This page is part of the PACIO Advance Directive Information Implementation Guide (v1.0.0: STU 1) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions
<Consent xmlns="http://hl7.org/fhir">
<id value="Example-McBee-HealthcareAgentConsent"/>
<meta>
<profile
value="http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-ParticipantConsent"/>
</meta>
<text>
<status value="additional"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>status</b>: active</p><p><b>scope</b>: <span title="Codes: {http://loinc.org 75786-4}">Powers granted to healthcare agent [Reported]</span></p><p><b>category</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/consentcategorycodes acd}">Advance Directive</span></p><p><b>patient</b>: <a href="Patient-Example-McBee-Patient1.html">Social Beneficiary Identifier: 555-12-1246, Roger Rienman McBee; Phone: +1(469)238-2858, Phone: +1(214)497-9529, rogerb@example.com; gender: male; birthDate: 1945-04-01</a></p><p><b>dateTime</b>: 2020-08-03</p><h3>Policies</h3><table class="grid"><tr><td>-</td><td><b>Authority</b></td><td><b>Uri</b></td></tr><tr><td>*</td><td><a href="https://www.michigan.gov/">https://www.michigan.gov/</a></td><td><a href="http://www.legislature.mi.gov/(S(tpnclc1ofteerx2x2dppcmdz))/mileg.aspx?page=GetObject&objectname=mcl-386-1998-V-5">http://www.legislature.mi.gov/(S(tpnclc1ofteerx2x2dppcmdz))/mileg.aspx?page=GetObject&objectname=mcl-386-1998-V-5</a></td></tr></table><blockquote><p><b>provision</b></p><p><b>type</b>: permit</p><blockquote><p><b>actor</b></p><p><b>role</b>: <span title="Codes: {http://loinc.org 75783-1}">Primary healthcare agent [Reported]</span></p><p><b>reference</b>: <a href="RelatedPerson-Example-McBee-HealthcareAgent1.html">Bobbins Sally ; SallyBobbins@example.com</a></p></blockquote><blockquote><p><b>actor</b></p><p><b>role</b>: <span title="Codes: {http://loinc.org 75784-9}">First alternate healthcare agent [Reported]</span></p><p><b>reference</b>: <a href="RelatedPerson-Example-McBee-HealthcareAgent2.html"><span title="Codes: {http://terminology.hl7.org/CodeSystem/v3-RoleCode FRND}">unrelated friend</span>; Susskind S. Leonard ; ssuskind@example.com</a></p></blockquote><p><b>action</b>: <span title="Codes: {http://loinc.org 75787-2}">Advance directive - request for intubation</span>, <span title="Codes: {http://loinc.org 75788-0}">Advance directive - request for tube feeding</span>, <span title="Codes: {http://loinc.org 75789-8}">Advance directive - request for life support</span></p><p><b>purpose</b>: <span title="{http://terminology.hl7.org/CodeSystem/v3-ActReason PWATRNY}">power of attorney</span></p></blockquote></div>
</text>
<status value="active"/>
<scope>
<coding>
<system value="http://loinc.org"/>
<code value="75786-4"/>
<display value="Powers granted to healthcare agent [Reported]"/>
</coding>
</scope>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/consentcategorycodes"/>
<code value="acd"/>
<display value="Advance Directive"/>
</coding>
</category>
<patient>🔗
<reference value="Patient/Example-McBee-Patient1"/>
</patient>
<dateTime value="2020-08-03"/>
<policy>
<authority value="https://www.michigan.gov/"/>
<uri
value="http://www.legislature.mi.gov/(S(tpnclc1ofteerx2x2dppcmdz))/mileg.aspx?page=GetObject&objectname=mcl-386-1998-V-5"/>
</policy>
<provision>
<type value="permit"/>
<actor>
<role>
<coding>
<system value="http://loinc.org"/>
<code value="75783-1"/>
<display value="Primary healthcare agent [Reported]"/>
</coding>
</role>
<reference>🔗
<reference value="RelatedPerson/Example-McBee-HealthcareAgent1"/>
</reference>
</actor>
<actor>
<role>
<coding>
<system value="http://loinc.org"/>
<code value="75784-9"/>
<display value="First alternate healthcare agent [Reported]"/>
</coding>
</role>
<reference>🔗
<reference value="RelatedPerson/Example-McBee-HealthcareAgent2"/>
</reference>
</actor>
<action>
<coding>
<system
value="http://hl7.org/fhir/us/pacio-adi/CodeSystem/ADIHCADecisionsCS"/>
<code value="intubation"/>
<display value="Intubation"/>
</coding>
</action>
<action>
<coding>
<system
value="http://hl7.org/fhir/us/pacio-adi/CodeSystem/ADIHCADecisionsCS"/>
<code value="tube-feeding"/>
<display value="Tube feeding"/>
</coding>
</action>
<action>
<coding>
<system
value="http://hl7.org/fhir/us/pacio-adi/CodeSystem/ADIHCADecisionsCS"/>
<code value="life-support"/>
<display value="Life support"/>
</coding>
</action>
<purpose>
<system value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/>
<code value="PWATRNY"/>
</purpose>
</provision>
</Consent>