this consent Definition The references to the policies that are included in this consent scope. Policies may be organizational, but are often defined jurisdictionally, or in law. Comments Either `.policy` or `.policyRule` should exist following core constraint ppc-1. If no explicit value is recorded, a fallback is to populate `.policy.uri` with https://www.belgielex.be/ if the advance directive is recorded following Belgium law and regulations. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
policyRule	Σ I	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element Id Consent.policyRule Short description Regulation that this consents to Definition A reference to the specific base computable regulation or policy. Requirements Might be a unique identifier of a policy set in XACML, or other rules engine. Comments If the policyRule is absent, computable consent would need to be constructed from the elements of the Consent resource. Data Type CodeableConcept Binding Regulatory policy examples. ConsentPolicyRuleCodes (extensible) 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
verification	Σ	0..*	BackboneElement	There are no (further) constraints on this element Element Id Consent.verification Short description Consent Verified by patient or family Definition Whether a treatment instruction (e.g. artificial respiration yes or no) was verified with the patient, his/her family or another authorized person. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
verified	Σ	1..1	boolean	There are no (further) constraints on this element Element Id Consent.verification.verified Short description Has been verified Definition Has the instruction been verified. Data Type boolean Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
verifiedWith	I	0..1	Reference(Patient \| RelatedPerson)	There are no (further) constraints on this element Element Id Consent.verification.verifiedWith Short description Person who verified Definition Who verified the instruction (Patient, Relative or other Authorized Person). Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Patient \| RelatedPerson) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
verificationDate		0..1	dateTime	There are no (further) constraints on this element Element Id Consent.verification.verificationDate Short description When consent verified Definition Date verification was collected. 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
provision	Σ	0..1	BackboneElement	There are no (further) constraints on this element Element Id Consent.provision Short description Constraints to the base Consent.policyRule Definition An exception to the base policy of this consent. An exception can be an addition or removal of access permissions. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
type	Σ	0..1	codeBinding	There are no (further) constraints on this element Element Id Consent.provision.type Short description deny \| permit Definition Action to take - permit or deny - when the rule conditions are met. Not permitted in root rule, required in all nested rules. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type code Binding How a rule statement is applied, such as adding additional consent or removing consent. ConsentProvisionType (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
period	Σ I	0..1	Period	There are no (further) constraints on this element Element Id Consent.provision.period Short description Timeframe for this rule Definition The timeframe in this rule is valid. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data Type Period Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` per-1:If present, start SHALL have a lower value than end `start.hasValue().not() or end.hasValue().not() or (start <= end)` Mappings rim:n/a v2:DR rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
actor		0..*	BackboneElement	Element Id Consent.provision.actor Short description Who\|what controlled by this rule (or group, by role) Definition Who or what is controlled by this rule. Use group to identify a set of actors by some property they share (e.g. 'admitting officers'). Data Type BackboneElement Sliced: Unordered, Open, by role(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
(All Slices)				There are no (further) constraints on this element
role		1..1	CodeableConceptBinding	There are no (further) constraints on this element Element Id Consent.provision.actor.role Short description How the actor is involved Definition How the individual is involved in the resources content that is described in the exception. 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 How an actor is involved in the consent considerations. SecurityRoleType (extensible) 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
reference	I	1..1	Reference(Device \| Group \| CareTeam \| Organization \| Patient \| Practitioner \| RelatedPerson \| PractitionerRole)	There are no (further) constraints on this element Element Id Consent.provision.actor.reference Short description Resource for the actor (or group, by role) Definition The resource that identifies the actor. To identify actors by type, use group to identify a set of actors by some property they share (e.g. 'admitting officers'). Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Device \| Group \| CareTeam \| Organization \| Patient \| Practitioner \| RelatedPerson \| PractitionerRole) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
representative		0..*	BackboneElement	There are no (further) constraints on this element Element Id Consent.provision.actor:representative Short description Who\|what controlled by this rule (or group, by role) Definition Who or what is controlled by this rule. Use group to identify a set of actors by some property they share (e.g. 'admitting officers'). Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
role		1..1	CodeableConceptBinding	Element Id Consent.provision.actor:representative.role Short description How the actor is involved Definition How the individual is involved in the resources content that is described in the exception. 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 How an actor is involved in the consent considerations. SecurityRoleType (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/v3-RoleCode", "code": "RESPRSN" } ] } Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
reference	I	1..1	Reference(Device \| Group \| CareTeam \| Organization \| Patient \| Practitioner \| RelatedPerson \| PractitionerRole \| HdBe ContactPerson)	Element Id Consent.provision.actor:representative.reference Short description Representative Alternate names Vertegenwoordiger Definition The person who is the legal representative or is appointed as the authorized representative in the signed authorization. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Device \| Group \| CareTeam \| Organization \| Patient \| Practitioner \| RelatedPerson \| PractitionerRole \| HdBe ContactPerson) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) zib-advancedirective-v3.1.1-2020EN:NL-CM:7.15.3 HdBe-AdvanceDirective:AdvanceDirective.Representative
action	Σ	0..*	CodeableConcept	There are no (further) constraints on this element Element Id Consent.provision.action Short description Actions controlled by this rule Definition Actions controlled by this Rule. Comments Note that this is the direct action (not the grounds for the action covered in the purpose element). At present, the only action in the understood and tested scope of this resource is 'read'. Data Type CodeableConcept Binding Detailed codes for the consent action. ConsentActionCodes (example) 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
securityLabel	Σ	0..*	CodingBinding	There are no (further) constraints on this element Element Id Consent.provision.securityLabel Short description Security Labels that define affected resources Definition A security label, comprised of 0..* security label fields (Privacy tags), which define which resources are controlled by this exception. Comments If the consent specifies a security label of "R" then it applies to all resources that are labeled "R" or lower. E.g. for Confidentiality, it's a high water mark. For other kinds of security labels, subsumption logic applies. When the purpose of use tag is on the data, access request purpose of use shall not conflict. Data Type Coding Binding Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible) 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 subset one of the sets of component 1-3 or 4-6 rim:CV orim:fhir:Coding rdfs:subClassOf dt:CDCoding
purpose	Σ	0..*	CodingBinding	There are no (further) constraints on this element Element Id Consent.provision.purpose Short description Context of activities covered by this rule Definition The context of the activities a user is taking - why the user is accessing the data - that are controlled by this rule. Comments When the purpose of use tag is on the data, access request purpose of use shall not conflict. Data Type Coding Binding What purposes of use are controlled by this exception. If more than one label is specified, operations must have all the specified labels. v3.PurposeOfUse (extensible) 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 subset one of the sets of component 1-3 or 4-6 rim:CV orim:fhir:Coding rdfs:subClassOf dt:CDCoding
class	Σ	0..*	CodingBinding	There are no (further) constraints on this element Element Id Consent.provision.class Short description e.g. Resource Type, Profile, CDA, etc. Definition The class of information covered by this rule. The type can be a FHIR resource type, a profile on a type, or a CDA document, or some other type that indicates what sort of information the consent relates to. Comments Multiple types are or'ed together. The intention of the contentType element is that the codes refer to profiles or document types defined in a standard or an implementation guide somewhere. Data Type Coding Binding The class (type) of information a consent rule covers. ConsentContentClass (extensible) 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 subset one of the sets of component 1-3 or 4-6 rim:CV orim:fhir:Coding rdfs:subClassOf dt:CDCoding
code	Σ	0..1	CodeableConceptBinding	Element Id Consent.provision.code Short description LivingWillType Alternate names WilsverklaringType Definition The type of living will. Comments Typical use of this is a Document code with class = CDA. Data Type CodeableConcept Binding If this code is found in an instance, then the exception applies. TypeOfLivingWill (extensible) 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 zib-advancedirective-v3.1.1-2020EN:NL-CM:7.15.2 HdBe-AdvanceDirective:AdvanceDirective.LivingWillType
dataPeriod	Σ I	0..1	Period	There are no (further) constraints on this element Element Id Consent.provision.dataPeriod Short description Timeframe for data controlled by this rule Definition Clinical or Operational Relevant period of time that bounds the data controlled by this rule. Comments This has a different sense to the Consent.period - that is when the consent agreement holds. This is the time period of the data that is controlled by the agreement. Data Type Period Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` per-1:If present, start SHALL have a lower value than end `start.hasValue().not() or end.hasValue().not() or (start <= end)` Mappings rim:n/a v2:DR rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
data	Σ	0..*	BackboneElement	There are no (further) constraints on this element Element Id Consent.provision.data Short description Data controlled by this rule Definition The resources controlled by this rule if specific resources are referenced. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:Role
meaning	Σ	1..1	codeBinding	There are no (further) constraints on this element Element Id Consent.provision.data.meaning Short description instance \| related \| dependents \| authoredby Definition How the resource reference is interpreted when testing consent restrictions. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type code Binding How a resource reference is interpreted when testing consent restrictions. ConsentDataMeaning (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
reference	Σ I	1..1	Reference(Resource)	There are no (further) constraints on this element Element Id Consent.provision.data.reference Short description The actual data reference Definition A reference to a specific resource that defines which resources are covered by this consent. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Resource) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
provision		0..*	see (provision)	There are no (further) constraints on this element Element Id Consent.provision.provision Short description Nested Exception Rules Definition Rules which provide exceptions to the base rule or subrules.

Consent	I		Consent	Element Id Consent Short description AdvanceDirective Alternate names Wilsverklaring Definition A record of a healthcare consumer’s choices, which permits or denies identified recipient(s) or recipient role(s) to perform one or more actions within a given policy context, for specific purposes and periods of time. Comments Broadly, there are 3 key areas of consent for patients: Consent around sharing information (aka Privacy Consent Directive - Authorization to Collect, Use, or Disclose information), consent for specific treatment, or kinds of treatment, and general advance care directives. Data Type Consent Constraints dom-2:If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-4: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-3: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-6:A resource should have narrative for robust management text.`div`.exists() dom-5:If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` ppc-4:IF Scope=adr, there must be a patient `patient.exists() or scope.coding.where(system='something' and code='adr').exists().not()` ppc-5:IF Scope=treatment, there must be a patient `patient.exists() or scope.coding.where(system='something' and code='treatment').exists().not()` ppc-2:IF Scope=privacy, there must be a patient `patient.exists() or scope.coding.where(system='something' and code='patient-privacy').exists().not()` ppc-3:IF Scope=research, there must be a patient `patient.exists() or scope.coding.where(system='something' and code='research').exists().not()` ppc-1:Either a Policy or PolicyRule `policy.exists() or policyRule.exists()` Mappings rim:Entity. Role, or Act workflow:Event v2:CON rim:FinancialConsent zib-advancedirective-v3.1.1-2020EN:NL-CM:7.15.1 HdBe-AdvanceDirective:AdvanceDirective
extension	I	0..*	Extension	Element Id Consent.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 resource. 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) 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
disorder	I	0..*	Extension(Reference(HdBe Problem))	Element Id Consent.extension:disorder Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. 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(Reference(HdBe Problem)) Extension URL https://fhir.healthdata.be/StructureDefinition/ext-AdvanceDirective.Disorder 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
comment	I	0..1	Extension(string)	Element Id Consent.extension:comment Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. 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(string) Extension URL https://fhir.healthdata.be/StructureDefinition/ext-Comment 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
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id Consent.extension:comment.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments 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. Data Type System.String Fixed Value https://fhir.healthdata.be/StructureDefinition/ext-Comment Mappings rim:N/A
value[x]		0..1		Element Id Consent.extension:comment.value[x] Short description Comment Alternate names Toelichting Definition Comment on the living will: the form, such as a medallion, tattoo, etc., or where the living will can be found. Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A zib-advancedirective-v3.1.1-2020EN:NL-CM:7.15.6 HdBe-AdvanceDirective:AdvanceDirective.Comment
valueString			string	There are no (further) constraints on this element Data Type string
identifier	Σ	0..*	Identifier	There are no (further) constraints on this element Element Id Consent.identifier Short description Identifier for this record (external references) Definition Unique identifier for this copy of the Consent Statement. Comments This identifier identifies this copy of the consent. Where this identifier is also used elsewhere as the identifier for a consent record (e.g. a CDA consent document) then the consent details are expected to be the same. Data Type Identifier Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General { "system": "urn:ietf:rfc:3986", "value": "Local eCMS identifier" } Mappings rim:n/a v2:CX / EI (occasionally, more often EI maps to a resource id or a URL) rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd:Identifier workflow:Event.identifier w5:FiveWs.identifier rim:.id
status	Σ ?!	1..1	codeBinding	Element Id Consent.status Short description draft \| proposed \| active \| rejected \| inactive \| entered-in-error Definition Indicates the current state of this consent. Requirements The Consent Directive that is pointed to might be in various lifecycle states, e.g., a revoked Consent Directive. Comments This element has no functional counterpart in the CBB and cannot be implicitly mapped to other concepts. Unless a more appropriate status is recorded, it is assumed that only active Consent resources will be exchanged. Data Type code Binding Indicates the state of the consent. ConsentState (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a workflow:Event.status w5:FiveWs.status v2:HL7 Table 0498 - Consent Status rim:.statusCode
scope	Σ ?!	1..1	CodeableConceptBinding	Element Id Consent.scope Short description Which of the four areas this resource covers (extensible) Definition A selector of the type of consent being presented: ADR, Privacy, Treatment, Research. This list is now extensible. Comments At the moment of writing (02-11-2021) the adr code is incorrectly removed from the ConsentScopeCodes CodeSystem (http://terminology.hl7.org/CodeSystem/consentscope). This will be corrected within the R4 release of FHIR based on this tracker item: https://jira.hl7.org/browse/FHIR-34215. Data Type CodeableConcept Binding The four anticipated uses for the Consent Resource. ConsentScopeCodes (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/consentscope", "code": "adr" } ] } Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
category	Σ	1..*	CodeableConceptBinding	Element Id Consent.category Short description Classification of the consent statement - for indexing/retrieval Definition A classification of the type of consents found in the statement. This element supports indexing and retrieval of consent statements. 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 A classification of the type of consents found in a consent statement. ConsentCategoryCodes (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/consentcategorycodes", "code": "acd" } ] } Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD workflow:Event.code w5:FiveWs.class v2:HL7 Table 0497 - Consent Type rim:CNTRCT
patient	Σ I	0..1	Reference(Patient)	There are no (further) constraints on this element Element Id Consent.patient Short description Who the consent applies to Definition The patient/healthcare consumer to whom this consent applies. Comments Commonly, the patient the consent pertains to is the author, but for young and old people, it may be some other person. Data Type Reference(Patient) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Event.subject w5:FiveWs.subject[x] rim:Role w5:FiveWs.subject
dateTime	Σ	0..1	dateTime	Element Id Consent.dateTime Short description LivingWillDate Alternate names WilsverklaringDatum Definition The date on which the living will was recorded. Comments This is not the time of the original consent, but the time that this statement was made or derived. 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 workflow:Event.occurrence[x] w5:FiveWs.recorded v2:Field 13/ Consent Decision Date rim:FinancialConsent effectiveTime zib-advancedirective-v3.1.1-2020EN:NL-CM:7.15.7 HdBe-AdvanceDirective:AdvanceDirective.LivingWillDate
performer	Σ I	0..*	Reference(Organization \| Patient \| Practitioner \| RelatedPerson \| PractitionerRole)	There are no (further) constraints on this element Element Id Consent.performer Short description Who is agreeing to the policy and rules Alternate names consentor Definition Either the Grantor, which is the entity responsible for granting the rights listed in a Consent Directive or the Grantee, which is the entity responsible for complying with the Consent Directive, including any obligations or limitations on authorizations and enforcement of prohibitions. Comments Commonly, the patient the consent pertains to is the consentor, but particularly for young and old people, it may be some other person - e.g. a legal guardian. Data Type Reference(Organization \| Patient \| Practitioner \| RelatedPerson \| PractitionerRole) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Event.performer w5:FiveWs.actor v2:Field 24/ ConsenterID
organization	Σ I	0..*	Reference(Organization)	There are no (further) constraints on this element Element Id Consent.organization Short description Custodian of the consent Alternate names custodian Definition The organization that manages the consent, and the framework within which it is executed. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Organization) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Event.performer w5:FiveWs.witness
source[x]	Σ	0..1		Element Id Consent.source[x] Short description Source from which this consent is taken Definition The source on which this consent statement is based. The source might be a scanned original paper form, or a reference to a consent that links back to such a source, a reference to a document repository (e.g. XDS) that stores the original consent document. Comments The source can be contained inline (Attachment), referenced directly (Consent), referenced in a consent repository (DocumentReference), or simply by an identifier (Identifier), e.g. a CDA document id. Sliced: Unordered, Open, by $this(Type) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:Field 19 Informational Material Supplied Indicator
sourceReference			Reference(Consent \| DocumentReference \| Contract \| QuestionnaireResponse)	There are no (further) constraints on this element Data Type Reference(Consent \| DocumentReference \| Contract \| QuestionnaireResponse)
sourceAttachment	Σ	0..1	Attachment	Element Id Consent.source[x]:sourceAttachment Short description Source from which this consent is taken Definition The source on which this consent statement is based. The source might be a scanned original paper form, or a reference to a consent that links back to such a source, a reference to a document repository (e.g. XDS) that stores the original consent document. Comments The source can be contained inline (Attachment), referenced directly (Consent), referenced in a consent repository (DocumentReference), or simply by an identifier (Identifier), e.g. a CDA document id. Data Type Attachment Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:Field 19 Informational Material Supplied Indicator
contentType	Σ	0..1	codeBinding	There are no (further) constraints on this element Element Id Consent.source[x]:sourceAttachment.contentType Short description Mime type of the content, with charset etc. Definition Identifies the type of the data in the attachment and allows a method to be chosen to interpret or render the data. Includes mime type parameters such as charset where appropriate. Requirements Processors of the data need to be able to know how to interpret the data. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type code Binding The mime type of an attachment. Any valid mime type is allowed. Mime Types (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General text/plain; charset=UTF-8, image/png Mappings rim:n/a v2:ED.2+ED.3/RP.2+RP.3. Note conversion may be needed if old style values are being used rim:./mediaType, ./charset
language	Σ	0..1	codeBinding	There are no (further) constraints on this element Element Id Consent.source[x]:sourceAttachment.language Short description Human language of the content (BCP-47) Definition The human language of the content. The value can be any valid value according to BCP 47. Requirements Users need to be able to choose between the languages in a set of attachments. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type code Binding A human language. CommonLanguages (preferred) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General en-AU Mappings rim:n/a rim:./language
data		0..1	base64Binary	Element Id Consent.source[x]:sourceAttachment.data Short description LivingWillDocument Alternate names WilsverklaringDocument Definition Scanned source document with the living will and the patient's signature, such as a PDF. Requirements The data needs to able to be transmitted inline. Comments The base64-encoded data SHALL be expressed in the same character set as the base resource XML or JSON. Data Type base64Binary Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:ED.5 rim:./data zib-advancedirective-v3.1.1-2020EN:NL-CM:7.15.5 HdBe-AdvanceDirective:AdvanceDirective.LivingWillDocument
url	Σ	0..1	url	There are no (further) constraints on this element Element Id Consent.source[x]:sourceAttachment.url Short description Uri where the data can be found Definition A location where the data can be accessed. Requirements The data needs to be transmitted by reference. Comments If both data and url are provided, the url SHALL point to the same content as the data contains. Urls may be relative references or may reference transient locations such as a wrapping envelope using cid: though this has ramifications for using signatures. Relative URLs are interpreted relative to the service url, like a resource reference, rather than relative to the resource itself. If a URL is provided, it SHALL resolve to actual data. Data Type url Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General http://www.acme.com/logo-small.png Mappings rim:n/a v2:RP.1+RP.2 - if they refer to a URL (see v2.6) rim:./reference/literal
size	Σ	0..1	unsignedInt	There are no (further) constraints on this element Element Id Consent.source[x]:sourceAttachment.size Short description Number of bytes of content (if url provided) Definition The number of bytes of data that make up this attachment (before base64 encoding, if that is done). Requirements Representing the size allows applications to determine whether they should fetch the content automatically in advance, or refuse to fetch it at all. Comments The number of bytes is redundant if the data is provided as a base64binary, but is useful if the data is provided as a url reference. Data Type unsignedInt Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A (needs data type R3 proposal)
hash	Σ	0..1	base64Binary	There are no (further) constraints on this element Element Id Consent.source[x]:sourceAttachment.hash Short description Hash of the data (sha-1, base64ed) Definition The calculated hash of the data using SHA-1. Represented using base64. Requirements Included so that applications can verify that the contents of a location have not changed due to technical failures (e.g., storage rot, transport glitch, incorrect version). Comments The hash is calculated on the data prior to base64 encoding, if the data is based64 encoded. The hash is not intended to support digital signatures. Where protection against malicious threats a digital signature should be considered, see Provenance.signature for mechanism to protect a resource with a digital signature. Data Type base64Binary Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:.integrityCheck[parent::ED/integrityCheckAlgorithm="SHA-1"]
title	Σ	0..1	string	There are no (further) constraints on this element Element Id Consent.source[x]:sourceAttachment.title Short description Label to display in place of the data Definition A label or set of text to display in place of the data. Requirements Applications need a label to display to a human user in place of the actual data if the data cannot be rendered or perceived by the viewer. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General Official Corporate Logo Mappings rim:n/a rim:./title/data
creation	Σ	0..1	dateTime	There are no (further) constraints on this element Element Id Consent.source[x]:sourceAttachment.creation Short description Date attachment was first created Definition The date that the attachment was first created. Requirements This is often tracked as an integrity issue for use of the attachment. 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 rim:N/A (needs data type R3 proposal)
policy		0..*	BackboneElement	There are no (further) constraints on this element Element Id Consent.policy Short description Policies covered by this consent Definition The references to the policies that are included in this consent scope. Policies may be organizational, but are often defined jurisdictionally, or in law. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
authority	I	0..1	uri	There are no (further) constraints on this element Element Id Consent.policy.authority Short description Enforcement source for policy Definition Entity or Organization having regulatory jurisdiction or accountability for enforcing policies pertaining to Consent Directives. Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
uri	I	0..1	uri	Element Id Consent.policy.uri Short description Specific policy covered by this consent Definition The references to the policies that are included in this consent scope. Policies may be organizational, but are often defined jurisdictionally, or in law. Comments Either `.policy` or `.policyRule` should exist following core constraint ppc-1. If no explicit value is recorded, a fallback is to populate `.policy.uri` with https://www.belgielex.be/ if the advance directive is recorded following Belgium law and regulations. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
policyRule	Σ I	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element Id Consent.policyRule Short description Regulation that this consents to Definition A reference to the specific base computable regulation or policy. Requirements Might be a unique identifier of a policy set in XACML, or other rules engine. Comments If the policyRule is absent, computable consent would need to be constructed from the elements of the Consent resource. Data Type CodeableConcept Binding Regulatory policy examples. ConsentPolicyRuleCodes (extensible) 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
verification	Σ	0..*	BackboneElement	There are no (further) constraints on this element Element Id Consent.verification Short description Consent Verified by patient or family Definition Whether a treatment instruction (e.g. artificial respiration yes or no) was verified with the patient, his/her family or another authorized person. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
verified	Σ	1..1	boolean	There are no (further) constraints on this element Element Id Consent.verification.verified Short description Has been verified Definition Has the instruction been verified. Data Type boolean Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
verifiedWith	I	0..1	Reference(Patient \| RelatedPerson)	There are no (further) constraints on this element Element Id Consent.verification.verifiedWith Short description Person who verified Definition Who verified the instruction (Patient, Relative or other Authorized Person). Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Patient \| RelatedPerson) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
verificationDate		0..1	dateTime	There are no (further) constraints on this element Element Id Consent.verification.verificationDate Short description When consent verified Definition Date verification was collected. 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
provision	Σ	0..1	BackboneElement	There are no (further) constraints on this element Element Id Consent.provision Short description Constraints to the base Consent.policyRule Definition An exception to the base policy of this consent. An exception can be an addition or removal of access permissions. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
type	Σ	0..1	codeBinding	There are no (further) constraints on this element Element Id Consent.provision.type Short description deny \| permit Definition Action to take - permit or deny - when the rule conditions are met. Not permitted in root rule, required in all nested rules. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type code Binding How a rule statement is applied, such as adding additional consent or removing consent. ConsentProvisionType (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
period	Σ I	0..1	Period	There are no (further) constraints on this element Element Id Consent.provision.period Short description Timeframe for this rule Definition The timeframe in this rule is valid. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data Type Period Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` per-1:If present, start SHALL have a lower value than end `start.hasValue().not() or end.hasValue().not() or (start <= end)` Mappings rim:n/a v2:DR rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
actor		0..*	BackboneElement	Element Id Consent.provision.actor Short description Who\|what controlled by this rule (or group, by role) Definition Who or what is controlled by this rule. Use group to identify a set of actors by some property they share (e.g. 'admitting officers'). Data Type BackboneElement Sliced: Unordered, Open, by role(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
(All Slices)				There are no (further) constraints on this element
role		1..1	CodeableConceptBinding	There are no (further) constraints on this element Element Id Consent.provision.actor.role Short description How the actor is involved Definition How the individual is involved in the resources content that is described in the exception. 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 How an actor is involved in the consent considerations. SecurityRoleType (extensible) 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
reference	I	1..1	Reference(Device \| Group \| CareTeam \| Organization \| Patient \| Practitioner \| RelatedPerson \| PractitionerRole)	There are no (further) constraints on this element Element Id Consent.provision.actor.reference Short description Resource for the actor (or group, by role) Definition The resource that identifies the actor. To identify actors by type, use group to identify a set of actors by some property they share (e.g. 'admitting officers'). Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Device \| Group \| CareTeam \| Organization \| Patient \| Practitioner \| RelatedPerson \| PractitionerRole) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
representative		0..*	BackboneElement	There are no (further) constraints on this element Element Id Consent.provision.actor:representative Short description Who\|what controlled by this rule (or group, by role) Definition Who or what is controlled by this rule. Use group to identify a set of actors by some property they share (e.g. 'admitting officers'). Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
role		1..1	CodeableConceptBinding	Element Id Consent.provision.actor:representative.role Short description How the actor is involved Definition How the individual is involved in the resources content that is described in the exception. 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 How an actor is involved in the consent considerations. SecurityRoleType (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/v3-RoleCode", "code": "RESPRSN" } ] } Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
reference	I	1..1	Reference(Device \| Group \| CareTeam \| Organization \| Patient \| Practitioner \| RelatedPerson \| PractitionerRole \| HdBe ContactPerson)	Element Id Consent.provision.actor:representative.reference Short description Representative Alternate names Vertegenwoordiger Definition The person who is the legal representative or is appointed as the authorized representative in the signed authorization. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Device \| Group \| CareTeam \| Organization \| Patient \| Practitioner \| RelatedPerson \| PractitionerRole \| HdBe ContactPerson) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) zib-advancedirective-v3.1.1-2020EN:NL-CM:7.15.3 HdBe-AdvanceDirective:AdvanceDirective.Representative
action	Σ	0..*	CodeableConcept	There are no (further) constraints on this element Element Id Consent.provision.action Short description Actions controlled by this rule Definition Actions controlled by this Rule. Comments Note that this is the direct action (not the grounds for the action covered in the purpose element). At present, the only action in the understood and tested scope of this resource is 'read'. Data Type CodeableConcept Binding Detailed codes for the consent action. ConsentActionCodes (example) 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
securityLabel	Σ	0..*	CodingBinding	There are no (further) constraints on this element Element Id Consent.provision.securityLabel Short description Security Labels that define affected resources Definition A security label, comprised of 0..* security label fields (Privacy tags), which define which resources are controlled by this exception. Comments If the consent specifies a security label of "R" then it applies to all resources that are labeled "R" or lower. E.g. for Confidentiality, it's a high water mark. For other kinds of security labels, subsumption logic applies. When the purpose of use tag is on the data, access request purpose of use shall not conflict. Data Type Coding Binding Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible) 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 subset one of the sets of component 1-3 or 4-6 rim:CV orim:fhir:Coding rdfs:subClassOf dt:CDCoding
purpose	Σ	0..*	CodingBinding	There are no (further) constraints on this element Element Id Consent.provision.purpose Short description Context of activities covered by this rule Definition The context of the activities a user is taking - why the user is accessing the data - that are controlled by this rule. Comments When the purpose of use tag is on the data, access request purpose of use shall not conflict. Data Type Coding Binding What purposes of use are controlled by this exception. If more than one label is specified, operations must have all the specified labels. v3.PurposeOfUse (extensible) 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 subset one of the sets of component 1-3 or 4-6 rim:CV orim:fhir:Coding rdfs:subClassOf dt:CDCoding
class	Σ	0..*	CodingBinding	There are no (further) constraints on this element Element Id Consent.provision.class Short description e.g. Resource Type, Profile, CDA, etc. Definition The class of information covered by this rule. The type can be a FHIR resource type, a profile on a type, or a CDA document, or some other type that indicates what sort of information the consent relates to. Comments Multiple types are or'ed together. The intention of the contentType element is that the codes refer to profiles or document types defined in a standard or an implementation guide somewhere. Data Type Coding Binding The class (type) of information a consent rule covers. ConsentContentClass (extensible) 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 subset one of the sets of component 1-3 or 4-6 rim:CV orim:fhir:Coding rdfs:subClassOf dt:CDCoding
code	Σ	0..1	CodeableConceptBinding	Element Id Consent.provision.code Short description LivingWillType Alternate names WilsverklaringType Definition The type of living will. Comments Typical use of this is a Document code with class = CDA. Data Type CodeableConcept Binding If this code is found in an instance, then the exception applies. TypeOfLivingWill (extensible) 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 zib-advancedirective-v3.1.1-2020EN:NL-CM:7.15.2 HdBe-AdvanceDirective:AdvanceDirective.LivingWillType
dataPeriod	Σ I	0..1	Period	There are no (further) constraints on this element Element Id Consent.provision.dataPeriod Short description Timeframe for data controlled by this rule Definition Clinical or Operational Relevant period of time that bounds the data controlled by this rule. Comments This has a different sense to the Consent.period - that is when the consent agreement holds. This is the time period of the data that is controlled by the agreement. Data Type Period Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` per-1:If present, start SHALL have a lower value than end `start.hasValue().not() or end.hasValue().not() or (start <= end)` Mappings rim:n/a v2:DR rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
data	Σ	0..*	BackboneElement	There are no (further) constraints on this element Element Id Consent.provision.data Short description Data controlled by this rule Definition The resources controlled by this rule if specific resources are referenced. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:Role
meaning	Σ	1..1	codeBinding	There are no (further) constraints on this element Element Id Consent.provision.data.meaning Short description instance \| related \| dependents \| authoredby Definition How the resource reference is interpreted when testing consent restrictions. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type code Binding How a resource reference is interpreted when testing consent restrictions. ConsentDataMeaning (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
reference	Σ I	1..1	Reference(Resource)	There are no (further) constraints on this element Element Id Consent.provision.data.reference Short description The actual data reference Definition A reference to a specific resource that defines which resources are covered by this consent. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Resource) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
provision		0..*	see (provision)	There are no (further) constraints on this element Element Id Consent.provision.provision Short description Nested Exception Rules Definition Rules which provide exceptions to the base rule or subrules.

Consent	I		Consent	Element Id Consent Short description AdvanceDirective Alternate names Wilsverklaring Definition A record of a healthcare consumer’s choices, which permits or denies identified recipient(s) or recipient role(s) to perform one or more actions within a given policy context, for specific purposes and periods of time. Comments Broadly, there are 3 key areas of consent for patients: Consent around sharing information (aka Privacy Consent Directive - Authorization to Collect, Use, or Disclose information), consent for specific treatment, or kinds of treatment, and general advance care directives. Data Type Consent Constraints dom-2:If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-4: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-3: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-6:A resource should have narrative for robust management text.`div`.exists() dom-5:If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` ppc-4:IF Scope=adr, there must be a patient `patient.exists() or scope.coding.where(system='something' and code='adr').exists().not()` ppc-5:IF Scope=treatment, there must be a patient `patient.exists() or scope.coding.where(system='something' and code='treatment').exists().not()` ppc-2:IF Scope=privacy, there must be a patient `patient.exists() or scope.coding.where(system='something' and code='patient-privacy').exists().not()` ppc-3:IF Scope=research, there must be a patient `patient.exists() or scope.coding.where(system='something' and code='research').exists().not()` ppc-1:Either a Policy or PolicyRule `policy.exists() or policyRule.exists()` Mappings rim:Entity. Role, or Act workflow:Event v2:CON rim:FinancialConsent zib-advancedirective-v3.1.1-2020EN:NL-CM:7.15.1 HdBe-AdvanceDirective:AdvanceDirective
extension	I	0..*	Extension	Element Id Consent.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 resource. 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) 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
disorder	I	0..*	Extension(Reference(HdBe Problem))	Element Id Consent.extension:disorder Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. 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(Reference(HdBe Problem)) Extension URL https://fhir.healthdata.be/StructureDefinition/ext-AdvanceDirective.Disorder 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
comment	I	0..1	Extension(string)	Element Id Consent.extension:comment Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. 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(string) Extension URL https://fhir.healthdata.be/StructureDefinition/ext-Comment 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
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id Consent.extension:comment.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments 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. Data Type System.String Fixed Value https://fhir.healthdata.be/StructureDefinition/ext-Comment Mappings rim:N/A
value[x]		0..1		Element Id Consent.extension:comment.value[x] Short description Comment Alternate names Toelichting Definition Comment on the living will: the form, such as a medallion, tattoo, etc., or where the living will can be found. Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A zib-advancedirective-v3.1.1-2020EN:NL-CM:7.15.6 HdBe-AdvanceDirective:AdvanceDirective.Comment
valueString			string	There are no (further) constraints on this element Data Type string
identifier	Σ	0..*	Identifier	There are no (further) constraints on this element Element Id Consent.identifier Short description Identifier for this record (external references) Definition Unique identifier for this copy of the Consent Statement. Comments This identifier identifies this copy of the consent. Where this identifier is also used elsewhere as the identifier for a consent record (e.g. a CDA consent document) then the consent details are expected to be the same. Data Type Identifier Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General { "system": "urn:ietf:rfc:3986", "value": "Local eCMS identifier" } Mappings rim:n/a v2:CX / EI (occasionally, more often EI maps to a resource id or a URL) rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd:Identifier workflow:Event.identifier w5:FiveWs.identifier rim:.id
status	Σ ?!	1..1	codeBinding	Element Id Consent.status Short description draft \| proposed \| active \| rejected \| inactive \| entered-in-error Definition Indicates the current state of this consent. Requirements The Consent Directive that is pointed to might be in various lifecycle states, e.g., a revoked Consent Directive. Comments This element has no functional counterpart in the CBB and cannot be implicitly mapped to other concepts. Unless a more appropriate status is recorded, it is assumed that only active Consent resources will be exchanged. Data Type code Binding Indicates the state of the consent. ConsentState (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a workflow:Event.status w5:FiveWs.status v2:HL7 Table 0498 - Consent Status rim:.statusCode
scope	Σ ?!	1..1	CodeableConceptBinding	Element Id Consent.scope Short description Which of the four areas this resource covers (extensible) Definition A selector of the type of consent being presented: ADR, Privacy, Treatment, Research. This list is now extensible. Comments At the moment of writing (02-11-2021) the adr code is incorrectly removed from the ConsentScopeCodes CodeSystem (http://terminology.hl7.org/CodeSystem/consentscope). This will be corrected within the R4 release of FHIR based on this tracker item: https://jira.hl7.org/browse/FHIR-34215. Data Type CodeableConcept Binding The four anticipated uses for the Consent Resource. ConsentScopeCodes (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/consentscope", "code": "adr" } ] } Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
category	Σ	1..*	CodeableConceptBinding	Element Id Consent.category Short description Classification of the consent statement - for indexing/retrieval Definition A classification of the type of consents found in the statement. This element supports indexing and retrieval of consent statements. 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 A classification of the type of consents found in a consent statement. ConsentCategoryCodes (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/consentcategorycodes", "code": "acd" } ] } Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD workflow:Event.code w5:FiveWs.class v2:HL7 Table 0497 - Consent Type rim:CNTRCT
patient	Σ I	0..1	Reference(Patient)	There are no (further) constraints on this element Element Id Consent.patient Short description Who the consent applies to Definition The patient/healthcare consumer to whom this consent applies. Comments Commonly, the patient the consent pertains to is the author, but for young and old people, it may be some other person. Data Type Reference(Patient) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Event.subject w5:FiveWs.subject[x] rim:Role w5:FiveWs.subject
dateTime	Σ	0..1	dateTime	Element Id Consent.dateTime Short description LivingWillDate Alternate names WilsverklaringDatum Definition The date on which the living will was recorded. Comments This is not the time of the original consent, but the time that this statement was made or derived. 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 workflow:Event.occurrence[x] w5:FiveWs.recorded v2:Field 13/ Consent Decision Date rim:FinancialConsent effectiveTime zib-advancedirective-v3.1.1-2020EN:NL-CM:7.15.7 HdBe-AdvanceDirective:AdvanceDirective.LivingWillDate
performer	Σ I	0..*	Reference(Organization \| Patient \| Practitioner \| RelatedPerson \| PractitionerRole)	There are no (further) constraints on this element Element Id Consent.performer Short description Who is agreeing to the policy and rules Alternate names consentor Definition Either the Grantor, which is the entity responsible for granting the rights listed in a Consent Directive or the Grantee, which is the entity responsible for complying with the Consent Directive, including any obligations or limitations on authorizations and enforcement of prohibitions. Comments Commonly, the patient the consent pertains to is the consentor, but particularly for young and old people, it may be some other person - e.g. a legal guardian. Data Type Reference(Organization \| Patient \| Practitioner \| RelatedPerson \| PractitionerRole) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Event.performer w5:FiveWs.actor v2:Field 24/ ConsenterID
organization	Σ I	0..*	Reference(Organization)	There are no (further) constraints on this element Element Id Consent.organization Short description Custodian of the consent Alternate names custodian Definition The organization that manages the consent, and the framework within which it is executed. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Organization) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Event.performer w5:FiveWs.witness
source[x]	Σ	0..1		Element Id Consent.source[x] Short description Source from which this consent is taken Definition The source on which this consent statement is based. The source might be a scanned original paper form, or a reference to a consent that links back to such a source, a reference to a document repository (e.g. XDS) that stores the original consent document. Comments The source can be contained inline (Attachment), referenced directly (Consent), referenced in a consent repository (DocumentReference), or simply by an identifier (Identifier), e.g. a CDA document id. Sliced: Unordered, Open, by $this(Type) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:Field 19 Informational Material Supplied Indicator
sourceReference			Reference(Consent \| DocumentReference \| Contract \| QuestionnaireResponse)	There are no (further) constraints on this element Data Type Reference(Consent \| DocumentReference \| Contract \| QuestionnaireResponse)
sourceAttachment	Σ	0..1	Attachment	Element Id Consent.source[x]:sourceAttachment Short description Source from which this consent is taken Definition The source on which this consent statement is based. The source might be a scanned original paper form, or a reference to a consent that links back to such a source, a reference to a document repository (e.g. XDS) that stores the original consent document. Comments The source can be contained inline (Attachment), referenced directly (Consent), referenced in a consent repository (DocumentReference), or simply by an identifier (Identifier), e.g. a CDA document id. Data Type Attachment Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:Field 19 Informational Material Supplied Indicator
contentType	Σ	0..1	codeBinding	There are no (further) constraints on this element Element Id Consent.source[x]:sourceAttachment.contentType Short description Mime type of the content, with charset etc. Definition Identifies the type of the data in the attachment and allows a method to be chosen to interpret or render the data. Includes mime type parameters such as charset where appropriate. Requirements Processors of the data need to be able to know how to interpret the data. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type code Binding The mime type of an attachment. Any valid mime type is allowed. Mime Types (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General text/plain; charset=UTF-8, image/png Mappings rim:n/a v2:ED.2+ED.3/RP.2+RP.3. Note conversion may be needed if old style values are being used rim:./mediaType, ./charset
language	Σ	0..1	codeBinding	There are no (further) constraints on this element Element Id Consent.source[x]:sourceAttachment.language Short description Human language of the content (BCP-47) Definition The human language of the content. The value can be any valid value according to BCP 47. Requirements Users need to be able to choose between the languages in a set of attachments. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type code Binding A human language. CommonLanguages (preferred) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General en-AU Mappings rim:n/a rim:./language
data		0..1	base64Binary	Element Id Consent.source[x]:sourceAttachment.data Short description LivingWillDocument Alternate names WilsverklaringDocument Definition Scanned source document with the living will and the patient's signature, such as a PDF. Requirements The data needs to able to be transmitted inline. Comments The base64-encoded data SHALL be expressed in the same character set as the base resource XML or JSON. Data Type base64Binary Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:ED.5 rim:./data zib-advancedirective-v3.1.1-2020EN:NL-CM:7.15.5 HdBe-AdvanceDirective:AdvanceDirective.LivingWillDocument
url	Σ	0..1	url	There are no (further) constraints on this element Element Id Consent.source[x]:sourceAttachment.url Short description Uri where the data can be found Definition A location where the data can be accessed. Requirements The data needs to be transmitted by reference. Comments If both data and url are provided, the url SHALL point to the same content as the data contains. Urls may be relative references or may reference transient locations such as a wrapping envelope using cid: though this has ramifications for using signatures. Relative URLs are interpreted relative to the service url, like a resource reference, rather than relative to the resource itself. If a URL is provided, it SHALL resolve to actual data. Data Type url Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General http://www.acme.com/logo-small.png Mappings rim:n/a v2:RP.1+RP.2 - if they refer to a URL (see v2.6) rim:./reference/literal
size	Σ	0..1	unsignedInt	There are no (further) constraints on this element Element Id Consent.source[x]:sourceAttachment.size Short description Number of bytes of content (if url provided) Definition The number of bytes of data that make up this attachment (before base64 encoding, if that is done). Requirements Representing the size allows applications to determine whether they should fetch the content automatically in advance, or refuse to fetch it at all. Comments The number of bytes is redundant if the data is provided as a base64binary, but is useful if the data is provided as a url reference. Data Type unsignedInt Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A (needs data type R3 proposal)
hash	Σ	0..1	base64Binary	There are no (further) constraints on this element Element Id Consent.source[x]:sourceAttachment.hash Short description Hash of the data (sha-1, base64ed) Definition The calculated hash of the data using SHA-1. Represented using base64. Requirements Included so that applications can verify that the contents of a location have not changed due to technical failures (e.g., storage rot, transport glitch, incorrect version). Comments The hash is calculated on the data prior to base64 encoding, if the data is based64 encoded. The hash is not intended to support digital signatures. Where protection against malicious threats a digital signature should be considered, see Provenance.signature for mechanism to protect a resource with a digital signature. Data Type base64Binary Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:.integrityCheck[parent::ED/integrityCheckAlgorithm="SHA-1"]
title	Σ	0..1	string	There are no (further) constraints on this element Element Id Consent.source[x]:sourceAttachment.title Short description Label to display in place of the data Definition A label or set of text to display in place of the data. Requirements Applications need a label to display to a human user in place of the actual data if the data cannot be rendered or perceived by the viewer. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General Official Corporate Logo Mappings rim:n/a rim:./title/data
creation	Σ	0..1	dateTime	There are no (further) constraints on this element Element Id Consent.source[x]:sourceAttachment.creation Short description Date attachment was first created Definition The date that the attachment was first created. Requirements This is often tracked as an integrity issue for use of the attachment. 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 rim:N/A (needs data type R3 proposal)
policy		0..*	BackboneElement	There are no (further) constraints on this element Element Id Consent.policy Short description Policies covered by this consent Definition The references to the policies that are included in this consent scope. Policies may be organizational, but are often defined jurisdictionally, or in law. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
authority	I	0..1	uri	There are no (further) constraints on this element Element Id Consent.policy.authority Short description Enforcement source for policy Definition Entity or Organization having regulatory jurisdiction or accountability for enforcing policies pertaining to Consent Directives. Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
uri	I	0..1	uri	Element Id Consent.policy.uri Short description Specific policy covered by this consent Definition The references to the policies that are included in this consent scope. Policies may be organizational, but are often defined jurisdictionally, or in law. Comments Either `.policy` or `.policyRule` should exist following core constraint ppc-1. If no explicit value is recorded, a fallback is to populate `.policy.uri` with https://www.belgielex.be/ if the advance directive is recorded following Belgium law and regulations. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
policyRule	Σ I	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element Id Consent.policyRule Short description Regulation that this consents to Definition A reference to the specific base computable regulation or policy. Requirements Might be a unique identifier of a policy set in XACML, or other rules engine. Comments If the policyRule is absent, computable consent would need to be constructed from the elements of the Consent resource. Data Type CodeableConcept Binding Regulatory policy examples. ConsentPolicyRuleCodes (extensible) 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
verification	Σ	0..*	BackboneElement	There are no (further) constraints on this element Element Id Consent.verification Short description Consent Verified by patient or family Definition Whether a treatment instruction (e.g. artificial respiration yes or no) was verified with the patient, his/her family or another authorized person. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
verified	Σ	1..1	boolean	There are no (further) constraints on this element Element Id Consent.verification.verified Short description Has been verified Definition Has the instruction been verified. Data Type boolean Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
verifiedWith	I	0..1	Reference(Patient \| RelatedPerson)	There are no (further) constraints on this element Element Id Consent.verification.verifiedWith Short description Person who verified Definition Who verified the instruction (Patient, Relative or other Authorized Person). Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Patient \| RelatedPerson) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
verificationDate		0..1	dateTime	There are no (further) constraints on this element Element Id Consent.verification.verificationDate Short description When consent verified Definition Date verification was collected. 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
provision	Σ	0..1	BackboneElement	There are no (further) constraints on this element Element Id Consent.provision Short description Constraints to the base Consent.policyRule Definition An exception to the base policy of this consent. An exception can be an addition or removal of access permissions. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
type	Σ	0..1	codeBinding	There are no (further) constraints on this element Element Id Consent.provision.type Short description deny \| permit Definition Action to take - permit or deny - when the rule conditions are met. Not permitted in root rule, required in all nested rules. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type code Binding How a rule statement is applied, such as adding additional consent or removing consent. ConsentProvisionType (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
period	Σ I	0..1	Period	There are no (further) constraints on this element Element Id Consent.provision.period Short description Timeframe for this rule Definition The timeframe in this rule is valid. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data Type Period Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` per-1:If present, start SHALL have a lower value than end `start.hasValue().not() or end.hasValue().not() or (start <= end)` Mappings rim:n/a v2:DR rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
actor		0..*	BackboneElement	Element Id Consent.provision.actor Short description Who\|what controlled by this rule (or group, by role) Definition Who or what is controlled by this rule. Use group to identify a set of actors by some property they share (e.g. 'admitting officers'). Data Type BackboneElement Sliced: Unordered, Open, by role(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
(All Slices)				There are no (further) constraints on this element
role		1..1	CodeableConceptBinding	There are no (further) constraints on this element Element Id Consent.provision.actor.role Short description How the actor is involved Definition How the individual is involved in the resources content that is described in the exception. 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 How an actor is involved in the consent considerations. SecurityRoleType (extensible) 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
reference	I	1..1	Reference(Device \| Group \| CareTeam \| Organization \| Patient \| Practitioner \| RelatedPerson \| PractitionerRole)	There are no (further) constraints on this element Element Id Consent.provision.actor.reference Short description Resource for the actor (or group, by role) Definition The resource that identifies the actor. To identify actors by type, use group to identify a set of actors by some property they share (e.g. 'admitting officers'). Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Device \| Group \| CareTeam \| Organization \| Patient \| Practitioner \| RelatedPerson \| PractitionerRole) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
representative		0..*	BackboneElement	There are no (further) constraints on this element Element Id Consent.provision.actor:representative Short description Who\|what controlled by this rule (or group, by role) Definition Who or what is controlled by this rule. Use group to identify a set of actors by some property they share (e.g. 'admitting officers'). Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
role		1..1	CodeableConceptBinding	Element Id Consent.provision.actor:representative.role Short description How the actor is involved Definition How the individual is involved in the resources content that is described in the exception. 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 How an actor is involved in the consent considerations. SecurityRoleType (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/v3-RoleCode", "code": "RESPRSN" } ] } Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
reference	I	1..1	Reference(Device \| Group \| CareTeam \| Organization \| Patient \| Practitioner \| RelatedPerson \| PractitionerRole \| HdBe ContactPerson)	Element Id Consent.provision.actor:representative.reference Short description Representative Alternate names Vertegenwoordiger Definition The person who is the legal representative or is appointed as the authorized representative in the signed authorization. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Device \| Group \| CareTeam \| Organization \| Patient \| Practitioner \| RelatedPerson \| PractitionerRole \| HdBe ContactPerson) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) zib-advancedirective-v3.1.1-2020EN:NL-CM:7.15.3 HdBe-AdvanceDirective:AdvanceDirective.Representative
action	Σ	0..*	CodeableConcept	There are no (further) constraints on this element Element Id Consent.provision.action Short description Actions controlled by this rule Definition Actions controlled by this Rule. Comments Note that this is the direct action (not the grounds for the action covered in the purpose element). At present, the only action in the understood and tested scope of this resource is 'read'. Data Type CodeableConcept Binding Detailed codes for the consent action. ConsentActionCodes (example) 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
securityLabel	Σ	0..*	CodingBinding	There are no (further) constraints on this element Element Id Consent.provision.securityLabel Short description Security Labels that define affected resources Definition A security label, comprised of 0..* security label fields (Privacy tags), which define which resources are controlled by this exception. Comments If the consent specifies a security label of "R" then it applies to all resources that are labeled "R" or lower. E.g. for Confidentiality, it's a high water mark. For other kinds of security labels, subsumption logic applies. When the purpose of use tag is on the data, access request purpose of use shall not conflict. Data Type Coding Binding Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible) 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 subset one of the sets of component 1-3 or 4-6 rim:CV orim:fhir:Coding rdfs:subClassOf dt:CDCoding
purpose	Σ	0..*	CodingBinding	There are no (further) constraints on this element Element Id Consent.provision.purpose Short description Context of activities covered by this rule Definition The context of the activities a user is taking - why the user is accessing the data - that are controlled by this rule. Comments When the purpose of use tag is on the data, access request purpose of use shall not conflict. Data Type Coding Binding What purposes of use are controlled by this exception. If more than one label is specified, operations must have all the specified labels. v3.PurposeOfUse (extensible) 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 subset one of the sets of component 1-3 or 4-6 rim:CV orim:fhir:Coding rdfs:subClassOf dt:CDCoding
class	Σ	0..*	CodingBinding	There are no (further) constraints on this element Element Id Consent.provision.class Short description e.g. Resource Type, Profile, CDA, etc. Definition The class of information covered by this rule. The type can be a FHIR resource type, a profile on a type, or a CDA document, or some other type that indicates what sort of information the consent relates to. Comments Multiple types are or'ed together. The intention of the contentType element is that the codes refer to profiles or document types defined in a standard or an implementation guide somewhere. Data Type Coding Binding The class (type) of information a consent rule covers. ConsentContentClass (extensible) 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 subset one of the sets of component 1-3 or 4-6 rim:CV orim:fhir:Coding rdfs:subClassOf dt:CDCoding
code	Σ	0..1	CodeableConceptBinding	Element Id Consent.provision.code Short description LivingWillType Alternate names WilsverklaringType Definition The type of living will. Comments Typical use of this is a Document code with class = CDA. Data Type CodeableConcept Binding If this code is found in an instance, then the exception applies. TypeOfLivingWill (extensible) 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 zib-advancedirective-v3.1.1-2020EN:NL-CM:7.15.2 HdBe-AdvanceDirective:AdvanceDirective.LivingWillType
dataPeriod	Σ I	0..1	Period	There are no (further) constraints on this element Element Id Consent.provision.dataPeriod Short description Timeframe for data controlled by this rule Definition Clinical or Operational Relevant period of time that bounds the data controlled by this rule. Comments This has a different sense to the Consent.period - that is when the consent agreement holds. This is the time period of the data that is controlled by the agreement. Data Type Period Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` per-1:If present, start SHALL have a lower value than end `start.hasValue().not() or end.hasValue().not() or (start <= end)` Mappings rim:n/a v2:DR rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
data	Σ	0..*	BackboneElement	There are no (further) constraints on this element Element Id Consent.provision.data Short description Data controlled by this rule Definition The resources controlled by this rule if specific resources are referenced. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:Role
meaning	Σ	1..1	codeBinding	There are no (further) constraints on this element Element Id Consent.provision.data.meaning Short description instance \| related \| dependents \| authoredby Definition How the resource reference is interpreted when testing consent restrictions. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type code Binding How a resource reference is interpreted when testing consent restrictions. ConsentDataMeaning (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
reference	Σ I	1..1	Reference(Resource)	There are no (further) constraints on this element Element Id Consent.provision.data.reference Short description The actual data reference Definition A reference to a specific resource that defines which resources are covered by this consent. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Resource) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
provision		0..*	see (provision)	There are no (further) constraints on this element Element Id Consent.provision.provision Short description Nested Exception Rules Definition Rules which provide exceptions to the base rule or subrules.

Mapping FHIR profile to CBB

Path	map	CBB
Consent	AdvanceDirective	HdBe-AdvanceDirective
Consent.extension:comment.value[x]	AdvanceDirective.Comment	HdBe-AdvanceDirective
Consent.dateTime	AdvanceDirective.LivingWillDate	HdBe-AdvanceDirective
Consent.source[x]:sourceAttachment.data	AdvanceDirective.LivingWillDocument	HdBe-AdvanceDirective
Consent.provision.actor:representative.reference	AdvanceDirective.Representative	HdBe-AdvanceDirective
Consent.provision.code	AdvanceDirective.LivingWillType	HdBe-AdvanceDirective

HdBe-AdvanceDirective-01

zib AdvanceDirective difference

Concept	Category	Description
`StructureDefinition.description`	textual	Replaced LivingWill with AdvanceDirective where appopriate. (zib ticket #1597).
`policy.uri`	textual	Replaced Dutch context about Dutch law and the uri https://wetten.overheid.nl with Belgian context and default uri of https://www.belgielex.be/.
`provision.actor:representative`	cardinality	Loosened the cardinality from 0..1 to 0..* (zib ticket #1557).
`provision.code`	textual	Improved text (zib ticket #1587).
`provision.code`	terminology	Included NL SNOMED codes based on the codes found in the AdvanceDirective-v4.1(2022EN) LivingWillTypeSnomedCodelist. This needs to become International codes or codes available in the BE edition. (zib-1683)) Also made the ValueSet binding strenght Extensible instead of Required which is inline with the future version of the zib as well.

Terminology Bindings

Path	Name	Strength	URL	ConceptMap
Consent.provision.code	TypeOfLivingWill	extensible	https://fhir.healthdata.be/ValueSet/TypeOfLivingWill	No bound ConceptMap