PACIO Advance Directive Interoperability Implementation Guide
0.1.0 - STU 1 Ballot

This page is part of the PACIO Advance Directive Information Implementation Guide (v0.1.0: STU 1 Ballot 1) based on FHIR R4. . For a full list of available versions, see the Directory of published versions

Example Consent: Example-Smith-Johnson-HealthcareAgentConsent

status: active

scope: Powers granted to healthcare agent [Reported]

category: Advance Directive

patient: Betsy Smith-Johnson ; BetsySJ@example.com; gender: female; birthDate: 1950-11-15

dateTime: 2020-08-03

Policies

-AuthorityUri
*https://www.michigan.gov/http://www.legislature.mi.gov/(S(tpnclc1ofteerx2x2dppcmdz))/mileg.aspx?page=GetObject&objectname=mcl-386-1998-V-5

provision

type: permit

actor

role: Primary healthcare agent [Reported]

reference: natural son; Charles Johnson ; CharlesSJ@example.com

actor

role: First alternate healthcare agent [Reported]

reference: First alternate healthcare agent [Reported], natural daughter; Debra Johnson ; DebraSJ@example.com

action: Advance directive - request for intubation, Advance directive - request for tube feeding, Advance directive - request for life support, Advance directive - request for IV fluid and support, Advance directive - request for antibiotics, Advance directive - request for resuscitation that differs from cardiopulmonary resuscitation

purpose: power of attorney