<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="zib-TreatmentDirective2" />
  <text>
    <status value="empty" />
    <div xmlns="http://www.w3.org/1999/xhtml">No narrative is provided for definitional resources. A human-readable rendering can be found in the implementation guide(s) where this resource is used.</div>
  </text>
  <url value="http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective2" />
  <name value="ZibTreatmentDirective2" />
  <title value="zib TreatmentDirective2" />
  <status value="draft" />
  <publisher value="Nictiz" />
  <contact>
    <name value="Nictiz" />
    <telecom>
      <system value="url" />
      <value value="https://www.nictiz.nl" />
      <use value="work" />
    </telecom>
  </contact>
  <description value="A treatment directive contains a joint decision between a health professional (for example a general practitioner) and a patient or his representative(s) about the desirability of performing a certain treatment, such as resuscitation, before this treatment becomes (acute) necessary.&#xD;&#xA;When the need arises and the treatment cannot be discussed with the patient or representative (s), that decision is an important indication for the treating health professional (for example an ER doctor).&#xD;&#xA;The term treatment limit is a synonym of the term treatment directive." />
  <purpose value="This Consent resource represents the Dutch [zib ('Zorginformatiebouwsteen', i.e. Health and Care Information Model) TreatmentDirective2-v1.0 (2020)](https://zibs.nl/wiki/TreatmentDirective2-v1.0(2020EN))." />
  <copyright value="Copyright and related rights waived via CC0, https://creativecommons.org/publicdomain/zero/1.0/. This does not apply to information from third parties, for example a medical terminology system. The implementer alone is responsible for identifying and obtaining any necessary licenses or authorizations to utilize third party IP in connection with the specification or otherwise." />
  <fhirVersion value="4.0.1" />
  <mapping>
    <identity value="zib-treatmentdirective2-v1.0-2020EN" />
    <uri value="https://zibs.nl/wiki/TreatmentDirective2-v1.0(2020EN)" />
    <name value="zib TreatmentDirective2-v1.0(2020EN)" />
  </mapping>
  <kind value="resource" />
  <abstract value="true" />
  <type value="Consent" />
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Consent" />
  <derivation value="constraint" />
  <snapshot>
    <element id="Consent">
      <path value="Consent" />
      <short value="TreatmentDirective" />
      <definition value="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." />
      <comment value="A straightforward and accurate mapping of zib TreatmentDirective2 to FHIR is not possible. The main consideration is to choose between the Consent and CarePlan resource. Unfortunately, the Consent resource does not have full support for treatment directives yet as its main focus is to model Patient's privacy consents. Regardless, it seems to be the best match to represent the intention of the zib, as both the resource and the zib cover a mutual agreement about treatments and not per se the resulting actions or policy for treatments, which would better be handled using the CarePlan resource. Future migration to a later version of FHIR or the zib will result in the reevaluation of the mapping." />
      <alias value="BehandelAanwijzing" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Consent" />
        <min value="0" />
        <max value="*" />
      </base>
      <constraint>
        <key value="dom-2" />
        <severity value="error" />
        <human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources" />
        <expression value="contained.contained.empty()" />
        <xpath value="not(parent::f:contained and f:contained)" />
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
      </constraint>
      <constraint>
        <key value="dom-4" />
        <severity value="error" />
        <human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated" />
        <expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()" />
        <xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))" />
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
      </constraint>
      <constraint>
        <key value="dom-3" />
        <severity value="error" />
        <human value="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" />
        <expression value="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()" />
        <xpath value="not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))" />
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
      </constraint>
      <constraint>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
          <valueBoolean value="true" />
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
          <valueMarkdown value="When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time." />
        </extension>
        <key value="dom-6" />
        <severity value="warning" />
        <human value="A resource should have narrative for robust management" />
        <expression value="text.`div`.exists()" />
        <xpath value="exists(f:text/h:div)" />
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
      </constraint>
      <constraint>
        <key value="dom-5" />
        <severity value="error" />
        <human value="If a resource is contained in another resource, it SHALL NOT have a security label" />
        <expression value="contained.meta.security.empty()" />
        <xpath value="not(exists(f:contained/*/f:meta/f:security))" />
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
      </constraint>
      <constraint>
        <key value="ppc-4" />
        <severity value="error" />
        <human value="IF Scope=adr, there must be a patient" />
        <expression value="patient.exists() or scope.coding.where(system='something' and code='adr').exists().not()" />
        <xpath value="exists(f:patient) or not(exists(f:scope/f:coding[f:system/@value='something' and f:code/@value='adr'])))" />
        <source value="http://hl7.org/fhir/StructureDefinition/Consent" />
      </constraint>
      <constraint>
        <key value="ppc-5" />
        <severity value="error" />
        <human value="IF Scope=treatment, there must be a patient" />
        <expression value="patient.exists() or scope.coding.where(system='something' and code='treatment').exists().not()" />
        <xpath value="exists(f:patient) or not(exists(f:scope/f:coding[f:system/@value='something' and f:code/@value='treatment'])))" />
        <source value="http://hl7.org/fhir/StructureDefinition/Consent" />
      </constraint>
      <constraint>
        <key value="ppc-2" />
        <severity value="error" />
        <human value="IF Scope=privacy, there must be a patient" />
        <expression value="patient.exists() or scope.coding.where(system='something' and code='patient-privacy').exists().not()" />
        <xpath value="exists(f:patient) or not(exists(f:scope/f:coding[f:system/@value='something' and f:code/@value='patient-privacy'])))" />
        <source value="http://hl7.org/fhir/StructureDefinition/Consent" />
      </constraint>
      <constraint>
        <key value="ppc-3" />
        <severity value="error" />
        <human value="IF Scope=research, there must be a patient" />
        <expression value="patient.exists() or scope.coding.where(system='something' and code='research').exists().not()" />
        <xpath value="exists(f:patient) or not(exists(f:scope/f:coding[f:system/@value='something' and f:code/@value='research'])))" />
        <source value="http://hl7.org/fhir/StructureDefinition/Consent" />
      </constraint>
      <constraint>
        <key value="ppc-1" />
        <severity value="error" />
        <human value="Either a Policy or PolicyRule" />
        <expression value="policy.exists() or policyRule.exists()" />
        <xpath value="exists(f:policy) or exists(f:policyRule)" />
        <source value="http://hl7.org/fhir/StructureDefinition/Consent" />
      </constraint>
      <constraint>
        <key value="zib-TreatmentDirective2-1" />
        <severity value="error" />
        <human value="`extension.additionalAdvanceDirective` may only be used for AdvanceDirective references in addition to first reference in `.source[x]`." />
        <expression value="extension.where(url = 'http://nictiz.nl/fhir/StructureDefinition/ext-TreatmentDirective2.AdvanceDirective').empty() or source.exists()" />
        <source value="http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective2" />
      </constraint>
      <constraint>
        <key value="zib-TreatmentDirective2-2" />
        <severity value="error" />
        <human value="If the specificationOther extension is used, `.provision.type` MUST be absent and vice versa" />
        <expression value="(extension.where(url = 'http://nictiz.nl/fhir/StructureDefinition/ext-TreatmentDirective2.SpecificitionOther').exists() and provision.type.exists()).not()" />
        <source value="http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective2" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="Entity. Role, or Act" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Event" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CON" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="FinancialConsent" />
      </mapping>
      <mapping>
        <identity value="zib-treatmentdirective2-v1.0-2020EN" />
        <map value="NL-CM:2.2.1" />
        <comment value="TreatmentDirective" />
      </mapping>
    </element>
    <element id="Consent.id">
      <path value="Consent.id" />
      <short value="Logical id of this artifact" />
      <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes." />
      <comment value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Resource.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <isSummary value="true" />
    </element>
    <element id="Consent.meta">
      <path value="Consent.meta" />
      <short value="Metadata about the resource" />
      <definition value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Resource.meta" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Meta" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Consent.implicitRules">
      <path value="Consent.implicitRules" />
      <short value="A set of rules under which this content was created" />
      <definition value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc." />
      <comment value="Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Resource.implicitRules" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isModifier value="true" />
      <isModifierReason value="This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="Consent.language">
      <path value="Consent.language" />
      <short value="Language of the resource content" />
      <definition value="The base language in which the resource is written." />
      <comment value="Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute)." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Resource.language" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages" />
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Language" />
        </extension>
        <strength value="preferred" />
        <description value="A human language." />
        <valueSet value="http://hl7.org/fhir/ValueSet/languages" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="Consent.text">
      <path value="Consent.text" />
      <short value="Text summary of the resource, for human interpretation" />
      <definition value="A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety." />
      <comment value="Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a &quot;text blob&quot; or where text is additionally entered raw or narrated and encoded information is added later." />
      <alias value="narrative" />
      <alias value="html" />
      <alias value="xhtml" />
      <alias value="display" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="DomainResource.text" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Narrative" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Act.text?" />
      </mapping>
    </element>
    <element id="Consent.contained">
      <path value="Consent.contained" />
      <short value="Contained, inline Resources" />
      <definition value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope." />
      <comment value="This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels." />
      <alias value="inline resources" />
      <alias value="anonymous resources" />
      <alias value="contained resources" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="DomainResource.contained" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Resource" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="Entity. Role, or Act" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Consent.extension">
      <path value="Consent.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the 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." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="DomainResource.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Consent.extension:comment">
      <path value="Consent.extension" />
      <sliceName value="comment" />
      <short value="Optional Extensions Element" />
      <definition value="Optional Extension Element - found in all resources." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="DomainResource.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
        <profile value="http://nictiz.nl/fhir/StructureDefinition/ext-Comment" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Consent.extension:comment.id">
      <path value="Consent.extension.id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="Consent.extension:comment.extension">
      <path value="Consent.extension.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Consent.extension:comment.url">
      <path value="Consent.extension.url" />
      <representation value="xmlAttr" />
      <short value="identifies the meaning of the extension" />
      <definition value="Source of the definition for the extension code - a logical name or a URL." />
      <comment value="The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Extension.url" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="uri" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <fixedUri value="http://nictiz.nl/fhir/StructureDefinition/ext-Comment" />
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Consent.extension:comment.value[x]">
      <path value="Consent.extension.value[x]" />
      <short value="Comment" />
      <definition value="The comment may include further information such as the reason why a treatment directive has been drawn up, persons who assisted the patient in agreeing the treatment directive but who are not otherwise involved in the agreement as a representative, etc." />
      <alias value="Toelichting" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Extension.value[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
      <mapping>
        <identity value="zib-treatmentdirective2-v1.0-2020EN" />
        <map value="NL-CM:2.2.13" />
        <comment value="Comment" />
      </mapping>
    </element>
    <element id="Consent.extension:additionalAdvanceDirective">
      <path value="Consent.extension" />
      <sliceName value="additionalAdvanceDirective" />
      <short value="Optional Extensions Element" />
      <definition value="Optional Extension Element - found in all resources." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="DomainResource.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
        <profile value="http://nictiz.nl/fhir/StructureDefinition/ext-TreatmentDirective2.AdvanceDirective" />
      </type>
      <condition value="ele-1" />
      <condition value="zib-TreatmentDirective2-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Consent.extension:additionalAdvanceDirective.id">
      <path value="Consent.extension.id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="Consent.extension:additionalAdvanceDirective.extension">
      <path value="Consent.extension.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Consent.extension:additionalAdvanceDirective.url">
      <path value="Consent.extension.url" />
      <representation value="xmlAttr" />
      <short value="identifies the meaning of the extension" />
      <definition value="Source of the definition for the extension code - a logical name or a URL." />
      <comment value="The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Extension.url" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="uri" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <fixedUri value="http://nictiz.nl/fhir/StructureDefinition/ext-TreatmentDirective2.AdvanceDirective" />
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Consent.extension:additionalAdvanceDirective.value[x]">
      <path value="Consent.extension.value[x]" />
      <short value="AdvanceDirective" />
      <definition value="A (written) statement in which a person indicates wishes concerning future medical action, in the event that this person is at that point no longer (deemed) capable of taking decisions on the matter." />
      <comment value="`Consent.source:sourceReference` is the primary target for referencing zib AdvanceDirective (zib concept NL-CM:2.2.8). However, the cardinality of `Consent.source[x]` is restricted to `0..1`. If more than one AdvanceDirective needs to be referenced, the _additional_ references can be communicated using this extension. If this extension is used, `Consent.source:sourceReference` SHALL be populated and it SHALL not contain the same reference as this extension." />
      <alias value="Wilsverklaring" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Extension.value[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://nictiz.nl/fhir/StructureDefinition/zib-AdvanceDirective" />
      </type>
      <condition value="ele-1" />
      <condition value="zib-TreatmentDirective2-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
      <mapping>
        <identity value="zib-treatmentdirective2-v1.0-2020EN" />
        <map value="NL-CM:2.2.8" />
        <comment value="AdvanceDirective" />
      </mapping>
    </element>
    <element id="Consent.modifierExtension">
      <path value="Consent.modifierExtension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Extensions that cannot be ignored" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.&#xA;&#xA;Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="DomainResource.modifierExtension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <isModifier value="true" />
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Consent.modifierExtension:specificationOther">
      <path value="Consent.modifierExtension" />
      <sliceName value="specificationOther" />
      <short value="Optional Extensions Element" />
      <definition value="Optional Extension Element - found in all resources." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="DomainResource.modifierExtension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
        <profile value="http://nictiz.nl/fhir/StructureDefinition/ext-TreatmentDirective2.SpecificationOther" />
      </type>
      <condition value="ele-1" />
      <condition value="zib-TreatmentDirective2-2" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <isModifier value="true" />
      <isModifierReason value="This extension extends the options of _deny_ and _permit_ of `Consent.provision.type` with the opportunity to provide free text. The `Consent.provision` cannot be safely interpreted if the free text in this extension is omitted, hence the reason for labeling this extension as a modifier." />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Consent.modifierExtension:specificationOther.id">
      <path value="Consent.modifierExtension.id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="Consent.modifierExtension:specificationOther.extension">
      <path value="Consent.modifierExtension.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Consent.modifierExtension:specificationOther.url">
      <path value="Consent.modifierExtension.url" />
      <representation value="xmlAttr" />
      <short value="identifies the meaning of the extension" />
      <definition value="Source of the definition for the extension code - a logical name or a URL." />
      <comment value="The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Extension.url" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="uri" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <fixedUri value="http://nictiz.nl/fhir/StructureDefinition/ext-TreatmentDirective2.SpecificationOther" />
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Consent.modifierExtension:specificationOther.value[x]">
      <path value="Consent.modifierExtension.value[x]" />
      <short value="SpecificationOther" />
      <definition value="Specification of the treatment decision when the decision is 'Other'." />
      <alias value="SpecificatieAnders" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Extension.value[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ele-1" />
      <condition value="zib-TreatmentDirective2-2" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
      <mapping>
        <identity value="zib-treatmentdirective2-v1.0-2020EN" />
        <map value="NL-CM:2.2.4" />
        <comment value="SpecificationOther" />
      </mapping>
    </element>
    <element id="Consent.identifier">
      <path value="Consent.identifier" />
      <short value="Identifier for this record (external references)" />
      <definition value="Unique identifier for this copy of the Consent Statement." />
      <comment value="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." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Consent.identifier" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Identifier" />
      </type>
      <example>
        <label value="General" />
        <valueIdentifier>
          <system value="urn:ietf:rfc:3986" />
          <value value="Local eCMS identifier" />
        </valueIdentifier>
      </example>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CX / EI (occasionally, more often EI maps to a resource id or a URL)" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="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]" />
      </mapping>
      <mapping>
        <identity value="servd" />
        <map value="Identifier" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Event.identifier" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.identifier" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".id" />
      </mapping>
    </element>
    <element id="Consent.status">
      <path value="Consent.status" />
      <short value="draft | proposed | active | rejected | inactive | entered-in-error" />
      <definition value="Indicates the current state of this consent." />
      <comment value="This element is implicitly mapped to the zib concepts NL-CM:2.2.5 (MostRecentReviewDate) and NL-CM:2.2.6 (DateExpired). Unless the status is explicitly recorded, the following guidance applies:&#xD;&#xA;&#xD;&#xA;* When MostRecentReviewDate is in the past and DateExpired is absent or in the future, `.status` will usually be set to _active_.&#xD;&#xA;* When DateExpired is in the past, `.status` will usually be set to _inactive_.&#xD;&#xA;* When MostRecentReviewDate is absent or in the future,  which is not possible following the zib, `.status` will usually be set to _draft_." />
      <requirements value="The Consent Directive that is pointed to might be in various lifecycle states, e.g., a revoked Consent Directive." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Consent.status" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isModifier value="true" />
      <isModifierReason value="This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid" />
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ConsentState" />
        </extension>
        <strength value="required" />
        <description value="Indicates the state of the consent." />
        <valueSet value="http://hl7.org/fhir/ValueSet/consent-state-codes|4.0.1" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Event.status" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.status" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="HL7 Table 0498 - Consent Status" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".statusCode" />
      </mapping>
      <mapping>
        <identity value="zib-treatmentdirective2-v1.0-2020EN" />
        <map value="NL-CM:2.2.5" />
        <comment value="MostRecentReviewDate (implicit, main mapping is on `Consent.dateTime`)" />
      </mapping>
      <mapping>
        <identity value="zib-treatmentdirective2-v1.0-2020EN" />
        <map value="NL-CM:2.2.6" />
        <comment value="DateExpired (implicit, main mapping is on `Consent.provision.period.end`)" />
      </mapping>
    </element>
    <element id="Consent.scope">
      <path value="Consent.scope" />
      <short value="Which of the four areas this resource covers (extensible)" />
      <definition value="A selector of the type of consent being presented: ADR, Privacy, Treatment, Research.  This list is now extensible." />
      <comment value="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." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Consent.scope" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <patternCodeableConcept>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/consentscope" />
          <code value="treatment" />
        </coding>
      </patternCodeableConcept>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isModifier value="true" />
      <isModifierReason value="Allows changes to codes based on scope selection" />
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ConsentScope" />
        </extension>
        <strength value="extensible" />
        <description value="The four anticipated uses for the Consent Resource." />
        <valueSet value="http://hl7.org/fhir/ValueSet/consent-scope" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
      </mapping>
    </element>
    <element id="Consent.category">
      <path value="Consent.category" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="$this" />
        </discriminator>
        <rules value="open" />
      </slicing>
      <short value="Classification of the consent statement - for indexing/retrieval" />
      <definition value="A classification of the type of consents found in the statement. This element supports indexing and retrieval of consent statements." />
      <comment value="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." />
      <min value="1" />
      <max value="*" />
      <base>
        <path value="Consent.category" />
        <min value="1" />
        <max value="*" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ConsentCategory" />
        </extension>
        <strength value="extensible" />
        <description value="A classification of the type of consents found in a consent statement." />
        <valueSet value="http://hl7.org/fhir/ValueSet/consent-category" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Event.code" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.class" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="HL7 Table 0497 - Consent Type" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CNTRCT" />
      </mapping>
    </element>
    <element id="Consent.category:treatmentDirectiveCode">
      <path value="Consent.category" />
      <sliceName value="treatmentDirectiveCode" />
      <short value="Classification of the consent statement - for indexing/retrieval" />
      <definition value="A classification of the type of consents found in the statement. This element supports indexing and retrieval of consent statements." />
      <comment value="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." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Consent.category" />
        <min value="1" />
        <max value="*" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <patternCodeableConcept>
        <coding>
          <system value="http://snomed.info/sct" />
          <code value="129125009" />
        </coding>
      </patternCodeableConcept>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ConsentCategory" />
        </extension>
        <strength value="extensible" />
        <description value="A classification of the type of consents found in a consent statement." />
        <valueSet value="http://hl7.org/fhir/ValueSet/consent-category" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Event.code" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.class" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="HL7 Table 0497 - Consent Type" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CNTRCT" />
      </mapping>
    </element>
    <element id="Consent.patient">
      <path value="Consent.patient" />
      <short value="Who the consent applies to" />
      <definition value="The patient/healthcare consumer to whom this consent applies." />
      <comment value="Commonly, the patient the consent pertains to is the author, but for young and old people, it may be some other person." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Consent.patient" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ref-1" />
        <severity value="error" />
        <human value="SHALL have a contained resource if a local reference is provided" />
        <expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))" />
        <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Event.subject" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.subject[x]" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Role" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.subject" />
      </mapping>
    </element>
    <element id="Consent.dateTime">
      <path value="Consent.dateTime" />
      <short value="MostRecentReviewDate" />
      <definition value="The date on which the treatment directive has been agreed with the patient and / or his representative (s). This can be the first time that the treatment directive have been discussed, but an existing treatment directive may also have been discussed again. The content of the treatment directive may have changed or remained the same." />
      <comment value="This is not the time of the original consent, but the time that this statement was made or derived." />
      <alias value="MeestRecenteBespreekdatum" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Consent.dateTime" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="dateTime" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Event.occurrence[x]" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.recorded" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="Field 13/ Consent Decision Date" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="FinancialConsent effectiveTime" />
      </mapping>
      <mapping>
        <identity value="zib-treatmentdirective2-v1.0-2020EN" />
        <map value="NL-CM:2.2.5" />
        <comment value="MostRecentReviewDate" />
      </mapping>
    </element>
    <element id="Consent.performer">
      <path value="Consent.performer" />
      <short value="Who is agreeing to the policy and rules" />
      <definition value="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." />
      <comment value="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." />
      <alias value="consentor" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Consent.performer" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ref-1" />
        <severity value="error" />
        <human value="SHALL have a contained resource if a local reference is provided" />
        <expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))" />
        <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Event.performer" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.actor" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="Field 24/ ConsenterID" />
      </mapping>
    </element>
    <element id="Consent.organization">
      <path value="Consent.organization" />
      <short value="Custodian of the consent" />
      <definition value="The organization that manages the consent, and the framework within which it is executed." />
      <comment value="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." />
      <alias value="custodian" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Consent.organization" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ref-1" />
        <severity value="error" />
        <human value="SHALL have a contained resource if a local reference is provided" />
        <expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))" />
        <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
      </mapping>
      <mapping>
        <identity value="workflow" />
        <map value="Event.performer" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="FiveWs.witness" />
      </mapping>
    </element>
    <element id="Consent.source[x]">
      <path value="Consent.source[x]" />
      <slicing>
        <discriminator>
          <type value="type" />
          <path value="$this" />
        </discriminator>
        <rules value="open" />
      </slicing>
      <short value="Source from which this consent is taken" />
      <definition value="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." />
      <comment value="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." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Consent.source[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Attachment" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Consent" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/DocumentReference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Contract" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse" />
      </type>
      <condition value="ele-1" />
      <condition value="zib-TreatmentDirective2-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="Field 19 Informational Material Supplied Indicator" />
      </mapping>
    </element>
    <element id="Consent.source[x]:sourceReference">
      <path value="Consent.source[x]" />
      <sliceName value="sourceReference" />
      <short value="AdvanceDirective" />
      <definition value="A (written) statement in which a person indicates wishes concerning future medical action, in the event that this person is at that point no longer (deemed) capable of taking decisions on the matter." />
      <comment value="The cardinality of this `Consent.source[x]` element is restricted to `0..1`, which is narrower than the AdvanceDirective concept (NL-CM:2.2.8) specified in the HCIM TreatmentDirective2. If additional AdvanceDirective references are needed, the additionalAdvanceDirective extension can be used _in addition to_ this element. If the additionalAdvanceDirective extension is used, this element SHALL be populated and it SHALL not contain a reference that is also present in the extension." />
      <alias value="Wilsverklaring" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Consent.source[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Consent" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/DocumentReference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Contract" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse" />
        <targetProfile value="http://nictiz.nl/fhir/StructureDefinition/zib-AdvanceDirective" />
      </type>
      <condition value="ele-1" />
      <condition value="zib-TreatmentDirective2-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="Field 19 Informational Material Supplied Indicator" />
      </mapping>
      <mapping>
        <identity value="zib-treatmentdirective2-v1.0-2020EN" />
        <map value="NL-CM:2.2.8" />
        <comment value="AdvanceDirective" />
      </mapping>
    </element>
    <element id="Consent.policy">
      <path value="Consent.policy" />
      <short value="Policies covered by this consent" />
      <definition value="The references to the policies that are included in this consent scope. Policies may be organizational, but are often defined jurisdictionally, or in law." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Consent.policy" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="BackboneElement" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="Consent.policy.id">
      <path value="Consent.policy.id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="Consent.policy.extension">
      <path value="Consent.policy.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Consent.policy.modifierExtension">
      <path value="Consent.policy.modifierExtension" />
      <short value="Extensions that cannot be ignored even if unrecognized" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions.&#xA;&#xA;Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
      <alias value="extensions" />
      <alias value="user content" />
      <alias value="modifiers" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="BackboneElement.modifierExtension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <isModifier value="true" />
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Consent.policy.authority">
      <path value="Consent.policy.authority" />
      <short value="Enforcement source for policy" />
      <definition value="Entity or Organization having regulatory jurisdiction or accountability for  enforcing policies pertaining to Consent Directives." />
      <comment value="see http://en.wikipedia.org/wiki/Uniform_resource_identifier" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Consent.policy.authority" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <condition value="ele-1" />
      <condition value="ppc-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="Consent.policy.uri">
      <path value="Consent.policy.uri" />
      <short value="Specific policy covered by this consent" />
      <definition value="The references to the policies that are included in this consent scope. Policies may be organizational, but are often defined jurisdictionally, or in law." />
      <comment value="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 &lt;https://wetten.overheid.nl/&gt; if the treatment directive is recorded following Dutch law and regulations." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Consent.policy.uri" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <condition value="ele-1" />
      <condition value="ppc-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="Consent.policyRule">
      <path value="Consent.policyRule" />
      <short value="Regulation that this consents to" />
      <definition value="A reference to the specific base computable regulation or policy." />
      <comment value="If the policyRule is absent, computable consent would need to be constructed from the elements of the Consent resource." />
      <requirements value="Might be a unique identifier of a policy set in XACML, or other rules engine." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Consent.policyRule" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <condition value="ele-1" />
      <condition value="ppc-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ConsentPolicyRule" />
        </extension>
        <strength value="extensible" />
        <description value="Regulatory policy examples." />
        <valueSet value="http://hl7.org/fhir/ValueSet/consent-policy" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
      </mapping>
    </element>
    <element id="Consent.verification">
      <path value="Consent.verification" />
      <short value="Consent Verified by patient or family" />
      <definition value="Whether a treatment instruction (e.g. artificial respiration yes or no) was verified with the patient, his/her family or another authorized person." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Consent.verification" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="BackboneElement" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="Consent.verification.id">
      <path value="Consent.verification.id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="Consent.verification.extension">
      <path value="Consent.verification.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Consent.verification.modifierExtension">
      <path value="Consent.verification.modifierExtension" />
      <short value="Extensions that cannot be ignored even if unrecognized" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions.&#xA;&#xA;Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
      <alias value="extensions" />
      <alias value="user content" />
      <alias value="modifiers" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="BackboneElement.modifierExtension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <isModifier value="true" />
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Consent.verification.verified">
      <path value="Consent.verification.verified" />
      <short value="Has been verified" />
      <definition value="Has the instruction been verified." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Consent.verification.verified" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="boolean" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="Consent.verification.verifiedWith">
      <path value="Consent.verification.verifiedWith" />
      <short value="Person who verified" />
      <definition value="Who verified the instruction (Patient, Relative or other Authorized Person)." />
      <comment value="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." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Consent.verification.verifiedWith" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ref-1" />
        <severity value="error" />
        <human value="SHALL have a contained resource if a local reference is provided" />
        <expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))" />
        <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
      </mapping>
    </element>
    <element id="Consent.verification.verificationDate">
      <path value="Consent.verification.verificationDate" />
      <short value="When consent verified" />
      <definition value="Date verification was collected." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Consent.verification.verificationDate" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="dateTime" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="Consent.provision">
      <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
        <valueString value="provision" />
      </extension>
      <path value="Consent.provision" />
      <short value="Constraints to the base Consent.policyRule" />
      <definition value="An exception to the base policy of this consent. An exception can be an addition or removal of access permissions." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Consent.provision" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="BackboneElement" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="Consent.provision.id">
      <path value="Consent.provision.id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="Consent.provision.extension">
      <path value="Consent.provision.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Consent.provision.extension:reasonForEnding">
      <path value="Consent.provision.extension" />
      <sliceName value="reasonForEnding" />
      <short value="Optional Extensions Element" />
      <definition value="Optional Extension Element - found in all resources." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
        <profile value="http://nictiz.nl/fhir/StructureDefinition/ext-TreatmentDirective2.ReasonForEnding" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Consent.provision.modifierExtension">
      <path value="Consent.provision.modifierExtension" />
      <short value="Extensions that cannot be ignored even if unrecognized" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions.&#xA;&#xA;Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
      <alias value="extensions" />
      <alias value="user content" />
      <alias value="modifiers" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="BackboneElement.modifierExtension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <isModifier value="true" />
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Consent.provision.type">
      <path value="Consent.provision.type" />
      <short value="TreatmentDecision" />
      <definition value="The joint decision taken with regard to the desirability of performing the indicated treatment. If the agreement is 'Other', 'Specification Other' shall contain the instructions for whether or not to carry out the treatment. Implementers SHALL support the specificationOther modifier extension for this." />
      <comment value="This element can only be used for situations where TreatmentDecision is _Wel uitvoeren_ (_allow_) or _Niet uitvoeren_ (_deny_). It the TreatmentDecision is _Anders_, this element MUST be absent and the modifier extension [ext-TreatmentDirective2.SpecificationOther](http://nictiz.nl/fhir/StructureDefinition/ext-TreatmentDirective2.SpecificationOther) MUST be populated with the textual decision according to zib concept SpecificationOther." />
      <alias value="BehandelBesluit" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Consent.provision.type" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <condition value="ele-1" />
      <condition value="zib-TreatmentDirective2-2" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ConsentProvisionType" />
        </extension>
        <strength value="required" />
        <description value="Use ConceptMap TreatmentDecisionCodelist-to-ConsentProvisionType to translate terminology from the functional model to profile terminology in ValueSet ConsentProvisionType." />
        <valueSet value="http://hl7.org/fhir/ValueSet/consent-provision-type|4.0.1">
          <extension url="http://hl7.org/fhir/StructureDefinition/11179-permitted-value-conceptmap">
            <valueCanonical value="http://nictiz.nl/fhir/ConceptMap/TreatmentDecisionCodelist-to-ConsentProvisionType" />
          </extension>
        </valueSet>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="zib-treatmentdirective2-v1.0-2020EN" />
        <map value="NL-CM:2.2.2" />
        <comment value="TreatmentDecision" />
      </mapping>
    </element>
    <element id="Consent.provision.period">
      <path value="Consent.provision.period" />
      <short value="Timeframe for this rule" />
      <definition value="The timeframe in this rule is valid." />
      <comment value="A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. &quot;the patient was an inpatient of the hospital for this time range&quot;) or one value from the range applies (e.g. &quot;give to the patient between these two times&quot;).&#xA;&#xA;Period is not used for a duration (a measure of elapsed time). See [Duration](datatypes.html#Duration)." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Consent.provision.period" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Period" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="per-1" />
        <severity value="error" />
        <human value="If present, start SHALL have a lower value than end" />
        <expression value="start.hasValue().not() or end.hasValue().not() or (start &lt;= end)" />
        <xpath value="not(exists(f:start/@value)) or not(exists(f:end/@value)) or (xs:dateTime(f:start/@value) &lt;= xs:dateTime(f:end/@value))" />
        <source value="http://hl7.org/fhir/StructureDefinition/Period" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="DR" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="IVL&lt;TS&gt;[lowClosed=&quot;true&quot; and highClosed=&quot;true&quot;] or URG&lt;TS&gt;[lowClosed=&quot;true&quot; and highClosed=&quot;true&quot;]" />
      </mapping>
    </element>
    <element id="Consent.provision.period.id">
      <path value="Consent.provision.period.id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="Consent.provision.period.extension">
      <path value="Consent.provision.period.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Consent.provision.period.start">
      <path value="Consent.provision.period.start" />
      <short value="Starting time with inclusive boundary" />
      <definition value="The start of the period. The boundary is inclusive." />
      <comment value="If the low element is missing, the meaning is that the low boundary is not known." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Period.start" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="dateTime" />
      </type>
      <condition value="ele-1" />
      <condition value="per-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="DR.1" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./low" />
      </mapping>
    </element>
    <element id="Consent.provision.period.end">
      <path value="Consent.provision.period.end" />
      <short value="DateExpired" />
      <definition value="The date on which the treatment directive has been withdrawn and therefore no longer applies. An explicit decision must be taken about the 'date expired', in consultation between the responsible care provider and the patient or his representative(s).Any future termination can only be entered as a condition. Often this will be linked to 1 or more events." />
      <comment value="The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03." />
      <alias value="DatumBeeindigd" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Period.end" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="dateTime" />
      </type>
      <meaningWhenMissing value="If the end of the period is missing, it means that the period is ongoing" />
      <condition value="ele-1" />
      <condition value="per-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="DR.2" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="./high" />
      </mapping>
      <mapping>
        <identity value="zib-treatmentdirective2-v1.0-2020EN" />
        <map value="NL-CM:2.2.6" />
        <comment value="DateExpired" />
      </mapping>
    </element>
    <element id="Consent.provision.actor">
      <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
        <valueString value="provisionActor" />
      </extension>
      <path value="Consent.provision.actor" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="role" />
        </discriminator>
        <rules value="open" />
      </slicing>
      <short value="Who|what controlled by this rule (or group, by role)" />
      <definition value="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')." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Consent.provision.actor" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="BackboneElement" />
      </type>
      <meaningWhenMissing value="There is no specific actor associated with the exception" />
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="Consent.provision.actor.id">
      <path value="Consent.provision.actor.id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="Consent.provision.actor.extension">
      <path value="Consent.provision.actor.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Consent.provision.actor.modifierExtension">
      <path value="Consent.provision.actor.modifierExtension" />
      <short value="Extensions that cannot be ignored even if unrecognized" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions.&#xA;&#xA;Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
      <alias value="extensions" />
      <alias value="user content" />
      <alias value="modifiers" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="BackboneElement.modifierExtension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <isModifier value="true" />
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Consent.provision.actor.role">
      <path value="Consent.provision.actor.role" />
      <short value="How the actor is involved" />
      <definition value="How the individual is involved in the resources content that is described in the exception." />
      <comment value="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." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Consent.provision.actor.role" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ConsentActorRole" />
        </extension>
        <strength value="extensible" />
        <description value="How an actor is involved in the consent considerations." />
        <valueSet value="http://hl7.org/fhir/ValueSet/security-role-type" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
      </mapping>
    </element>
    <element id="Consent.provision.actor.reference">
      <path value="Consent.provision.actor.reference" />
      <short value="Resource for the actor (or group, by role)" />
      <definition value="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')." />
      <comment value="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." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Consent.provision.actor.reference" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/CareTeam" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ref-1" />
        <severity value="error" />
        <human value="SHALL have a contained resource if a local reference is provided" />
        <expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))" />
        <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
      </mapping>
    </element>
    <element id="Consent.provision.actor:agreementParty">
      <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
        <valueString value="provisionActor" />
      </extension>
      <path value="Consent.provision.actor" />
      <sliceName value="agreementParty" />
      <short value="AgreementParty" />
      <definition value="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')." />
      <alias value="AfspraakPartij" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Consent.provision.actor" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="BackboneElement" />
      </type>
      <meaningWhenMissing value="There is no specific actor associated with the exception" />
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="zib-treatmentdirective2-v1.0-2020EN" />
        <map value="NL-CM:2.2.9" />
        <comment value="AgreementParty" />
      </mapping>
    </element>
    <element id="Consent.provision.actor:agreementParty.id">
      <path value="Consent.provision.actor.id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="Consent.provision.actor:agreementParty.extension">
      <path value="Consent.provision.actor.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Consent.provision.actor:agreementParty.modifierExtension">
      <path value="Consent.provision.actor.modifierExtension" />
      <short value="Extensions that cannot be ignored even if unrecognized" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions.&#xA;&#xA;Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
      <alias value="extensions" />
      <alias value="user content" />
      <alias value="modifiers" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="BackboneElement.modifierExtension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <isModifier value="true" />
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Consent.provision.actor:agreementParty.role">
      <path value="Consent.provision.actor.role" />
      <short value="How the actor is involved" />
      <definition value="How the individual is involved in the resources content that is described in the exception." />
      <comment value="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." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Consent.provision.actor.role" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <patternCodeableConcept>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode" />
          <code value="CONSENTER" />
        </coding>
      </patternCodeableConcept>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ConsentActorRole" />
        </extension>
        <strength value="extensible" />
        <description value="How an actor is involved in the consent considerations." />
        <valueSet value="http://hl7.org/fhir/ValueSet/security-role-type" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
      </mapping>
    </element>
    <element id="Consent.provision.actor:agreementParty.reference">
      <path value="Consent.provision.actor.reference" />
      <short value="Patient / Representative / HealthProfessional" />
      <definition value="* Patient as the person with whom the agreement was made.&#xD;&#xA;* Person who represents the patient in health care matters and with whom the agreement has been made (too).&#xD;&#xA;* HealthProfessional who has made the agreement regarding the treatment directive." />
      <comment value="Each occurrence of the zib HealthProfessional is normally represented by _two_ FHIR resources: a PractitionerRole resource (instance of [zib-HealthProfessional-PractitionerRole](http://nictiz.nl/fhir/StructureDefinition/zib-HealthProfessional-PractitionerRole)) and a Practitioner resource (instance of [zib-HealthProfessional-Practitioner](http://nictiz.nl/fhir/StructureDefinition/zib-HealthProfessional-Practitioner)). The Practitioner resource is referenced from the PractitionerRole instance. For this reason, sending systems should fill the reference to the PractitionerRole instance here, and not the Practitioner resource. Receiving systems can then retrieve the reference to the Practitioner resource from that PractitionerRole instance.&#xD;&#xA;&#xD;&#xA;In rare circumstances, there is only a Practitioner instance, in which case it is that instance which will be referenced here. However, since this should be the exception, the zib-HealthProfessional-Practitioner profile is not explicitly mentioned as a target profile." />
      <alias value="Patient" />
      <alias value="Vertegenwoordiger" />
      <alias value="Zorgverlener" />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Consent.provision.actor.reference" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/CareTeam" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" />
        <targetProfile value="http://nictiz.nl/fhir/StructureDefinition/zib-Patient" />
        <targetProfile value="http://nictiz.nl/fhir/StructureDefinition/zib-ContactPerson" />
        <targetProfile value="http://nictiz.nl/fhir/StructureDefinition/zib-HealthProfessional-PractitionerRole" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ref-1" />
        <severity value="error" />
        <human value="SHALL have a contained resource if a local reference is provided" />
        <expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))" />
        <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
      </mapping>
      <mapping>
        <identity value="zib-treatmentdirective2-v1.0-2020EN" />
        <map value="NL-CM:2.2.10" />
        <comment value="Patient" />
      </mapping>
      <mapping>
        <identity value="zib-treatmentdirective2-v1.0-2020EN" />
        <map value="NL-CM:2.2.11" />
        <comment value="Representative" />
      </mapping>
      <mapping>
        <identity value="zib-treatmentdirective2-v1.0-2020EN" />
        <map value="NL-CM:2.2.12" />
        <comment value="HealthProfessional" />
      </mapping>
    </element>
    <element id="Consent.provision.action">
      <path value="Consent.provision.action" />
      <short value="Actions controlled by this rule" />
      <definition value="Actions controlled by this Rule." />
      <comment value="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'." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Consent.provision.action" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <meaningWhenMissing value="all actions" />
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ConsentAction" />
        </extension>
        <strength value="example" />
        <description value="Detailed codes for the consent action." />
        <valueSet value="http://hl7.org/fhir/ValueSet/consent-action" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
      </mapping>
    </element>
    <element id="Consent.provision.securityLabel">
      <path value="Consent.provision.securityLabel" />
      <short value="Security Labels that define affected resources" />
      <definition value="A security label, comprised of 0..* security label fields (Privacy tags), which define which resources are controlled by this exception." />
      <comment value="If the consent specifies a security label of &quot;R&quot; then it applies to all resources that are labeled &quot;R&quot; 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." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Consent.provision.securityLabel" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Coding" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="SecurityLabels" />
        </extension>
        <strength value="extensible" />
        <description value="Security Labels from the Healthcare Privacy and Security Classification System." />
        <valueSet value="http://hl7.org/fhir/ValueSet/security-labels" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CV" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" />
      </mapping>
    </element>
    <element id="Consent.provision.purpose">
      <path value="Consent.provision.purpose" />
      <short value="Context of activities covered by this rule" />
      <definition value="The context of the activities a user is taking - why the user is accessing the data - that are controlled by this rule." />
      <comment value="When the purpose of use tag is on the data, access request purpose of use shall not conflict." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Consent.provision.purpose" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Coding" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="PurposeOfUse" />
        </extension>
        <strength value="extensible" />
        <description value="What purposes of use are controlled by this exception. If more than one label is specified, operations must have all the specified labels." />
        <valueSet value="http://terminology.hl7.org/ValueSet/v3-PurposeOfUse" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CV" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" />
      </mapping>
    </element>
    <element id="Consent.provision.class">
      <path value="Consent.provision.class" />
      <short value="e.g. Resource Type, Profile, CDA, etc." />
      <definition value="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." />
      <comment value="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." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Consent.provision.class" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Coding" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ConsentContentClass" />
        </extension>
        <strength value="extensible" />
        <description value="The class (type) of information a consent rule covers." />
        <valueSet value="http://hl7.org/fhir/ValueSet/consent-content-class" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CV" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" />
      </mapping>
    </element>
    <element id="Consent.provision.code">
      <path value="Consent.provision.code" />
      <short value="Treatment" />
      <definition value="The medical treatment to which the treatment instruction applies." />
      <comment value="Typical use of this is a Document code with class = CDA." />
      <alias value="Behandeling" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Consent.provision.code" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ConsentContentCode" />
        </extension>
        <strength value="required" />
        <description value="If this code is found in an instance, then the exception applies." />
        <valueSet value="http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.2.2.1--20200901000000" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
      </mapping>
      <mapping>
        <identity value="zib-treatmentdirective2-v1.0-2020EN" />
        <map value="NL-CM:2.2.3" />
        <comment value="Treatment" />
      </mapping>
    </element>
    <element id="Consent.provision.dataPeriod">
      <path value="Consent.provision.dataPeriod" />
      <short value="Timeframe for data controlled by this rule" />
      <definition value="Clinical or Operational Relevant period of time that bounds the data controlled by this rule." />
      <comment value="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." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Consent.provision.dataPeriod" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Period" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="per-1" />
        <severity value="error" />
        <human value="If present, start SHALL have a lower value than end" />
        <expression value="start.hasValue().not() or end.hasValue().not() or (start &lt;= end)" />
        <xpath value="not(exists(f:start/@value)) or not(exists(f:end/@value)) or (xs:dateTime(f:start/@value) &lt;= xs:dateTime(f:end/@value))" />
        <source value="http://hl7.org/fhir/StructureDefinition/Period" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="DR" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="IVL&lt;TS&gt;[lowClosed=&quot;true&quot; and highClosed=&quot;true&quot;] or URG&lt;TS&gt;[lowClosed=&quot;true&quot; and highClosed=&quot;true&quot;]" />
      </mapping>
    </element>
    <element id="Consent.provision.data">
      <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
        <valueString value="provisionData" />
      </extension>
      <path value="Consent.provision.data" />
      <short value="Data controlled by this rule" />
      <definition value="The resources controlled by this rule if specific resources are referenced." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Consent.provision.data" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="BackboneElement" />
      </type>
      <meaningWhenMissing value="all data" />
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Role" />
      </mapping>
    </element>
    <element id="Consent.provision.data.id">
      <path value="Consent.provision.data.id" />
      <representation value="xmlAttr" />
      <short value="Unique id for inter-element referencing" />
      <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string" />
        </extension>
        <code value="http://hl7.org/fhirpath/System.String" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="Consent.provision.data.extension">
      <path value="Consent.provision.data.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Consent.provision.data.modifierExtension">
      <path value="Consent.provision.data.modifierExtension" />
      <short value="Extensions that cannot be ignored even if unrecognized" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions.&#xA;&#xA;Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
      <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
      <alias value="extensions" />
      <alias value="user content" />
      <alias value="modifiers" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="BackboneElement.modifierExtension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <isModifier value="true" />
      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Consent.provision.data.meaning">
      <path value="Consent.provision.data.meaning" />
      <short value="instance | related | dependents | authoredby" />
      <definition value="How the resource reference is interpreted when testing consent restrictions." />
      <comment value="Note that FHIR strings SHALL NOT exceed 1MB in size" />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Consent.provision.data.meaning" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ConsentDataMeaning" />
        </extension>
        <strength value="required" />
        <description value="How a resource reference is interpreted when testing consent restrictions." />
        <valueSet value="http://hl7.org/fhir/ValueSet/consent-data-meaning|4.0.1" />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="Consent.provision.data.reference">
      <path value="Consent.provision.data.reference" />
      <short value="The actual data reference" />
      <definition value="A reference to a specific resource that defines which resources are covered by this consent." />
      <comment value="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." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Consent.provision.data.reference" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() or (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Element" />
      </constraint>
      <constraint>
        <key value="ref-1" />
        <severity value="error" />
        <human value="SHALL have a contained resource if a local reference is provided" />
        <expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))" />
        <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
      </mapping>
    </element>
    <element id="Consent.provision.provision">
      <path value="Consent.provision.provision" />
      <short value="Nested Exception Rules" />
      <definition value="Rules which provide exceptions to the base rule or subrules." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Consent.provision.provision" />
        <min value="0" />
        <max value="*" />
      </base>
      <contentReference value="http://hl7.org/fhir/StructureDefinition/Consent#Consent.provision" />
    </element>
  </snapshot>
  <differential>
    <element id="Consent">
      <path value="Consent" />
      <short value="TreatmentDirective" />
      <comment value="A straightforward and accurate mapping of zib TreatmentDirective2 to FHIR is not possible. The main consideration is to choose between the Consent and CarePlan resource. Unfortunately, the Consent resource does not have full support for treatment directives yet as its main focus is to model Patient's privacy consents. Regardless, it seems to be the best match to represent the intention of the zib, as both the resource and the zib cover a mutual agreement about treatments and not per se the resulting actions or policy for treatments, which would better be handled using the CarePlan resource. Future migration to a later version of FHIR or the zib will result in the reevaluation of the mapping." />
      <alias value="BehandelAanwijzing" />
      <constraint>
        <key value="zib-TreatmentDirective2-1" />
        <severity value="error" />
        <human value="`extension.additionalAdvanceDirective` may only be used for AdvanceDirective references in addition to first reference in `.source[x]`." />
        <expression value="extension.where(url = 'http://nictiz.nl/fhir/StructureDefinition/ext-TreatmentDirective2.AdvanceDirective').empty() or source.exists()" />
      </constraint>
      <constraint>
        <key value="zib-TreatmentDirective2-2" />
        <severity value="error" />
        <human value="If the specificationOther extension is used, `.provision.type` MUST be absent and vice versa" />
        <expression value="(extension.where(url = 'http://nictiz.nl/fhir/StructureDefinition/ext-TreatmentDirective2.SpecificitionOther').exists() and provision.type.exists()).not()" />
      </constraint>
      <mapping>
        <identity value="zib-treatmentdirective2-v1.0-2020EN" />
        <map value="NL-CM:2.2.1" />
        <comment value="TreatmentDirective" />
      </mapping>
    </element>
    <element id="Consent.extension:comment">
      <path value="Consent.extension" />
      <sliceName value="comment" />
      <max value="1" />
      <type>
        <code value="Extension" />
        <profile value="http://nictiz.nl/fhir/StructureDefinition/ext-Comment" />
      </type>
    </element>
    <element id="Consent.extension:comment.value[x]">
      <path value="Consent.extension.value[x]" />
      <short value="Comment" />
      <definition value="The comment may include further information such as the reason why a treatment directive has been drawn up, persons who assisted the patient in agreeing the treatment directive but who are not otherwise involved in the agreement as a representative, etc." />
      <alias value="Toelichting" />
      <mapping>
        <identity value="zib-treatmentdirective2-v1.0-2020EN" />
        <map value="NL-CM:2.2.13" />
        <comment value="Comment" />
      </mapping>
    </element>
    <element id="Consent.extension:additionalAdvanceDirective">
      <path value="Consent.extension" />
      <sliceName value="additionalAdvanceDirective" />
      <type>
        <code value="Extension" />
        <profile value="http://nictiz.nl/fhir/StructureDefinition/ext-TreatmentDirective2.AdvanceDirective" />
      </type>
      <condition value="zib-TreatmentDirective2-1" />
    </element>
    <element id="Consent.extension:additionalAdvanceDirective.value[x]">
      <path value="Consent.extension.value[x]" />
      <comment value="`Consent.source:sourceReference` is the primary target for referencing zib AdvanceDirective (zib concept NL-CM:2.2.8). However, the cardinality of `Consent.source[x]` is restricted to `0..1`. If more than one AdvanceDirective needs to be referenced, the _additional_ references can be communicated using this extension. If this extension is used, `Consent.source:sourceReference` SHALL be populated and it SHALL not contain the same reference as this extension." />
      <condition value="zib-TreatmentDirective2-1" />
    </element>
    <element id="Consent.modifierExtension:specificationOther">
      <path value="Consent.modifierExtension" />
      <sliceName value="specificationOther" />
      <type>
        <code value="Extension" />
        <profile value="http://nictiz.nl/fhir/StructureDefinition/ext-TreatmentDirective2.SpecificationOther" />
      </type>
      <condition value="zib-TreatmentDirective2-2" />
    </element>
    <element id="Consent.modifierExtension:specificationOther.value[x]">
      <path value="Consent.modifierExtension.value[x]" />
      <condition value="zib-TreatmentDirective2-2" />
    </element>
    <element id="Consent.status">
      <path value="Consent.status" />
      <comment value="This element is implicitly mapped to the zib concepts NL-CM:2.2.5 (MostRecentReviewDate) and NL-CM:2.2.6 (DateExpired). Unless the status is explicitly recorded, the following guidance applies:&#xD;&#xA;&#xD;&#xA;* When MostRecentReviewDate is in the past and DateExpired is absent or in the future, `.status` will usually be set to _active_.&#xD;&#xA;* When DateExpired is in the past, `.status` will usually be set to _inactive_.&#xD;&#xA;* When MostRecentReviewDate is absent or in the future,  which is not possible following the zib, `.status` will usually be set to _draft_." />
      <mapping>
        <identity value="zib-treatmentdirective2-v1.0-2020EN" />
        <map value="NL-CM:2.2.5" />
        <comment value="MostRecentReviewDate (implicit, main mapping is on `Consent.dateTime`)" />
      </mapping>
      <mapping>
        <identity value="zib-treatmentdirective2-v1.0-2020EN" />
        <map value="NL-CM:2.2.6" />
        <comment value="DateExpired (implicit, main mapping is on `Consent.provision.period.end`)" />
      </mapping>
    </element>
    <element id="Consent.scope">
      <path value="Consent.scope" />
      <patternCodeableConcept>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/consentscope" />
          <code value="treatment" />
        </coding>
      </patternCodeableConcept>
    </element>
    <element id="Consent.category">
      <path value="Consent.category" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="$this" />
        </discriminator>
        <rules value="open" />
      </slicing>
    </element>
    <element id="Consent.category:treatmentDirectiveCode">
      <path value="Consent.category" />
      <sliceName value="treatmentDirectiveCode" />
      <min value="1" />
      <max value="1" />
      <patternCodeableConcept>
        <coding>
          <system value="http://snomed.info/sct" />
          <code value="129125009" />
        </coding>
      </patternCodeableConcept>
    </element>
    <element id="Consent.dateTime">
      <path value="Consent.dateTime" />
      <short value="MostRecentReviewDate" />
      <definition value="The date on which the treatment directive has been agreed with the patient and / or his representative (s). This can be the first time that the treatment directive have been discussed, but an existing treatment directive may also have been discussed again. The content of the treatment directive may have changed or remained the same." />
      <alias value="MeestRecenteBespreekdatum" />
      <mapping>
        <identity value="zib-treatmentdirective2-v1.0-2020EN" />
        <map value="NL-CM:2.2.5" />
        <comment value="MostRecentReviewDate" />
      </mapping>
    </element>
    <element id="Consent.source[x]">
      <path value="Consent.source[x]" />
      <slicing>
        <discriminator>
          <type value="type" />
          <path value="$this" />
        </discriminator>
        <rules value="open" />
      </slicing>
      <condition value="zib-TreatmentDirective2-1" />
    </element>
    <element id="Consent.source[x]:sourceReference">
      <path value="Consent.source[x]" />
      <sliceName value="sourceReference" />
      <short value="AdvanceDirective" />
      <definition value="A (written) statement in which a person indicates wishes concerning future medical action, in the event that this person is at that point no longer (deemed) capable of taking decisions on the matter." />
      <comment value="The cardinality of this `Consent.source[x]` element is restricted to `0..1`, which is narrower than the AdvanceDirective concept (NL-CM:2.2.8) specified in the HCIM TreatmentDirective2. If additional AdvanceDirective references are needed, the additionalAdvanceDirective extension can be used _in addition to_ this element. If the additionalAdvanceDirective extension is used, this element SHALL be populated and it SHALL not contain a reference that is also present in the extension." />
      <alias value="Wilsverklaring" />
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Consent" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/DocumentReference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Contract" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse" />
        <targetProfile value="http://nictiz.nl/fhir/StructureDefinition/zib-AdvanceDirective" />
      </type>
      <condition value="zib-TreatmentDirective2-1" />
      <mapping>
        <identity value="zib-treatmentdirective2-v1.0-2020EN" />
        <map value="NL-CM:2.2.8" />
        <comment value="AdvanceDirective" />
      </mapping>
    </element>
    <element id="Consent.policy.uri">
      <path value="Consent.policy.uri" />
      <comment value="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 &lt;https://wetten.overheid.nl/&gt; if the treatment directive is recorded following Dutch law and regulations." />
    </element>
    <element id="Consent.provision.extension:reasonForEnding">
      <path value="Consent.provision.extension" />
      <sliceName value="reasonForEnding" />
      <type>
        <code value="Extension" />
        <profile value="http://nictiz.nl/fhir/StructureDefinition/ext-TreatmentDirective2.ReasonForEnding" />
      </type>
    </element>
    <element id="Consent.provision.type">
      <path value="Consent.provision.type" />
      <short value="TreatmentDecision" />
      <definition value="The joint decision taken with regard to the desirability of performing the indicated treatment. If the agreement is 'Other', 'Specification Other' shall contain the instructions for whether or not to carry out the treatment. Implementers SHALL support the specificationOther modifier extension for this." />
      <comment value="This element can only be used for situations where TreatmentDecision is _Wel uitvoeren_ (_allow_) or _Niet uitvoeren_ (_deny_). It the TreatmentDecision is _Anders_, this element MUST be absent and the modifier extension [ext-TreatmentDirective2.SpecificationOther](http://nictiz.nl/fhir/StructureDefinition/ext-TreatmentDirective2.SpecificationOther) MUST be populated with the textual decision according to zib concept SpecificationOther." />
      <alias value="BehandelBesluit" />
      <condition value="zib-TreatmentDirective2-2" />
      <binding>
        <strength value="required" />
        <description value="Use ConceptMap TreatmentDecisionCodelist-to-ConsentProvisionType to translate terminology from the functional model to profile terminology in ValueSet ConsentProvisionType." />
        <valueSet value="http://hl7.org/fhir/ValueSet/consent-provision-type|4.0.1">
          <extension url="http://hl7.org/fhir/StructureDefinition/11179-permitted-value-conceptmap">
            <valueCanonical value="http://nictiz.nl/fhir/ConceptMap/TreatmentDecisionCodelist-to-ConsentProvisionType" />
          </extension>
        </valueSet>
      </binding>
      <mapping>
        <identity value="zib-treatmentdirective2-v1.0-2020EN" />
        <map value="NL-CM:2.2.2" />
        <comment value="TreatmentDecision" />
      </mapping>
    </element>
    <element id="Consent.provision.period.end">
      <path value="Consent.provision.period.end" />
      <short value="DateExpired" />
      <definition value="The date on which the treatment directive has been withdrawn and therefore no longer applies. An explicit decision must be taken about the 'date expired', in consultation between the responsible care provider and the patient or his representative(s).Any future termination can only be entered as a condition. Often this will be linked to 1 or more events." />
      <alias value="DatumBeeindigd" />
      <mapping>
        <identity value="zib-treatmentdirective2-v1.0-2020EN" />
        <map value="NL-CM:2.2.6" />
        <comment value="DateExpired" />
      </mapping>
    </element>
    <element id="Consent.provision.actor">
      <path value="Consent.provision.actor" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="role" />
        </discriminator>
        <rules value="open" />
      </slicing>
    </element>
    <element id="Consent.provision.actor:agreementParty">
      <path value="Consent.provision.actor" />
      <sliceName value="agreementParty" />
      <short value="AgreementParty" />
      <alias value="AfspraakPartij" />
      <mapping>
        <identity value="zib-treatmentdirective2-v1.0-2020EN" />
        <map value="NL-CM:2.2.9" />
        <comment value="AgreementParty" />
      </mapping>
    </element>
    <element id="Consent.provision.actor:agreementParty.role">
      <path value="Consent.provision.actor.role" />
      <patternCodeableConcept>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode" />
          <code value="CONSENTER" />
        </coding>
      </patternCodeableConcept>
    </element>
    <element id="Consent.provision.actor:agreementParty.reference">
      <path value="Consent.provision.actor.reference" />
      <short value="Patient / Representative / HealthProfessional" />
      <definition value="* Patient as the person with whom the agreement was made.&#xD;&#xA;* Person who represents the patient in health care matters and with whom the agreement has been made (too).&#xD;&#xA;* HealthProfessional who has made the agreement regarding the treatment directive." />
      <comment value="Each occurrence of the zib HealthProfessional is normally represented by _two_ FHIR resources: a PractitionerRole resource (instance of [zib-HealthProfessional-PractitionerRole](http://nictiz.nl/fhir/StructureDefinition/zib-HealthProfessional-PractitionerRole)) and a Practitioner resource (instance of [zib-HealthProfessional-Practitioner](http://nictiz.nl/fhir/StructureDefinition/zib-HealthProfessional-Practitioner)). The Practitioner resource is referenced from the PractitionerRole instance. For this reason, sending systems should fill the reference to the PractitionerRole instance here, and not the Practitioner resource. Receiving systems can then retrieve the reference to the Practitioner resource from that PractitionerRole instance.&#xD;&#xA;&#xD;&#xA;In rare circumstances, there is only a Practitioner instance, in which case it is that instance which will be referenced here. However, since this should be the exception, the zib-HealthProfessional-Practitioner profile is not explicitly mentioned as a target profile." />
      <alias value="Patient" />
      <alias value="Vertegenwoordiger" />
      <alias value="Zorgverlener" />
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/CareTeam" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" />
        <targetProfile value="http://nictiz.nl/fhir/StructureDefinition/zib-Patient" />
        <targetProfile value="http://nictiz.nl/fhir/StructureDefinition/zib-ContactPerson" />
        <targetProfile value="http://nictiz.nl/fhir/StructureDefinition/zib-HealthProfessional-PractitionerRole" />
      </type>
      <mapping>
        <identity value="zib-treatmentdirective2-v1.0-2020EN" />
        <map value="NL-CM:2.2.10" />
        <comment value="Patient" />
      </mapping>
      <mapping>
        <identity value="zib-treatmentdirective2-v1.0-2020EN" />
        <map value="NL-CM:2.2.11" />
        <comment value="Representative" />
      </mapping>
      <mapping>
        <identity value="zib-treatmentdirective2-v1.0-2020EN" />
        <map value="NL-CM:2.2.12" />
        <comment value="HealthProfessional" />
      </mapping>
    </element>
    <element id="Consent.provision.code">
      <path value="Consent.provision.code" />
      <short value="Treatment" />
      <definition value="The medical treatment to which the treatment instruction applies." />
      <alias value="Behandeling" />
      <max value="1" />
      <binding>
        <strength value="required" />
        <valueSet value="http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.2.2.1--20200901000000" />
      </binding>
      <mapping>
        <identity value="zib-treatmentdirective2-v1.0-2020EN" />
        <map value="NL-CM:2.2.3" />
        <comment value="Treatment" />
      </mapping>
    </element>
  </differential>
</StructureDefinition>