TEMPLATE Advance care directive (Advance care directive)

TEMPLATE IDAdvance care directive
ConceptAdvance care directive
DescriptionNot Specified
PurposeNot Specified
References
Authorsname: Ian McNicoll; organisation: freshEHR Clinical Informatics Ltd.; email: ian@freshehr.com; date: 2020-03-16
Other Details Languagename: Ian McNicoll; organisation: freshEHR Clinical Informatics Ltd.; email: ian@freshehr.com; date: 2020-03-16
OtherDetails Language Independent{licence=This work is licensed under the Creative Commons Attribution-ShareAlike 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/4.0/., custodian_organisation=openEHR Foundation, PARENT:MD5-CAM-1.0.1=89aa50dbd220bedccacba9ea709f5cad, original_namespace=org.openehr, original_publisher=openEHR Foundation, custodian_namespace=org.openehr, MD5-CAM-1.0.1=b5ee6afc1aa400a03cbae97caa9e8541}
Language useden
Citeable Identifier1051.57.229
AllOperationalTemplate [rootArchetypeId=openEHR-EHR-COMPOSITION.advance_care_directive.v0, otherContributors=null, tshis=[ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.advance_care_directive.v0], code=at0000, itemType=COMPOSITION, level=0, text=Advance care directive, description=A framework to communicate the preferences of an individual for future medical treatment or end-of-life care., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=COMPOSITION, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=null, code=null, itemType=UNSUPPORTEDTOPLEVELATTRIBUTE, level=1, text=Other Context, description=null, comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=UNSUPPORTEDTOPLEVELATTRIBUTE, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.advance_care_directive.v0]/context[at0002]/other_context[at0003]/items[openEHR-EHR-CLUSTER.xds_metadata.v0], code=at0000, itemType=CLUSTER, level=2, text=XDS Metadata, description=Additional composition metadata aligned with IHE-XDS which is not already available from the Reference Model COMPOSITION class., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.advance_care_directive.v0]/context[at0002]/other_context[at0003]/items[openEHR-EHR-CLUSTER.xds_metadata.v0]/items[at0001], code=at0001, itemType=ELEMENT, level=3, text=Author specialty, description=The speciality of the author/composer of the document., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.advance_care_directive.v0]/context[at0002]/other_context[at0003]/items[openEHR-EHR-CLUSTER.xds_metadata.v0]/items[at0002], code=at0002, itemType=ELEMENT, level=3, text=Class code, description=A high-level document class code, normally selected from a valueset provided by the IHE-XDS Affinity Domain., comment=For example: Report, Summary, Images, Plan, Patient Preferences, Workflow. These codes are specific to an XDS Affinity Domain., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.advance_care_directive.v0]/context[at0002]/other_context[at0003]/items[openEHR-EHR-CLUSTER.xds_metadata.v0]/items[at0003], code=at0003, itemType=ELEMENT, level=3, text=Document type, description=The code specifying the precise type of document from the user perspective. Normally selected from a valueset provided by the local IHE-XDS Affinity Domain or national standard., comment=for example: Pulmonary History and Physical, Discharge Summary, Ultrasound Report. These codes are specific to an XDS Affinity Domain., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.advance_care_directive.v0]/context[at0002]/other_context[at0003]/items[openEHR-EHR-CLUSTER.xds_metadata.v0]/items[at0004], code=at0004, itemType=ELEMENT, level=3, text=Confidentiality code, description=A term specifying the level of confidentiality of the XDS Document., comment=Coded text is preferred, normally specific to an XDS Affinity Domain., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.advance_care_directive.v0]/context[at0002]/other_context[at0003]/items[openEHR-EHR-CLUSTER.xds_metadata.v0]/items[at0007], code=at0007, itemType=ELEMENT, level=3, text=Health care facility type, description=A term defining the healthcare facility type., comment=Coded text is preferred. The codes are specific to an XDS Affinity Domain., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.advance_care_directive.v0]/context[at0002]/other_context[at0003]/items[openEHR-EHR-CLUSTER.xds_metadata.v0]/items[at0009], code=at0009, itemType=ELEMENT, level=3, text=Practice setting code, description=The code specifying the clinical specialty where the act that resulted in the document was performed., comment=For example: Family Practice, Laboratory, Radiology. Coded text is preferred, normally specific to an XDS Affinity Domain., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.advance_care_directive.v0]/context[at0002]/other_context[at0003]/items[openEHR-EHR-CLUSTER.xds_metadata.v0]/items[at0011], code=at0011, itemType=ELEMENT, level=3, text=Event code, description=This list of codes represents the main clinical acts., comment=For example: Colonoscopy or appendicectomy., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.advance_care_directive.v0]/context[at0002]/other_context[at0003]/items[openEHR-EHR-CLUSTER.xds_metadata.v0]/items[at0010], code=at0010, itemType=ELEMENT, level=3, text=Document_media, description=Additional metadata about the document itself, including size, url., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_MULTIMEDIA, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.advance_care_directive.v0]/content[openEHR-EHR-EVALUATION.advance_care_directive.v0], code=at0000, itemType=EVALUATION, level=1, text=Advance care directive, description=A framework to communicate the preferences of an individual for future medical treatment or end-of-life care., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=EVALUATION, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.advance_care_directive.v0]/content[openEHR-EHR-EVALUATION.advance_care_directive.v0]/data[at0001], code=at0001, itemType=UNSUPPORTEDTOPLEVELATTRIBUTE, level=2, text=Data, description=, comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=UNSUPPORTEDTOPLEVELATTRIBUTE, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.advance_care_directive.v0]/content[openEHR-EHR-EVALUATION.advance_care_directive.v0]/data[at0001]/items[at0005], code=at0005, itemType=ELEMENT, level=3, text=Type of directive, description=The type of advance care directive., comment=A short text description of the nature of the advance care directive. Coding of the type of directive with a terminology is preferred, where possible. It is expected that this is largely localised to reflect local policy and legislation. For example, in the Netherlands, advance care directive types include, but are not limited to, 'Treatment prohibition', 'Treatment prohibition with completion of Completed Life', 'Euthanasia request' and 'Declaration of life'. In the UK, advance care directive types include 'Advance Decision', 'Advance Directive' and 'Advance Statement'., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=
  • Advance Directive
  • Advance Decision
  • Advance Statement
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.advance_care_directive.v0]/content[openEHR-EHR-EVALUATION.advance_care_directive.v0]/data[at0001]/items[at0004], code=at0004, itemType=ELEMENT, level=3, text=Status, description=The status of the advance care directive., comment=Coding of the advance care directive status with a terminology is preferred, where possible., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=
  •  Coded Text
    • Present 
    • Absent 
    • Unknown 
  •  Text
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.advance_care_directive.v0]/content[openEHR-EHR-EVALUATION.advance_care_directive.v0]/data[at0001]/items[at0006], code=at0006, itemType=ELEMENT, level=3, text=Description, description=Narrative description of the overall advance care directive., comment=May be used to record a narrative overview of the complete advance care directive, which may or may not be supported by structured data. Details of specific structured findings can be included using CLUSTER archetypes in the 'Directive details' slot. This data element may be used to capture legacy data that is not available in a structured format., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.advance_care_directive.v0]/content[openEHR-EHR-EVALUATION.advance_care_directive.v0]/data[at0001]/items[at0007], code=at0007, itemType=ELEMENT, level=3, text=Condition, description=The conditions or situations in which the individual wishes the advance care directive to apply., comment=For example: dementia, brain injury, diseases of the central nervous system, and terminal illness. Coding with a terminology is preferred, where possible. The advance care directive applies to all specified conditions if the individual can no longer make or communicate decisions about their medical treatment and is unlikely to regain the ability to make such decisions. Details of specific decisions that apply to different conditions or situations can be included using CLUSTER archetypes in the 'Directive details' slot., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=
  • Dementia
  • Brain injury
  • Diseases of the central nervous system
  • Terminal illness
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.advance_care_directive.v0]/content[openEHR-EHR-EVALUATION.advance_care_directive.v0]/data[at0001]/items[openEHR-EHR-CLUSTER.living_will_details_uk.v0], code=at0000, itemType=CLUSTER, level=3, text=Advance Directive UK, description=Details relating to a living will document based on the UK requirements. Living will is a document to communicate the individual's wishes with regard to future medical action or end-of-life care, to be used in situations in which the individual has lost the capacity to make or express choices., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.advance_care_directive.v0]/content[openEHR-EHR-EVALUATION.advance_care_directive.v0]/data[at0001]/items[openEHR-EHR-CLUSTER.living_will_details_uk.v0]/items[at0018], code=at0018, itemType=ELEMENT, level=4, text=Refusal of all life-sustaining treatment, description=Confirms the individual’s decision to refuse all life-sustaining treatment even if their life is at risk or may be shortened as a result., comment=Life-sustaining treatment includes, but is not limited to, CPR, clinically assisted nutrition and hydration, artificial or mechanical ventilation, and antibiotics for life-threatening infections., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Yes 
  • No 
  • Unknown 
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.advance_care_directive.v0]/content[openEHR-EHR-EVALUATION.advance_care_directive.v0]/data[at0001]/items[openEHR-EHR-CLUSTER.living_will_details_uk.v0]/items[at0002], code=at0002, itemType=CLUSTER, level=4, text=Refusal of specific treatment, description=States the individual’s decision to refuse specific treatment even if their life is at risk or may be shortened as a result., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.advance_care_directive.v0]/content[openEHR-EHR-EVALUATION.advance_care_directive.v0]/data[at0001]/items[openEHR-EHR-CLUSTER.living_will_details_uk.v0]/items[at0002]/items[at0003], code=at0003, itemType=ELEMENT, level=5, text=Name of treatment, description=Name of the treatment., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=
  •  Coded TextValue set: external
  •  Text
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.advance_care_directive.v0]/content[openEHR-EHR-EVALUATION.advance_care_directive.v0]/data[at0001]/items[openEHR-EHR-CLUSTER.living_will_details_uk.v0]/items[at0002]/items[at0004], code=at0004, itemType=ELEMENT, level=5, text=Description, description=Narrative description of the treatment., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.advance_care_directive.v0]/content[openEHR-EHR-EVALUATION.advance_care_directive.v0]/data[at0001]/items[openEHR-EHR-CLUSTER.living_will_details_uk.v0]/items[at0008], code=at0008, itemType=ELEMENT, level=4, text=Pain relief, description=Confirms whether the individual wishes to receive all medical treatment intended to alleviate pain or distress, or to ensure comfort, even if the result of the treatment may shorten their life., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Yes 
  • No 
  • Not applicable 
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.advance_care_directive.v0]/content[openEHR-EHR-EVALUATION.advance_care_directive.v0]/data[at0001]/items[openEHR-EHR-CLUSTER.living_will_details_uk.v0]/items[at0010], code=at0010, itemType=ELEMENT, level=4, text=Pregnancy, description=Confirms whether the individual, if pregnant, wishes to receive medical treatment or procedures leading to the safe delivery of their child. Once their child is safely delivered, the individual wishes to reinstate the decisions set out in the living will., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Yes 
  • No 
  • Not applicable 
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.advance_care_directive.v0]/content[openEHR-EHR-EVALUATION.advance_care_directive.v0]/data[at0001]/items[openEHR-EHR-CLUSTER.living_will_details_uk.v0]/items[at0007], code=at0007, itemType=ELEMENT, level=4, text=Additional decisions on medical treatment, description=Any other decisions on medical treatment that the individual wishes to include in the living will., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.advance_care_directive.v0]/content[openEHR-EHR-EVALUATION.advance_care_directive.v0]/data[at0001]/items[at0058], code=at0058, itemType=CLUSTER, level=3, text=Location details, description=Information regarding where the advance care directive is stored and who has a copy of it., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.advance_care_directive.v0]/content[openEHR-EHR-EVALUATION.advance_care_directive.v0]/data[at0001]/items[at0058]/items[at0030], code=at0030, itemType=ELEMENT, level=4, text=Location, description=Information regarding where the advance care directive is stored and how to gain access to it., comment=For example, 'In the top drawer of the bedside table'., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.advance_care_directive.v0]/content[openEHR-EHR-EVALUATION.advance_care_directive.v0]/data[at0001]/items[at0038], code=at0038, itemType=ELEMENT, level=3, text=Comment, description=Additional narrative about the advance care directive not captured in other fields., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.advance_care_directive.v0]/content[openEHR-EHR-EVALUATION.advance_care_directive.v0]/protocol[at0010], code=at0010, itemType=UNSUPPORTEDTOPLEVELATTRIBUTE, level=2, text=Protocol, description=, comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=UNSUPPORTEDTOPLEVELATTRIBUTE, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.advance_care_directive.v0]/content[openEHR-EHR-EVALUATION.advance_care_directive.v0]/protocol[at0010]/items[at0053], code=at0053, itemType=ELEMENT, level=3, text=Valid period start, description=The date/time that marks the beginning of the valid period of time for this advance care directive., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DATE_TIME, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.advance_care_directive.v0]/content[openEHR-EHR-EVALUATION.advance_care_directive.v0]/protocol[at0010]/items[at0054], code=at0054, itemType=ELEMENT, level=3, text=Valid period end, description=The date/time that marks the conclusion of the valid period of time for this advance care directive., comment='Valid period end' may often overlap with 'Review due date'. However, they may need to be recorded separately in circumstances where a document has an extended period of validity but requires an interim review. That may be due to changed personal circumstances/events or local policy., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DATE_TIME, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.advance_care_directive.v0]/content[openEHR-EHR-EVALUATION.advance_care_directive.v0]/protocol[at0010]/items[at0056], code=at0056, itemType=ELEMENT, level=3, text=Review due date, description=The date at which the advance care directive is due to be reviewed., comment='Valid period end' may often overlap with 'Review due date'. However, they may need to be recorded separately in circumstances where a document has an extended period of validity but requires an interim review. That may be due to changed personal circumstances/events or local policy., uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DATE_TIME, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.advance_care_directive.v0]/content[openEHR-EHR-EVALUATION.advance_care_directive.v0]/protocol[at0010]/items[at0055], code=at0055, itemType=ELEMENT, level=3, text=Last updated, description=The date when this advance directive record was last updated. This may not be a formal review but e.g. a typo correction., comment=null, uncommonOntologyItems=null, occurencesFormal=null, occurencesText=null, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DATE_TIME, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=[openEHR-EHR-COMPOSITION.advance_care_directive.v0]/content[openEHR-EHR-EVALUATION.advance_care_directive.v0]/protocol[at0010]/items[at0027], code=at0027, itemType=ELEMENT, level=3, text=Mandate, description=Description of any legislation or other authoritative guidance that apply., comment=For example, 'In England and Wales, advance decisions are covered by the Mental Capacity Act. Mandate: https://www.bma.org.uk/advice/employment/ethics/consent/consent-tool-kit/9-advance-decisions'. Or 'Jehovah's Witnesses believe that the Bible prohibits Christians from accepting blood transfusions. Mandate: https://en.wikipedia.org/wiki/Jehovah%27s_Witnesses_and_blood_transfusions'., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=
  •  Text
  •  URI
, extendedValues=null]], templateType=normal]