---
type: "resource"
title: "Consent"
resource: "Consent"
---
# Consent
## Introduction
## Scope and Usage
The purpose of this Resource is to be used to express a Consent regarding Healthcare. There are three anticipated uses for the Consent Resource, all of which are written or verbal agreements by a healthcare consumer `grantor` or a personal representative, made to an authorized entity `grantee` concerning authorized or restricted actions with any limitations on purpose of use, and handling instructions to which the authorized entity must comply:
- Privacy Consent Directive: Agreement, Restriction, or Prohibition to collect, access, use or disclose (share) information.
- Medical Treatment Consent Directive: Consent to undergo a specific treatment (or record of refusal to consent).
- Research Consent Directive: Consent to participate in research protocol and information sharing required.
This resource is scoped to cover all three uses and specified via the Category element, but at this time, only the privacy use case is fully modeled, others are being used but no formal modelling exists. Other use cases are possible through the use of the use of other category codes. The scope of the resource may change when the other possible scopes are investigated, tested, or profiled. It is possible to have multiply scoped consent in one Consent resource (e.g., Privacy and Research, or Research and Treatment, etc.) by having multiple provision trees paired.
Usage of the [Provenance](https://www.hl7.org/fhir/provenance.html) resource may be the best way to manage the tracking of the changes to Consent. In addition, the [DocumentReference](https://www.hl7.org/fhir/documentreference.html) may be used as an attachment to show the stages of consent ceremony with additional or updated document(s) attached at each stage. [Contract](https://www.hl7.org/fhir/contract.html) may also be used in this fashion where as signatures are gathered or conditions applied, the Contract resource can be updated and attached to the Consent.
### Simple vs. Computable Consent
In its simplest form, the Consent resource provides the means to record the content and the metadata of a consent (either implicit consent as an event or an explicit consent document). At this level of implementation, basic metadata about the Consent (e.g., status, data and time, patient, and organization) is recorded in the corresponding attributes of the Consent resource to enable consent discovery by indexing, searching, and retrieval of consents based on this metadata. The `sourceAttachment` and/or `sourceReference` elements can be used to record the original consent document either in the form of a pointer to another resource or in the form of an attachment.
In a more advanced usage of the Consent resource, in addition to recording the metadata and potentially the original content, the privacy preferences stated in the consent are encoded directly in the form of machine-readable rules. These rules can be processed by a decision engine to adjudicate whether the consent permits a specific given activity (e.g., sharing the patient information with a requester or enrolling the patient in a research project). In other words, the Consent resource is used directly to record rules that can be used by a rules engine to understand and enforce the preferences expressed by the consenter as they were intended.
The current version of the Consent resource provides two different mechanisms for recording computable rules:
- the `provision` structure which provides a simple structure for capturing most common privacy rules.
- the `policyBasis` attribute which provides a more flexible mechanism to reference a policy coded in a policy language of choice (e.g., [XACML](https://www.oasis-open.org/committees/tc_home.php?wg_abbrev=xacml), [ODRL](https://www.w3.org/community/odrl/), etc.).
## Boundaries and Relationships
Consent management - particularly privacy consent - is complicated by the fact that consent to share is often itself necessary to protect. The need to protect the privacy of the privacy statement itself competes with the execution of the consent statement. For this reason, it is common to deal with 'consent statements' that are only partial representations of the full consent statement that the patient provided.
For this reason, the consent resource contains two elements that refer back to the source: an inline attachment and a direct reference to content from which this Consent Statement was derived. That reference can be one of several things:
- A reference to another consent resource from which this limited statement was derived
- A reference to a document format for the original source (e.g. PDF or CDA - see the [HL7 CDAR2 ConsentDirective Implementation Guide](http://www.hl7.org/implement/standards/product_brief.cfm?product_id=280) , which incorporated the [IHE Basic Patient Privacy Consents (BPPC)](https://profiles.ihe.net/ITI/TF/Volume1/ch-19.html) ), either directly, or in a reference
- The source can be included in the consent as an attachment
The consent statements represent a chain that refers back to the original source consent directive. Applications may be able to follow the chain back to the source but should not generally assume that they are authorized to do this.
Consent Directives are executed by verbal acknowledgement or by being signed - either on paper, or digitally. Consent Signatures will be found in the [Provenance](provenance) resource. Implementation Guides will generally make rules about what signatures are required, and how they are to be shared and used.
## Background and Context
The Consent resource is structured with a base policy (represented as Consent.decision) which is either permit or deny, followed by a listing of exceptions to that policy (represented as Consent.provision(s)). The exceptions can be additional positive or negative exceptions upon the base policy. The set of exceptions include a list of data objects, list of authors, list of recipients, list of Organizations, list of purposeOfUse, and Date Range.
The enforcement of the Privacy Consent Directive is not included but is expected that enforcement can be done using a mix of the various Access Control enforcement methodologies (e.g. OAuth, UMA, XACML). This enforcement includes the details of the enforcement meaning of the elements of the Privacy Consent Directive, such as the rules in place when there is an opt-in consent would be specific about which organizational roles have access to what kinds of resources (e.g. RBAC, ABAC). The specification of these details is not in scope for the Consent resource.
## Notes
## Policies
The Consent resource has a reference to a single `PolicyBasis`. Many organizations will work in a context where multiple different consent regulations and policies apply. In these cases, the single rule reference refers to a policy document that resolves and reconciles the various policies and presents a single policy for patient consent. If it is still necessary to track which of the underlying regulations an exception is make in regard to, the `RegulatoryBasis` may be used.
Policies attached to PolicyBasis should be written using positive language. For an example, a patient wanting to opt-out will be recorded with an opt-in policy where the Consent.provision\[0\].type indicates "deny".
## Privacy Consent General Model
The following is the general model of Privacy Consent Directives.
There are context setting parameters:
1. Who - The **patient**or **third-party grantor**
2. What - The **data** - specific resources are listed, empty list means all data covered by the consent.
3. Where Required - The **location boundary** and **authority boundary** of this consent policy domain.
4. Where Accountability Lies - The organization or performer
5. When - The date **issued** or captured
6. When - The timeframe for which the Consent **applies**
7. How - The **actions** covered. (such as purposes of use that are covered)
8. Whom - The **actor** are grantees by the consent.
A Privacy Consent may transition through many states including: that no consent has been sought, consent has been proposed, consent has been rejected, and consent approved.
There are set of patterns.
1. No consent: All settings need a policy for when no consent has been captured. Often this allows treatment only.;
2. Opt-out: No sharing allowed for the specified domain, location, actions, and purposes;
3. Opt-out with exceptions: No sharing allowed, with some exceptions where it is allowed. Example: Withhold Authorization for Treatment except for Emergency Treatment;
4. Opt-in: Sharing for some purpose of use is authorized Sharing allowed for Treatment, Payment, and normal Operations; and
5. Opt-in with restrictions: Sharing allowed, but the patient may make exceptions.
For each of these patterns (positive or negative pattern), there can be exceptions. These exceptions are explicitly recorded in the **provision** element.
## Provisions
The provision structure provides a mechanism for modeling consent rules in a machine-readable and computable way. This is the FHIR Consent's native mechanism for expressing and encoding policy rules within the resource --an alternative to using an external policy language.
The default decision of the consent is stated by the `decision` attribute (`permit` or `deny`) and provisions state the exceptions to the base decision. Each provision may have its own sub-provisions that, in turn, state the exceptions to the rules stated in the parent provision. The following figure depicts this structure:
For example, if the base `decision` for a consent is `permit`, the first level of provisions express exceptions to this decision, therefore, the decision when matching these provisions will be a `deny`. The immediate child provisions to any of these provisions would express exceptions to their `deny` decision, therefore, their effect, when matched, will be `permit`.
The provision structure provides a rich mechanism to construct complex rules using logical _AND_ and _OR_:
- Provisions at the same level of depth are interpreted as disjunctive (i.e., _OR_\-ed). This means that matching _any_ of the sibling provisions at one level constitutes an exception to the rule stated in the parent provision.
- Within a provision, the conditions implied by different attributes are interpreted conjunctively (i.e., _AND_\-ed). This means that in order to match the provision, all the attributes must match.
- Within an attribute, if the attribute is multi-valued, the values are interpreted as disjunctive (i.e., _OR_\-ed). This means that matching _any_ of the values listed for the attribute is sufficient for the attribute to match. For single-valued attributes, matching is simply based on matching the value of the attribute.
If the value of an attribute is a code from a hierarchical code structure (e.g., a [Confidentiality code](https://terminology.hl7.org/ValueSet-v3-Confidentiality.html)), the subsumption relationship between the codes in the hierarchy must be considered in the interpretation of the provision:
- If the (implicit or explicit) type of the provision is `permit`, all the subsumed descending codes (that are below the mentioned code in the hierarchy) are also permitted. For example, if a provision permits access to _very restricted_ (`V`) data, it also permits access to _restricted_ (`R`) data.
- If the (implicit or explicit) type of the provision is `deny`, all the subsuming parent codes (that are above the mentioned code in the hierarchy) are also denied. For example, if a provision denies access to _restricted_ (`R`) data, it also denies access to _very restricted_ (`V`) data.
The following figure visualizes this in the course of an example.
The base decision is a `deny` to which the first exception, expressed in the first provision, states that during the time period from 01/01/2020 to 31/12/2022 all access by _Org A_ is permitted. In order to match this provision, and therefore for this _permit_ decision to be applicable, the requestor identifier must match _Org A_ AND the current date must be within the range 01/01/2020-31/12/2022.
The subsequent child provisions state exceptions to this base rule. Matching _any_ of these provisions results in a _deny_ since these are exceptions to a _permit_ parent provision.
- access is denied if the purpose of use is _marketing_ (`HMK`).
- access is denied if the requested data is _restricted_ (`R`). Note that this implies access is also denied if the requested data is _very restricted_ (`V`).
- access is denied if the purpose of use is _payment_ (`PAY`) unless:
- content type is `Claims`, _OR_ `Claim Responses`, _OR_ `Accounts`.
## Tracking Changes in Consent
Tracking changes in consent can be managed in two possible ways:
1. Submitting changes to the Consent resource and tracking the changes via a versioning server
2. Submitting a new Consent resource and marking the old resource as inactive
HL7 does not recommend a specific method.
A FHIR Consent Directive instance is considered the encoded legally binding Consent Directive if it meets requirements of a policy domain requirements for an enforceable contract. In some domains, electronic signatures of one or both of the parties to the content of an encoded representation of a Consent Form is deemed to constitute a legally binding Consent Directive. Some domains accept a notary’s electronic signature over the wet or electronic signature of a party to the Consent Directive as the additional identity proofing required to make an encoded Consent Directive legally binding. Other domains may only accept a wet signature or might not require the parties’ signatures at all.
Whatever the criteria are for making an encoded FHIR Consent Directive legally binding, anything less than a legally binding representation of a Consent Directive must be identified as such, i.e., as a derivative of the legally binding Consent Directive, which has specific usage in Consent Directive workflow management.
**Definitions:**
| Consent | The record of a healthcare consumer’s policy choices or choices made on their behalf by a third party, 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 |
| --- | --- |
| Consent Directive | The legal record of a healthcare consumer's agreement or agreements made on their behalf with a party responsible for enforcing the consumer’s choices or choices made on their behalf by a third party, which permits or denies identified actors or roles to perform actions affecting the consumer within a given context for specific purposes and periods of time |
| Consent Form | Human readable consent content describing one or more actions impacting the grantor for which the grantee would be authorized or prohibited from performing. It includes the terms, rules, and conditions pertaining to the authorization or restrictions, such as effective time, applicability or scope, purposes of use, obligations and prohibitions to which the grantee must comply. Once a Consent Form is “executed” by means required by policy, such as verbal agreement, wet signature, or electronic/digital signature, it becomes a legally binding Consent Directive. |
| Consent Directive Derivative | Consent Content that conveys the minimal set of information needed to manage Consent Directive workflow, including providing Consent Directive content sufficient to:
- Represent a Consent Directive
- Register or index a Consent Directive
- Query and respond about a Consent Directive
- Retrieve a Consent Directive
- Notify authorized entities about Consent Directive status changes
- Determine entities authorized to collect, access, use or disclose information about the Consent Directive or about the information governed by the Consent Directive.
Derived Consent content includes the Security Labels encoding the applicable privacy and security policies. Consent Security Labels inform recipients about specific access control measures required for compliance.
|
| Consent Statement | A Consent Directive derivative has less than full fidelity to the legally binding Consent Directive from which it was "transcribed". It provides recipients with the full content representation they may require for compliance purposes, and typically include a reference to or an attached unstructured representation for recipients needing an exact copy of the legal agreement. |
| Consent Registration | The legal record of a healthcare consumer's agreement with a party responsible for enforcing the consumer’s choices, which permits or denies identified actors or roles to perform actions affecting the consumer within a given context for specific purposes and periods of time. A Consent Directive derivative that conveys the minimal set of information needed to register an active and revoked Consent Directive, or to update Consent status as it changes during its lifecycle. |
| Policy context | Any organizational or jurisdictional policies, which may limit the consumer’s policy choices, and which includes the named range of actions allowed |
| Healthcare Consumer | The individual establishing his/her personal consent (i.e. Consenter). In FHIR, this is referred to as the 'Patient' though this word is not used across all contexts of care |
### Privacy Consent Directive (PCD)
Privacy policies define how Individually Identifiable Health Information (IIHI) is to be collected, accessed, used and disclosed. A Privacy Consent Directive as a legal record of a patient's (e.g. a healthcare consumer) agreement with a party responsible for enforcing the patient's choices, which permits or denies identified actors or roles to perform actions affecting the patient within a given context for specific purposes and periods of time. All consent directives have a policy context, which is any set of organizational or jurisdictional policies which may limit the consumer’s policy choices, and which include a named range of actions allowed. In addition, Privacy Consent Directives provide the ability for a healthcare consumer to delegate authority to a Substitute Decision Maker who may act on behalf of that individual. Alternatively, a consumer may author/publish their privacy preferences as a self-declared Privacy Consent Directive.
The Consent resource on FHIR provides support for alternative representations for expressing interoperable health information privacy consent directives in a standard form for the exchange and enforcement by sending, intermediating, or receiving systems of privacy policies that can be enforced by consuming systems (e.g., scanned documents, of computable structured entries elements, FHIR structures with optional attached, or referenced unstructured representations.) It may be used to represent the Privacy Consent Directive itself, a Consent Statement, which electronically represents a Consent Directive, or Consent Metadata, which is the minimum necessary consent content derived from a Consent Directive for use in workflow management.
## Optimal Searching
The following steps represent the optimal path for searching for a Consent resource.
1. Request one or more Consent where status=active by Consent.scope (with patient(s), if none specified, get all). Policy will decide how to deal with multiple per patient and how to iterate through (e.g., select most recent).
2. Locally inspect Consent.provision for base policy acceptance/denial with Consent.policyRule
3. If policyRule not understandable, refer to Privacy Office
4. Locally inspect Consent.provision for contexts (e.g., provision.purpose, provision.actor, etc.) as above
5. Inspect Consent.provision.provision (et.al) for exceptions
## StructureDefinition
### Elements (Simplified)
- **[Consent](/consent-definitions#Consent)** [0..*]: - A healthcare consumer's or third party's choices to permit or deny recipients or roles to perform actions for specific purposes and periods of time
- **[Consent.identifier](/consent-definitions#Consent.identifier)** [0..*]: [Identifier](/Identifier) Identifier for this record (external references)
- **[Consent.status](/consent-definitions#Consent.status)** [1..1]: [code](/code) required:[consent-state-codes](/valueset-consent-state-codes) draft | active | inactive | not-done | entered-in-error | unknown
- **[Consent.category](/consent-definitions#Consent.category)** [0..*]: [CodeableConcept](/CodeableConcept) example:[consent-category-example](/valueset-consent-category-example) Classification of the consent statement - for indexing/retrieval
- **[Consent.subject](/consent-definitions#Consent.subject)** [0..1]: [Reference(Patient](/Reference(Patient), [Practitioner](/Practitioner), [ResearchSubject](/ResearchSubject), [Group)](/Group)) Who the consent applies to
- **[Consent.date](/consent-definitions#Consent.date)** [0..1]: [date](/date) Fully executed date of the consent
- **[Consent.period](/consent-definitions#Consent.period)** [0..1]: [Period](/Period) Effective period for this Consent
- **[Consent.grantor](/consent-definitions#Consent.grantor)** [0..*]: [Reference(CareTeam](/Reference(CareTeam), [Group](/Group), [HealthcareService](/HealthcareService), [Organization](/Organization), [Patient](/Patient), [Practitioner](/Practitioner), [RelatedPerson](/RelatedPerson), [PractitionerRole)](/PractitionerRole)) Who is granting rights according to the policy and rules
- **[Consent.grantee](/consent-definitions#Consent.grantee)** [0..*]: [Reference(CareTeam](/Reference(CareTeam), [Group](/Group), [HealthcareService](/HealthcareService), [Organization](/Organization), [Patient](/Patient), [Practitioner](/Practitioner), [RelatedPerson](/RelatedPerson), [PractitionerRole)](/PractitionerRole)) Who is agreeing to the policy and rules
- **[Consent.manager](/consent-definitions#Consent.manager)** [0..*]: [Reference(HealthcareService](/Reference(HealthcareService), [Organization](/Organization), [Patient](/Patient), [Practitioner)](/Practitioner)) Consent workflow management
- **[Consent.controller](/consent-definitions#Consent.controller)** [0..*]: [Reference(HealthcareService](/Reference(HealthcareService), [Organization](/Organization), [Patient](/Patient), [Practitioner)](/Practitioner)) Consent Enforcer
- **[Consent.sourceAttachment](/consent-definitions#Consent.sourceAttachment)** [0..*]: [Attachment](/Attachment) Source from which this consent is taken
- **[Consent.sourceReference](/consent-definitions#Consent.sourceReference)** [0..*]: [Reference(Consent](/Reference(Consent), [DocumentReference](/DocumentReference), [Contract](/Contract), [QuestionnaireResponse)](/QuestionnaireResponse)) Source from which this consent is taken
- **[Consent.regulatoryBasis](/consent-definitions#Consent.regulatoryBasis)** [0..*]: [CodeableConcept](/CodeableConcept) example:[consent-policy](/valueset-consent-policy) Regulations establishing base Consent
- **[Consent.policyBasis](/consent-definitions#Consent.policyBasis)** [0..1]: [BackboneElement](/BackboneElement) Computable version of the backing policy
- **[Consent.policyBasis.reference](/consent-definitions#Consent.policyBasis.reference)** [0..1]: Reference([Resource](/Resource)) Reference backing policy resource
- **[Consent.policyBasis.uri](/consent-definitions#Consent.policyBasis.uri)** [0..1]: [uri](/uri) URI to a computable backing policy
- **[Consent.policyText](/consent-definitions#Consent.policyText)** [0..*]: Reference([DocumentReference](/DocumentReference)) Human Readable Policy
- **[Consent.verification](/consent-definitions#Consent.verification)** [0..*]: [BackboneElement](/BackboneElement) Consent Verified by patient or family
- **[Consent.verification.verified](/consent-definitions#Consent.verification.verified)** [1..1]: [boolean](/boolean) Has been verified
- **[Consent.verification.type](/consent-definitions#Consent.verification.type)** [0..1]: [CodeableConcept](/CodeableConcept) example:[consent-verification](/valueset-consent-verification) Business case of verification
- **[Consent.verification.verifiedBy](/consent-definitions#Consent.verification.verifiedBy)** [0..1]: [Reference(Organization](/Reference(Organization), [Practitioner](/Practitioner), [PractitionerRole)](/PractitionerRole)) Person conducting verification
- **[Consent.verification.verifiedWith](/consent-definitions#Consent.verification.verifiedWith)** [0..1]: [Reference(Patient](/Reference(Patient), [RelatedPerson](/RelatedPerson), [Group)](/Group)) Person who verified
- **[Consent.verification.date](/consent-definitions#Consent.verification.date)** [0..*]: [dateTime](/dateTime) When consent verified
- **[Consent.decision](/consent-definitions#Consent.decision)** [0..1]: [code](/code) required:[consent-provision-type](/valueset-consent-provision-type) deny | permit
- **[Consent.provision](/consent-definitions#Consent.provision)** [0..*]: [BackboneElement](/BackboneElement) Constraints to the base Consent.policyRule/Consent.policy
- **[Consent.provision.period](/consent-definitions#Consent.provision.period)** [0..1]: [Period](/Period) Timeframe for this provision
- **[Consent.provision.actor](/consent-definitions#Consent.provision.actor)** [0..*]: [BackboneElement](/BackboneElement) Who|what controlled by this provision (or group, by role)
- **[Consent.provision.actor.role](/consent-definitions#Consent.provision.actor.role)** [0..1]: [CodeableConcept](/CodeableConcept) extensible:[participation-role-type](/valueset-participation-role-type) How the actor is involved
- **[Consent.provision.actor.reference](/consent-definitions#Consent.provision.actor.reference)** [0..1]: [Reference(Device](/Reference(Device), [Group](/Group), [CareTeam](/CareTeam), [Organization](/Organization), [Patient](/Patient), [Practitioner](/Practitioner), [RelatedPerson](/RelatedPerson), [PractitionerRole)](/PractitionerRole)) Resource for the actor (or group, by role)
- **[Consent.provision.action](/consent-definitions#Consent.provision.action)** [0..*]: [CodeableConcept](/CodeableConcept) example:[consent-action](/valueset-consent-action) Actions controlled by this provision
- **[Consent.provision.securityLabel](/consent-definitions#Consent.provision.securityLabel)** [0..*]: [Coding](/Coding) example:[security-label-example](/valueset-security-label-example) Security Labels that define affected resources
- **[Consent.provision.purpose](/consent-definitions#Consent.provision.purpose)** [0..*]: [Coding](/Coding) extensible:[v3-PurposeOfUse](/valueset-v3-PurposeOfUse) Context of activities covered by this provision
- **[Consent.provision.documentType](/consent-definitions#Consent.provision.documentType)** [0..*]: [Coding](/Coding) preferred:[consent-content-class](/valueset-consent-content-class) e.g. Resource Type, Profile, CDA, etc
- **[Consent.provision.resourceType](/consent-definitions#Consent.provision.resourceType)** [0..*]: [Coding](/Coding) extensible:[resource-types](/valueset-resource-types) e.g. Resource Type, Profile, etc
- **[Consent.provision.code](/consent-definitions#Consent.provision.code)** [0..*]: [CodeableConcept](/CodeableConcept) example:[consent-content-code](/valueset-consent-content-code) e.g. LOINC or SNOMED CT code, etc. in the content
- **[Consent.provision.dataPeriod](/consent-definitions#Consent.provision.dataPeriod)** [0..1]: [Period](/Period) Timeframe for data controlled by this provision
- **[Consent.provision.data](/consent-definitions#Consent.provision.data)** [0..*]: [BackboneElement](/BackboneElement) Data controlled by this provision
- **[Consent.provision.data.meaning](/consent-definitions#Consent.provision.data.meaning)** [1..1]: [code](/code) required:[consent-data-meaning](/valueset-consent-data-meaning) instance | related | dependents | authoredby
- **[Consent.provision.data.reference](/consent-definitions#Consent.provision.data.reference)** [1..1]: Reference([Resource](/Resource)) The actual data reference
- **[Consent.provision.expression](/consent-definitions#Consent.provision.expression)** [0..1]: [Expression](/Expression) A computable expression of the consent
- **[Consent.provision.provision](/consent-definitions#Consent.provision.provision)** [0..*]: - Nested Exception Provisions
## Mappings
- [Consent Mappings](/consent-mappings) — 22 mapping entries
## Implementation Guide
### implementationguide-Consent-core.xml
```xml
```
## Resource Packs
### list-Consent-packs.xml
```xml
-
```
## Search Parameters
- [action](/consent-search#action) — **token** — Actions controlled by this rule — `Consent.repeat(provision).action`
- [action](/consent-search#action) — **token** — LOINC or SNOMED CT code, etc. in the content — `Consent.repeat(provision).code`
- [actor](/consent-search#actor) — **reference** — Resource for the actor (or group, by role) — `Consent.repeat(provision).actor.reference`
- [category](/consent-search#category) — **token** — Classification of the consent statement - for indexing/retrieval — `Consent.category`
- [grantee](/consent-search#grantee) — **reference** — Who is agreeing to the policy and rules — `Consent.grantee`
- [controller](/consent-search#controller) — **reference** — Consent Enforcer — `Consent.controller`
- [data](/consent-search#data) — **reference** — The actual data reference — `Consent.repeat(provision).data.reference`
- [date](/consent-search#date) — **date** — When consent was agreed to — `Consent.date`
- [identifier](/consent-search#identifier) — **token** — Identifier for this record (external references) — `Consent.identifier`
- [manager](/consent-search#manager) — **reference** — Consent workflow management — `Consent.manager`
- [patient](/consent-search#patient) — **reference** — Who the consent applies to — `Consent.subject.where(resolve() is Patient)`
- [period](/consent-search#period) — **date** — Timeframe for this rule — `Consent.repeat(provision).period`
- [purpose](/consent-search#purpose) — **token** — Context of activities covered by this rule — `Consent.repeat(provision).purpose`
- [security-label](/consent-search#security-label) — **token** — Security Labels that define affected resources — `Consent.repeat(provision).securityLabel`
- [source-reference](/consent-search#source-reference) — **reference** — Search by reference to a Consent, DocumentReference, Contract or QuestionnaireResponse — `Consent.sourceReference`
- [status](/consent-search#status) — **token** — draft | active | inactive | entered-in-error | unknown — `Consent.status`
- [subject](/consent-search#subject) — **reference** — Who the consent applies to — `Consent.subject`
- [verified](/consent-search#verified) — **token** — Has been verified — `Consent.verification.verified`
- [verified-date](/consent-search#verified-date) — **date** — When consent verified — `Consent.verification.date`
[Full Search Parameters](/consent-search)
## Examples
- [consent-example](/consent-example-consent-example) — consent-example
- [consent-example-basic](/consent-example-consent-example-basic) — consent-example — General Consent Example
- [consent-example-CDA](/consent-example-consent-example-CDA) — consent-example-CDA — Share CDA documents from a specific author to a specific recipient
- [consent-example-Emergency](/consent-example-consent-example-Emergency) — consent-example-Emergency — Consent withholding access to data for Treatment exept for Emergency Treatment
- [consent-example-grantor](/consent-example-consent-example-grantor) — consent-example-grantor — Patient grants access to a specified individual for read-only access
- [consent-example-No-Emergency](/consent-example-consent-example-No-Emergency) — consent-example-No-Emergency
- [consent-example-notAuthor](/consent-example-consent-example-notAuthor) — consent-example-notAuthor — Withhold or withdraw consent for disclosure of records that were authored by a specific organization (or service delivery location).
- [consent-example-notLabs](/consent-example-consent-example-notLabs) — consent-example-notLabs
- [consent-example-notOrg](/consent-example-consent-example-notOrg) — consent-example-notOrg — Withhold or withdraw consent for disclosure to a specific provider organization
- [consent-example-notSecLabel](/consent-example-consent-example-notSecLabel) — consent-example-notSecLabel
- [consent-example-notThem](/consent-example-consent-example-notThem) — consent-example-notThem — Withhold or withdraw consent for disclosure to a specific provider agent (an individual within an organization)
- [consent-example-notThis](/consent-example-consent-example-notThis) — consent-example-notThis — Withhold or withdraw consent for disclosure of records related to specific domain (e.g. DI, LAB, etc.)
- [consent-example-notTime](/consent-example-consent-example-notTime) — consent-example-notTime — Withhold or withdraw consent for disclosure of a specific timeframe
- [consent-example-OrgToOrg](/consent-example-consent-example-OrgToOrg) — consent-example-OrgToOrg
- [consent-example-Out](/consent-example-consent-example-Out) — consent-example-Out — Consent withholding access
- [consent-example-pkb](/consent-example-consent-example-pkb) — consent-example-pkb — Example of Patients Know Best Usage
- [consent-example-provider](/consent-example-consent-example-provider) — consent-example-provider
- [consent-example-signature](/consent-example-consent-example-signature) — consent-example-signature
- [consent-example-smartonfhir](/consent-example-consent-example-smartonfhir) — consent-example-smartonfhir — Template for recording a Smart on FHIR Authorization
- [consent-examples-header](/consent-example-consent-examples-header) — consent-examples-header
[Full Examples](/consent-examples)
## Mapping Exceptions
### consent-event-mapping-exceptions.xml
### Divergent Elements
- **Event.identifier** → **Consent.identifier**
- shortUnmatched | reason=Unknown | pattern=Business identifier for consent | resource=Identifier for this record (external references)
- definitionUnmatched | reason=Unknown | pattern=Business identifiers assigned to this consent by the performer and/or other systems. These identifiers remain constant as the resource is updated and propagates from server to server. | resource=Unique identifier for this copy of the Consent Statement.
- commentsUnmatched | reason=Unknown | pattern=Note: This is a business identifier, not a resource identifier (see [discussion](resource.html#identifiers)). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number. | resource=This identifier 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.
- requirementsUnmatched | reason=Unknown | pattern=Allows identification of the consent as it is known by various participating systems and in a way that remains consistent across servers.
- **Event.status** → **Consent.status**
- shortUnmatched | reason=Unknown | pattern=preparation | in-progress | not-done | suspended | aborted | completed | entered-in-error | unknown | resource=draft | active | inactive | not-done | entered-in-error | unknown
- definitionUnmatched | reason=Unknown | pattern=The current state of the consent. | resource=Indicates the current state of this Consent resource.
- commentsUnmatched | reason=Unknown | pattern=A nominal state-transition diagram can be found in the (Event pattern documentation
Unknown does not represent "other" - one of the defined statuses must apply. Unknown is used when the authoring system is not sure what the current status is. | resource=This element is labeled as a modifier because the status contains the codes rejected and entered-in-error that mark the Consent as not currently valid.
- **Event.code** → **Consent.category**
- shortUnmatched | reason=Unknown | pattern=What service was done | resource=Classification of the consent statement - for indexing/retrieval
- definitionUnmatched | reason=Unknown | pattern=A code that identifies the specific service or action that was or is being performed. | resource=A classification of the type of consents found in the statement. This element supports indexing and retrieval of consent statements.
- **Event.subject** → **Consent.subject**
- extraTypes | reason=Unknown
- shortUnmatched | reason=Unknown | pattern=Individual service was done for/to | resource=Who the consent applies to
- definitionUnmatched | reason=Unknown | pattern=The individual or set of individuals the action is being or was performed on. | resource=The patient, healthcare practitioner, research subject, or a group of persons to whom this consent applies.
- requirementsUnmatched | reason=Unknown | pattern=Links the consent to the Patient context. May also affect access control.
- **Event.occurrence[x]** → **Consent.date**
- missingTypes | reason=Unknown | pattern=dateTime, Period, Timing
- extraTypes | reason=Unknown
- shortUnmatched | reason=Unknown | pattern=When consent occurred/is occurring | resource=Fully executed date of the consent
- definitionUnmatched | reason=Unknown | pattern=The date, period or timing when the consent did occur or is occurring. | resource=Date the consent instance was agreed to.
- commentsUnmatched | reason=Unknown | pattern=This indicates when the activity actually occurred or is occurring, not when it was asked/requested/ordered to occur. For the latter, look at the occurence element of the Request this {{event}} is "basedOn". The status code allows differentiation of whether the timing reflects a historic event or an ongoing event. Ongoing events should not include an upper bound in the Period or Timing.bounds.
.
### Unmapped Elements
- **Event.partOf** — Unknown
- **Event.reported** — Unknown
- **Event.reason** — Unknown
- **Event.relevantHistory** — Unknown
- **Event.location** — Unknown
- **Event.statusReason** — Unknown
- **Event.performer.actor** — Unknown
- **Event.performer.function** — Unknown
- **Event.note** — Unknown
- **Event.category** — Unknown
- **Event.encounter** — Unknown
- **Event.recorded** — Unknown
- **Event.product** — Unknown
- **Event.performer** — Unknown
### consent-fivews-mapping-exceptions.xml
### Unmapped Elements
- **FiveWs.what** — Unknown
- **FiveWs.author** — Unknown
- **FiveWs.actor** — Unknown
- **FiveWs.cause** — Unknown
- **FiveWs.version** — Unknown
- **FiveWs.where** — Unknown
- **FiveWs.context** — Unknown
- **FiveWs.init** — Unknown
- **FiveWs.why** — Unknown
- **FiveWs.source** — Unknown
- **FiveWs.who** — Unknown
- **FiveWs.grade** — Unknown
- **FiveWs.planned** — Unknown
- **FiveWs.done** — Unknown