Release 5

This page is part of the FHIR Specification (v5.0.0: R5 - STU). This is the current published version. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3

Example Consent/consent-example-notThem (XML)

Community Based Collaborative Care Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: Patient

Raw XML (canonical form + also see XML Format Specification)

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Withhold or withdraw consent for disclosure to a specific provider agent (an individual within an organization) (id = "consent-example-notThem")

<?xml version="1.0" encoding="UTF-8"?>

<Consent xmlns="http://hl7.org/fhir">
  <id value="consent-example-notThem"/> 
  <text> 
    <status value="generated"/> 
    <div xmlns="http://www.w3.org/1999/xhtml">The following scenario is based on existing jurisdictional policy and are realized
       in existing systems in Canada. 
    The default policy is one of implied consent for the provision of care, so these
       scenarios all deal with withdrawal or withholding consent for that purpose. <p> 
    specific to use-case 4) Withhold or withdraw consent for disclosure to a specific
         provider agent (an individual within an organization) </p> 
      <p> Patient &quot;Eve Everywoman&quot;'s ex-spouse, Carla Espinosa is a Nurse that
         is employed by Burgers University Medical Center.
    Eve realizes that she may receive treatment at BUMC, however she does not want
         her ex-spouse to have any 
    access to her IIHI.  She indicates that she would like to withdraw/withhold
         consent to disclose any instance 
    of her health information to her ex-spouse as a result of her ex's employment
         at Burgers University Medical Center.
      </p> 
    </div> 
  </text> 
  <status value="active"/> 
  <category> 
    <coding> 
      <system value="http://loinc.org"/> 
      <code value="59284-0"/> 
    </coding> 
  </category> 
  <subject> 
    <reference value="Patient/mom"/> 
    <display value="Eve Everywoman"/> 
  </subject> 
  <date value="2018-12-24"/> 
  <controller> 
    <reference value="Organization/f001"/> 
  </controller> 
    <!--   the text terms of the consent in lawyer speak   -->
  <sourceAttachment> 
    <title value="The terms of the consent in lawyer speak."/> 
      <!--   likely use url pointer to common text   -->
  </sourceAttachment> 
    <!--   this is opt-in - e.g. everything approved unless otherwise stated   -->
  <regulatoryBasis> 
    <coding> 
      <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/> 
      <code value="INFA"/> 
    </coding> 
  </regulatoryBasis> 
  <verification> 
    <verified value="true"/> 
    <verifiedBy> 
      <reference value="Organization/f001"/> 
    </verifiedBy> 
    <verifiedWith> 
      <reference value="RelatedPerson/benedicte"/> 
    </verifiedWith> 
    <verificationDate value="2021-11-11"/> 
  </verification> 
  <decision value="permit"/> 

  <provision> 
      <!--   no read or write access for this individual   -->
    <actor> 
      <role> 
        <coding> 
          <system value="http://terminology.hl7.org/CodeSystem/v3-ParticipationType"/> 
          <code value="PRCP"/> 
            <!--   PRCP: recipient of the information   -->
        </coding> 
      </role> 
      <reference> 
        <reference value="Practitioner/f204"/> 
        <display value="Carla Espinosa"/> 
      </reference> 
    </actor> 
    <action> 
      <coding> 
        <system value="http://terminology.hl7.org/CodeSystem/consentaction"/> 
        <code value="access"/> 
      </coding> 
    </action> 
    <action> 
      <coding> 
        <system value="http://terminology.hl7.org/CodeSystem/consentaction"/> 
        <code value="correct"/> 
      </coding> 
    </action> 
  </provision> 

</Consent> 

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.