A record of a healthcare consumer’s policy 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.

Broadly, there are 3 key areas of consent for patients: Consent around sharing information (aka Privacy Consent Directive - Authorization to Collect, Use, or Disclose information), consent for specific treatment, or kinds of treatment, and general advance care directives.

Unique identifier for this copy of the Consent Statement.

This identifier is 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.

Indicates the current state of this consent.

The Consent Directive that is pointed to might be in various lifecycle states, e.g., a revoked Consent Directive.

This is the status of this consent at the time it was issued / created / indexed.

A classification of the type of consents found in the statement. This element supports indexing and retrieval of consent statements.

When this Consent was issued / created / indexed.

This is not the time of the original consent, but the time that this statement was made or derived.

Relevant time or time-period when this Consent is applicable.

This can be a subset of the period of the original statement.

The patient/healthcare consumer to whom this consent applies.

Commonly, the patient the consent pertains to is the author, but for young and old people, it may be some other person.

The patient/consumer that is responsible for agreeing to the consent represented by this resource. This is the person (usually) that agreed to the policy, along with the exceptions, e.g. the persion who takes responsibility for the agreement. In the signature this corresponds to the role "Consent Signature".

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.

The organization that manages the consent, and the framework within which it is executed.

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.

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.

A reference to the policy that this consents to. Policies may be organizational, but are often defined jurisdictionally, or in law.

If the policy reference is not known, the resource cannot be processed. Where the reference is absent, there is no particular policy other than what is expressed directly in the consent resource.

Actor whose access is controlled by this consent under the terms of the policy and exceptions.

The Consent recipient is the person/organization who is being granted or denied permission according to the stated policy.

The context of the activities a user is taking - why the user is accessing the data - that are controlled by this consent.

This element is for discoverability / documentation, and does not modify or qualify the policy (e.g. the policy itself describes the purposes for which it applies).

An exception to the base policy of this consent. An exception can be an addition or removal of access permissions.

Action to take - permit or deny - when the exception conditions are met.

The timeframe in which data is controlled by this exception.

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.

Who or what is controlled by this Exception. Use group to identify a set of actors by some property they share (e.g. 'admitting officers').

How the individual is or was involved in the resourcescontent that is described in the exception.

The resource that identifies the actor. To identify a actors by type, use group to identify a set of actors by some property they share (e.g. 'admitting officers').

Actions controlled by this Exception.

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'.

A set of security labels that define which resources are controlled by this exception. If more than one label is specified, all resources must have all the specified labels.

If the consent specifies a security label of "R" then it applies to all resources that are labelled "R" or lower. E.g. for Confidentiality, it's a high water mark. For other kinds of security labels, subsumption logic applies. Not all of the security labels make sense for use in this element (may define a narrower value set?).

The context of the activities a user is taking - why the user is accessing the data - that are controlled by this exception.

E.g. if the purpose is 'research', then the operational context must be research, in order for the consent to apply. Not all of the security labels make sense for use in this element (may define a narrower value set?).

The class of information covered by this exception. 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.

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.

If this code is found in an instance, then the exception applies. TODO: where do you not have to look? This is a problematic element.

Typical use of this is a Document code with class = CDA.

The resources controlled by this exception, if specific resources are referenced.

How the resource reference is interpreted when testing consent restrictions.

A reference to a specific resource that defines which resources are covered by this consent.