{
  "resourceType": "StructureDefinition",
  "id": "StfTodesursache",
  "url": "http://gematik.de/fhir/oegd/stf/StructureDefinition/StfTodesursache",
  "version": "1.0.2",
  "name": "StfTodesursache",
  "title": "STF Todesursache",
  "status": "active",
  "experimental": false,
  "date": "2026-03-30",
  "publisher": "ELFA Maßnahme Interoperabilität",
  "description": "Todesursache (kompatibel zu [MII PR Onkologie Tod](https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-pr-onko-tod) )",
  "fhirVersion": "4.0.1",
  "kind": "resource",
  "abstract": false,
  "type": "Observation",
  "baseDefinition": "http://gematik.de/fhir/oegd/stf/StructureDefinition/StfBasisObservation",
  "derivation": "constraint",
  "differential": {
    "element": [
      {
        "id": "Observation.code.coding",
        "path": "Observation.code.coding",
        "slicing": {
          "discriminator": [
            {
              "type": "pattern",
              "path": "$this"
            }
          ],
          "rules": "open"
        },
        "min": 1
      },
      {
        "id": "Observation.code.coding:SCT",
        "path": "Observation.code.coding",
        "sliceName": "SCT",
        "min": 1,
        "max": "1",
        "patternCoding": {
          "code": "184305005",
          "system": "http://snomed.info/sct"
        },
        "mustSupport": true
      },
      {
        "id": "Observation.effective[x]",
        "path": "Observation.effective[x]",
        "type": [
          {
            "code": "dateTime"
          }
        ]
      },
      {
        "id": "Observation.effective[x]:effectiveDateTime",
        "path": "Observation.effective[x]",
        "sliceName": "effectiveDateTime",
        "comment": "Beginn der Krankheit",
        "type": [
          {
            "code": "dateTime"
          }
        ]
      },
      {
        "id": "Observation.performer",
        "path": "Observation.performer",
        "comment": "Referenz auf den oder die ausstellende Arztin",
        "mustSupport": true
      },
      {
        "id": "Observation.value[x]",
        "path": "Observation.value[x]",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ]
      },
      {
        "id": "Observation.value[x].coding.system",
        "path": "Observation.value[x].coding.system",
        "min": 1,
        "patternUri": "http://hl7.org/fhir/sid/icd-10",
        "mustSupport": true
      },
      {
        "id": "Observation.value[x].coding.version",
        "path": "Observation.value[x].coding.version",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Observation.value[x].coding.code",
        "path": "Observation.value[x].coding.code",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Observation.value[x].coding.display",
        "path": "Observation.value[x].coding.display",
        "comment": "Im Display sind nur die offiziell in ICD-10 gelisteten Bezeichnungen zu verwenden. Freitexte sind im Text-Element zu hinterlegen.",
        "mustSupport": true
      },
      {
        "id": "Observation.value[x].text",
        "path": "Observation.value[x].text",
        "mustSupport": true
      },
      {
        "id": "Observation.dataAbsentReason",
        "path": "Observation.dataAbsentReason",
        "comment": "Todesart ungeklärt\nWenn Todesart = ungeklärt ODER\n= schwebende Ermittlung\ndann j\nsonst n",
        "mustSupport": true
      },
      {
        "id": "Observation.note",
        "path": "Observation.note",
        "comment": "Nähere Angaben zur Todesursache und zu Begleiterkrankung (Epikrise)"
      },
      {
        "id": "Observation.hasMember",
        "path": "Observation.hasMember",
        "comment": "Verknüpfung von nachgelagerten Todesursachen. Alle weiteren Todesursachen, die zur Haupttodesursache geführt haben, werden über hasMember referenziert. Die weiteren Todesursachen selber dürfen keine hasMember Referenzen enthalten."
      },
      {
        "id": "Observation.hasMember.reference",
        "path": "Observation.hasMember.reference",
        "mustSupport": true
      },
      {
        "id": "Observation.component",
        "path": "Observation.component",
        "slicing": {
          "discriminator": [
            {
              "type": "pattern",
              "path": "code"
            }
          ],
          "rules": "open"
        },
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Observation.component.code",
        "path": "Observation.component.code",
        "mustSupport": true,
        "binding": {
          "strength": "extensible",
          "valueSet": "http://gematik.de/fhir/oegd/stf/ValueSet/StfObservationCodes"
        }
      },
      {
        "id": "Observation.component.value[x]",
        "path": "Observation.component.value[x]",
        "slicing": {
          "discriminator": [
            {
              "type": "type",
              "path": "$this"
            }
          ],
          "ordered": false,
          "rules": "open"
        },
        "mustSupport": true
      },
      {
        "id": "Observation.component.value[x]:valueCodeableConcept",
        "path": "Observation.component.value[x]",
        "sliceName": "valueCodeableConcept",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Observation.component:Todesursachensequenz",
        "path": "Observation.component",
        "sliceName": "Todesursachensequenz",
        "comment": "Hier ist abgebildet, an welcher Stelle der Sequenz diese Todesursache kommt. (Ia, Ib, Ic, II)",
        "min": 1,
        "max": "1",
        "mustSupport": true
      },
      {
        "id": "Observation.component:Todesursachensequenz.code",
        "path": "Observation.component.code",
        "patternCodeableConcept": {
          "coding": [
            {
              "code": "82791-5",
              "system": "http://loinc.org"
            }
          ]
        }
      },
      {
        "id": "Observation.component:Todesursachensequenz.value[x]",
        "path": "Observation.component.value[x]",
        "min": 1,
        "type": [
          {
            "code": "CodeableConcept"
          }
        ]
      },
      {
        "id": "Observation.component:Todesursachensequenz.value[x]:valueCodeableConcept",
        "path": "Observation.component.value[x]",
        "sliceName": "valueCodeableConcept",
        "min": 1,
        "type": [
          {
            "code": "CodeableConcept"
          }
        ]
      },
      {
        "id": "Observation.component:Todesursachensequenz.value[x]:valueCodeableConcept.coding",
        "path": "Observation.component.value[x].coding",
        "min": 1,
        "mustSupport": true,
        "binding": {
          "strength": "required",
          "valueSet": "http://gematik.de/fhir/oegd/stf/ValueSet/StfTodesursachensequenzVS"
        }
      },
      {
        "id": "Observation.component:NichtNatuerlicherTod",
        "path": "Observation.component",
        "sliceName": "NichtNatuerlicherTod",
        "comment": "Anhaltspunkte für einen nicht-natürlichen Tod\n\nWenn Todesart = natürlich, \ndann 'ja' (Y)\n\nWenn Todesart =  nicht natürlich ODER \n= Tötung ODER \n= Selbsttötung ODER \n= Unfall ODER\n= Komplikationen medizinischer Behandlungen ODER\n= Ereignis, dessen nähere Umstände unbestimmt dann 'nein' (N) \n\nWenn Todesart = leer, \ndann unbekannt (unknown);",
        "min": 0,
        "max": "1",
        "mustSupport": true
      },
      {
        "id": "Observation.component:NichtNatuerlicherTod.code",
        "path": "Observation.component.code",
        "patternCodeableConcept": {
          "coding": [
            {
              "code": "nichtNatuerlicherTod",
              "system": "http://gematik.de/fhir/oegd/stf/CodeSystem/StfObservationCodesErweiterungCS"
            }
          ]
        }
      },
      {
        "id": "Observation.component:NichtNatuerlicherTod.value[x]",
        "path": "Observation.component.value[x]",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ]
      },
      {
        "id": "Observation.component:NichtNatuerlicherTod.value[x]:valueCodeableConcept",
        "path": "Observation.component.value[x]",
        "sliceName": "valueCodeableConcept",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ]
      },
      {
        "id": "Observation.component:NichtNatuerlicherTod.value[x]:valueCodeableConcept.coding",
        "path": "Observation.component.value[x].coding",
        "binding": {
          "strength": "required",
          "valueSet": "http://gematik.de/fhir/oegd/stf/ValueSet/StfJaNeinUnbekanntVS"
        }
      },
      {
        "id": "Observation.component:NichtNatuerlicherTod.value[x]:valueCodeableConcept.text",
        "path": "Observation.component.value[x].text",
        "mustSupport": true
      },
      {
        "id": "Observation.component:WeitereAngaben",
        "path": "Observation.component",
        "sliceName": "WeitereAngaben",
        "comment": "Weitere Angaben zur Klassifikation der Todesursache, z.B. bei Unfall, Vergiftung,  Gewalteinwirkung, Selbsttötung sowie bei Komplikationen medizinischer Behandlung Äußere Ursache der Schädigung (Angaben über den Hergang); bei Vergiftungen zusätzlich Angabe des Mittels",
        "min": 0,
        "max": "*",
        "mustSupport": true
      },
      {
        "id": "Observation.component:WeitereAngaben.code",
        "path": "Observation.component.code",
        "patternCodeableConcept": {
          "coding": [
            {
              "code": "todesursacheKlassifikation",
              "system": "http://gematik.de/fhir/oegd/stf/CodeSystem/StfObservationCodesErweiterungCS"
            }
          ]
        }
      },
      {
        "id": "Observation.component:WeitereAngaben.value[x]",
        "path": "Observation.component.value[x]",
        "type": [
          {
            "code": "CodeableConcept"
          },
          {
            "code": "string"
          }
        ]
      },
      {
        "id": "Observation.component:WeitereAngaben.value[x]:valueCodeableConcept",
        "path": "Observation.component.value[x]",
        "sliceName": "valueCodeableConcept",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ]
      },
      {
        "id": "Observation.component:WeitereAngaben.value[x]:valueCodeableConcept.coding",
        "path": "Observation.component.value[x].coding",
        "mustSupport": true
      },
      {
        "id": "Observation.component:WeitereAngaben.value[x]:valueCodeableConcept.coding.system",
        "path": "Observation.component.value[x].coding.system",
        "min": 1,
        "patternUri": "http://hl7.org/fhir/sid/icd-10",
        "mustSupport": true
      },
      {
        "id": "Observation.component:WeitereAngaben.value[x]:valueCodeableConcept.coding.version",
        "path": "Observation.component.value[x].coding.version",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Observation.component:WeitereAngaben.value[x]:valueCodeableConcept.coding.code",
        "path": "Observation.component.value[x].coding.code",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Observation.component:WeitereAngaben.value[x]:valueCodeableConcept.coding.display",
        "path": "Observation.component.value[x].coding.display",
        "mustSupport": true
      },
      {
        "id": "Observation.component:WeitereAngaben.value[x]:valueCodeableConcept.text",
        "path": "Observation.component.value[x].text",
        "mustSupport": true
      },
      {
        "id": "Observation.component:WeitereAngaben.value[x]:valueString",
        "path": "Observation.component.value[x]",
        "sliceName": "valueString",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "string"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Observation.component:ZeitdauerBeginnBisTod",
        "path": "Observation.component",
        "sliceName": "ZeitdauerBeginnBisTod",
        "comment": "Angabe der Zeitdauer von Beginn der Krankheit bis zum Tod in beliebiger Angabe",
        "min": 0,
        "max": "1",
        "mustSupport": true
      },
      {
        "id": "Observation.component:ZeitdauerBeginnBisTod.code",
        "path": "Observation.component.code",
        "patternCodeableConcept": {
          "coding": [
            {
              "code": "zeitdauerBeginnBisTod",
              "system": "http://gematik.de/fhir/oegd/stf/CodeSystem/StfObservationCodesErweiterungCS"
            }
          ]
        }
      },
      {
        "id": "Observation.component:ZeitdauerBeginnBisTod.value[x]",
        "path": "Observation.component.value[x]",
        "type": [
          {
            "code": "string"
          }
        ]
      },
      {
        "id": "Observation.component:ZeitdauerBeginnBisTod.value[x]:valueString",
        "path": "Observation.component.value[x]",
        "sliceName": "valueString",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "string"
          }
        ],
        "mustSupport": true
      }
    ]
  }
}