A record of a healthcare consumer’s 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.

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

An Extension

Khi việc xử lý dữ liệu diễn ra KHÔNG qua sự đồng ý (cấp cứu, hoạt động cơ quan nhà nước...), ghi căn cứ Điều 19 khoản 1 tại đây thay vì dùng category miễn trừ (mô hình cũ ≤0.7.0 đã deprecated). Bên viện dẫn điểm a chịu nghĩa vụ chứng minh; hệ thống lưu bằng chứng qua AuditEvent (Điều 19 khoản 2).

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Trạng thái theo ma trận Luật 91/2025/QH15: active (bản ghi đang hiệu lực — kể cả từ chối chủ động qua rule nested provision.provision.type=deny), rejected (đề nghị đồng ý bị từ chối ngay từ đầu theo Điều 4 khoản 1 điểm b), inactive (đã chấm dứt: rút lại theo Điều 10, hết thời hạn, hoặc bị thay thế).

KHÔNG dùng rejected cho việc rút lại — rút lại sự đồng ý đang hiệu lực (Điều 10) chuyển bản ghi sang inactive; bản chép mới ghi nhận từ chối tiếp theo (nếu có) dùng active + rule nested deny.

Indicates the state of the consent.

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

Phạm vi đồng ý — mặc định patient-privacy cho DLCN y tế nhạy cảm.

The four anticipated uses for the Consent Resource.

Phân loại chỉ thị đồng ý: quyền riêng tư, điều trị, nghiên cứu, đồng ý qua đại diện. Theo Luật 91/2025/QH15 Điều 9 (sự đồng ý), Điều 24 (đại diện theo pháp luật). Các trường hợp KHÔNG cần đồng ý (Điều 19) không phải loại đồng ý — dùng extension[processingLegalBasis].

Bệnh nhân — chủ thể dữ liệu cá nhân theo Luật 91/2025/QH15 Điều 2 khoản 5.

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

Thời điểm ghi nhận sự đồng ý hoặc từ chối. Hình thức đồng ý phải rõ ràng, cụ thể, kiểm chứng được theo Luật 91/2025/QH15 Điều 9 khoản 3.

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

Người thực hiện đồng ý: bệnh nhân, hoặc người đại diện theo pháp luật đối với trẻ em/người bị mất hoặc hạn chế năng lực hành vi dân sự (Luật 91/2025/QH15 Điều 24 khoản 2). Trẻ em từ đủ 07 tuổi: công bố thông tin đời tư cần đồng ý của CẢ trẻ và người đại diện.

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.

Cơ sở khám chữa bệnh — bên kiểm soát dữ liệu (Luật 91/2025/QH15 Điều 2 khoản 7) hoặc bên kiểm soát và xử lý dữ liệu (Điều 2 khoản 9) khi tự vận hành hệ thống. Chịu nghĩa vụ lưu trữ và chứng minh sự đồng ý theo NĐ 356/2025/NĐ-CP Điều 6 khoản 2.

Tài liệu gốc: bản scan chữ ký, phiếu đồng ý điện tử, hoặc ghi nhận khác kiểm chứng được (5 phương thức theo NĐ 356/2025/NĐ-CP Điều 6 khoản 1 — xem vn-ext-consent-method). Bên kiểm soát PHẢI lưu trữ sự đồng ý và chịu trách nhiệm chứng minh khi tranh chấp (NĐ 356/2025/NĐ-CP Điều 6 khoản 2). Im lặng/không phản hồi không được coi là đồng ý (Luật 91/2025/QH15 Điều 9 khoản 4 điểm d); cấm thiết lập mặc định đồng ý (NĐ 356/2025/NĐ-CP Điều 6 khoản 3).

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.

Tham chiếu đến văn bản pháp luật làm căn cứ cho đồng ý.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Entity or Organization having regulatory jurisdiction or accountability for enforcing policies pertaining to Consent Directives.

URL/URI văn bản pháp luật (VD: Luật 91/2025/QH15, NĐ 356/2025/NĐ-CP, TT 13/2025/TT-BYT).

This element is for discoverability / documentation and does not modify or qualify the policy rules.

Quy tắc cho phép/từ chối xử lý dữ liệu theo mục đích, đối tượng, thời hạn cụ thể.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Action to take - permit or deny - when the rule conditions are met. Not permitted in root rule, required in all nested rules.

R4: type không được dùng ở root rule — root chỉ là khung; mọi rule permit/deny nằm ở provision.provision (vn-consent-provision-structure).

How a rule statement is applied, such as adding additional consent or removing consent.

Thời hạn đồng ý (nếu chủ thể ấn định). Chủ thể có quyền yêu cầu rút lại/hạn chế xử lý theo Luật 91/2025/QH15 Điều 10 (trừ trường hợp Điều 19 hoặc pháp luật quy định khác); hệ thống lưu bằng chứng thời hạn và việc rút lại theo NĐ 356/2025/NĐ-CP Điều 6 khoản 2.

KHÔNG bắt buộc period.end: sự đồng ý vô thời hạn là hợp pháp — có hiệu lực cho đến khi chủ thể thay đổi (Luật 91/2025/QH15 Điều 9 khoản 4 điểm c). Invariant vn-consent-period-end-required (≤0.7.0) đã gỡ vì mâu thuẫn điều khoản này.

Bên được phép/từ chối xử lý: CSKCB, BHXH, cơ quan y tế dự phòng, người đại diện, v.v. LƯU Ý Điều 26 khoản 2 Luật 91/2025/QH15: cấm cung cấp DLCN cho bên thứ ba là tổ chức CSSK/bảo hiểm khác trừ khi chủ thể yêu cầu bằng văn bản hoặc thuộc Điều 19 khoản 1 — mô hình mặc định là deny với bên thứ ba.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

How the individual is involved in the resources content that is described in the exception.

How an actor is involved in the consent considerations.

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

Mục đích cụ thể: khám chữa bệnh, BHYT, y tế công cộng, nghiên cứu, bệnh án điện tử, chia sẻ hồ sơ. Sự đồng ý thể hiện theo TỪNG mục đích — Luật 91/2025/QH15 Điều 9 khoản 4 điểm a; không được kèm điều kiện ép đồng ý mục đích khác (điểm b).

When the purpose of use tag is on the data, access request purpose of use shall not conflict.

Loại resource FHIR được phép/từ chối: Condition, Observation, Claim, v.v.

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.

The class (type) of information a consent rule covers.

Rules which provide exceptions to the base rule or subrules.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

permit = cho phép xử lý, deny = từ chối xử lý. Quyền đồng ý/không đồng ý/rút lại theo Luật 91/2025/QH15 Điều 4 khoản 1 điểm b; với thông tin sức khỏe, đồng ý là bắt buộc trừ Điều 19 khoản 1 (Điều 26 khoản 1 điểm a). Từ chối đang hiệu lực = status active + rule deny (nested).

How a rule statement is applied, such as adding additional consent or removing consent.

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

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

How the individual is involved in the resources content that is described in the exception.

How an actor is involved in the consent considerations.

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

Actor là người đại diện theo pháp luật/giám hộ/được ủy quyền (Luật 91/2025/QH15 Điều 24 khoản 2). BẮT BUỘC gắn extension vn-ext-representation-authority ngay tại actor này — PDP resolve token thẩm quyền (type/source/verifiedDate/period) và quyết định permit/deny THEO rule chứa actor: hạn chế lớp dữ liệu biểu diễn bằng rule type=deny + securityLabel (vn-data-sensitivity-class-vs), thay cho sub-extension restrictedSensitivity đã xóa ở 0.8.0.

An Extension

Extension ghi nhận THẨM QUYỀN PHÁP LÝ để một người đại diện/giám hộ/được uỷ quyền truy cập dữ liệu y tế thay người khác (vd cha/mẹ xem Sổ SKĐT của con qua VNeID). Mô hình hoá 'token đại diện' phục vụ Policy Decision Point (PDP): loại thẩm quyền, nguồn xác minh, thời điểm xác minh, thời hạn. PDP deny-by-default khi quan hệ mâu thuẫn/hết hạn. THAY ĐỔI 0.8.0 (breaking — hậu kiểm toán Codex): sub-extension restrictedSensitivity đã XÓA — ngữ nghĩa hạn chế truy cập là QUYẾT ĐỊNH CHÍNH SÁCH, không phải thuộc tính token: biểu diễn bằng VNCoreConsent.provision (type=deny + securityLabel theo vn-data-sensitivity-class-vs + actor[representative] gắn chính extension này để link token↔consent — PDP resolve một chiều qua Consent). Căn cứ: Bộ luật Dân sự 2015 (đại diện/giám hộ/uỷ quyền); Luật Căn cước 2023 (quan hệ nhân thân CSDLQGDC); Luật 91/2025/QH15 Điều 24 (đại diện theo pháp luật) + Luật Trẻ em 2016 (dữ liệu trẻ em, lớp nhạy cảm).

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

How the individual is involved in the resources content that is described in the exception.

How an actor is involved in the consent considerations.

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

Lớp nhạy cảm dữ liệu (vn-data-sensitivity-class-vs) mà rule áp dụng. Mô hình hạn chế theo lớp: permit theo lớp cơ bản + provision con type=deny với securityLabel lớp bị hạn chế (vd special-protection với người đại diện của vị thành niên — thay sub-extension restrictedSensitivity đã xóa 0.8.0). PDP deny-by-default: không có provision permit phủ lớp dữ liệu → từ chối.

If the consent specifies a security label of "R" then it applies to all resources that are labeled "R" or lower. E.g. for Confidentiality, it's a high water mark. For other kinds of security labels, subsumption logic applies. When the purpose of use tag is on the data, access request purpose of use shall not conflict.

Khi việc xử lý dữ liệu diễn ra KHÔNG qua sự đồng ý (cấp cứu, hoạt động cơ quan nhà nước...), ghi căn cứ Điều 19 khoản 1 tại đây thay vì dùng category miễn trừ (mô hình cũ ≤0.7.0 đã deprecated). Bên viện dẫn điểm a chịu nghĩa vụ chứng minh; hệ thống lưu bằng chứng qua AuditEvent (Điều 19 khoản 2).

Trạng thái theo ma trận Luật 91/2025/QH15: active (bản ghi đang hiệu lực — kể cả từ chối chủ động qua rule nested provision.provision.type=deny), rejected (đề nghị đồng ý bị từ chối ngay từ đầu theo Điều 4 khoản 1 điểm b), inactive (đã chấm dứt: rút lại theo Điều 10, hết thời hạn, hoặc bị thay thế).

KHÔNG dùng rejected cho việc rút lại — rút lại sự đồng ý đang hiệu lực (Điều 10) chuyển bản ghi sang inactive; bản chép mới ghi nhận từ chối tiếp theo (nếu có) dùng active + rule nested deny.

Phạm vi đồng ý — mặc định patient-privacy cho DLCN y tế nhạy cảm.

Phân loại chỉ thị đồng ý: quyền riêng tư, điều trị, nghiên cứu, đồng ý qua đại diện. Theo Luật 91/2025/QH15 Điều 9 (sự đồng ý), Điều 24 (đại diện theo pháp luật). Các trường hợp KHÔNG cần đồng ý (Điều 19) không phải loại đồng ý — dùng extension[processingLegalBasis].

Bệnh nhân — chủ thể dữ liệu cá nhân theo Luật 91/2025/QH15 Điều 2 khoản 5.

Thời điểm ghi nhận sự đồng ý hoặc từ chối. Hình thức đồng ý phải rõ ràng, cụ thể, kiểm chứng được theo Luật 91/2025/QH15 Điều 9 khoản 3.

Người thực hiện đồng ý: bệnh nhân, hoặc người đại diện theo pháp luật đối với trẻ em/người bị mất hoặc hạn chế năng lực hành vi dân sự (Luật 91/2025/QH15 Điều 24 khoản 2). Trẻ em từ đủ 07 tuổi: công bố thông tin đời tư cần đồng ý của CẢ trẻ và người đại diện.

Cơ sở khám chữa bệnh — bên kiểm soát dữ liệu (Luật 91/2025/QH15 Điều 2 khoản 7) hoặc bên kiểm soát và xử lý dữ liệu (Điều 2 khoản 9) khi tự vận hành hệ thống. Chịu nghĩa vụ lưu trữ và chứng minh sự đồng ý theo NĐ 356/2025/NĐ-CP Điều 6 khoản 2.

Tài liệu gốc: bản scan chữ ký, phiếu đồng ý điện tử, hoặc ghi nhận khác kiểm chứng được (5 phương thức theo NĐ 356/2025/NĐ-CP Điều 6 khoản 1 — xem vn-ext-consent-method). Bên kiểm soát PHẢI lưu trữ sự đồng ý và chịu trách nhiệm chứng minh khi tranh chấp (NĐ 356/2025/NĐ-CP Điều 6 khoản 2). Im lặng/không phản hồi không được coi là đồng ý (Luật 91/2025/QH15 Điều 9 khoản 4 điểm d); cấm thiết lập mặc định đồng ý (NĐ 356/2025/NĐ-CP Điều 6 khoản 3).

Tham chiếu đến văn bản pháp luật làm căn cứ cho đồng ý.

URL/URI văn bản pháp luật (VD: Luật 91/2025/QH15, NĐ 356/2025/NĐ-CP, TT 13/2025/TT-BYT).

Quy tắc cho phép/từ chối xử lý dữ liệu theo mục đích, đối tượng, thời hạn cụ thể.

R4: type không được dùng ở root rule — root chỉ là khung; mọi rule permit/deny nằm ở provision.provision (vn-consent-provision-structure).

Thời hạn đồng ý (nếu chủ thể ấn định). Chủ thể có quyền yêu cầu rút lại/hạn chế xử lý theo Luật 91/2025/QH15 Điều 10 (trừ trường hợp Điều 19 hoặc pháp luật quy định khác); hệ thống lưu bằng chứng thời hạn và việc rút lại theo NĐ 356/2025/NĐ-CP Điều 6 khoản 2.

KHÔNG bắt buộc period.end: sự đồng ý vô thời hạn là hợp pháp — có hiệu lực cho đến khi chủ thể thay đổi (Luật 91/2025/QH15 Điều 9 khoản 4 điểm c). Invariant vn-consent-period-end-required (≤0.7.0) đã gỡ vì mâu thuẫn điều khoản này.

Bên được phép/từ chối xử lý: CSKCB, BHXH, cơ quan y tế dự phòng, người đại diện, v.v. LƯU Ý Điều 26 khoản 2 Luật 91/2025/QH15: cấm cung cấp DLCN cho bên thứ ba là tổ chức CSSK/bảo hiểm khác trừ khi chủ thể yêu cầu bằng văn bản hoặc thuộc Điều 19 khoản 1 — mô hình mặc định là deny với bên thứ ba.

Mục đích cụ thể: khám chữa bệnh, BHYT, y tế công cộng, nghiên cứu, bệnh án điện tử, chia sẻ hồ sơ. Sự đồng ý thể hiện theo TỪNG mục đích — Luật 91/2025/QH15 Điều 9 khoản 4 điểm a; không được kèm điều kiện ép đồng ý mục đích khác (điểm b).

Loại resource FHIR được phép/từ chối: Condition, Observation, Claim, v.v.

permit = cho phép xử lý, deny = từ chối xử lý. Quyền đồng ý/không đồng ý/rút lại theo Luật 91/2025/QH15 Điều 4 khoản 1 điểm b; với thông tin sức khỏe, đồng ý là bắt buộc trừ Điều 19 khoản 1 (Điều 26 khoản 1 điểm a). Từ chối đang hiệu lực = status active + rule deny (nested).

Actor là người đại diện theo pháp luật/giám hộ/được ủy quyền (Luật 91/2025/QH15 Điều 24 khoản 2). BẮT BUỘC gắn extension vn-ext-representation-authority ngay tại actor này — PDP resolve token thẩm quyền (type/source/verifiedDate/period) và quyết định permit/deny THEO rule chứa actor: hạn chế lớp dữ liệu biểu diễn bằng rule type=deny + securityLabel (vn-data-sensitivity-class-vs), thay cho sub-extension restrictedSensitivity đã xóa ở 0.8.0.

Lớp nhạy cảm dữ liệu (vn-data-sensitivity-class-vs) mà rule áp dụng. Mô hình hạn chế theo lớp: permit theo lớp cơ bản + provision con type=deny với securityLabel lớp bị hạn chế (vd special-protection với người đại diện của vị thành niên — thay sub-extension restrictedSensitivity đã xóa 0.8.0). PDP deny-by-default: không có provision permit phủ lớp dữ liệu → từ chối.

A record of a healthcare consumer’s 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.

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

The base language in which the resource is written.

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

A human language.

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

An Extension

Khi việc xử lý dữ liệu diễn ra KHÔNG qua sự đồng ý (cấp cứu, hoạt động cơ quan nhà nước...), ghi căn cứ Điều 19 khoản 1 tại đây thay vì dùng category miễn trừ (mô hình cũ ≤0.7.0 đã deprecated). Bên viện dẫn điểm a chịu nghĩa vụ chứng minh; hệ thống lưu bằng chứng qua AuditEvent (Điều 19 khoản 2).

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Unique identifier for this copy of the Consent Statement.

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.

Trạng thái theo ma trận Luật 91/2025/QH15: active (bản ghi đang hiệu lực — kể cả từ chối chủ động qua rule nested provision.provision.type=deny), rejected (đề nghị đồng ý bị từ chối ngay từ đầu theo Điều 4 khoản 1 điểm b), inactive (đã chấm dứt: rút lại theo Điều 10, hết thời hạn, hoặc bị thay thế).

KHÔNG dùng rejected cho việc rút lại — rút lại sự đồng ý đang hiệu lực (Điều 10) chuyển bản ghi sang inactive; bản chép mới ghi nhận từ chối tiếp theo (nếu có) dùng active + rule nested deny.

Indicates the state of the consent.

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

Phạm vi đồng ý — mặc định patient-privacy cho DLCN y tế nhạy cảm.

The four anticipated uses for the Consent Resource.

Phân loại chỉ thị đồng ý: quyền riêng tư, điều trị, nghiên cứu, đồng ý qua đại diện. Theo Luật 91/2025/QH15 Điều 9 (sự đồng ý), Điều 24 (đại diện theo pháp luật). Các trường hợp KHÔNG cần đồng ý (Điều 19) không phải loại đồng ý — dùng extension[processingLegalBasis].

Bệnh nhân — chủ thể dữ liệu cá nhân theo Luật 91/2025/QH15 Điều 2 khoản 5.

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

Thời điểm ghi nhận sự đồng ý hoặc từ chối. Hình thức đồng ý phải rõ ràng, cụ thể, kiểm chứng được theo Luật 91/2025/QH15 Điều 9 khoản 3.

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

Người thực hiện đồng ý: bệnh nhân, hoặc người đại diện theo pháp luật đối với trẻ em/người bị mất hoặc hạn chế năng lực hành vi dân sự (Luật 91/2025/QH15 Điều 24 khoản 2). Trẻ em từ đủ 07 tuổi: công bố thông tin đời tư cần đồng ý của CẢ trẻ và người đại diện.

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.

Cơ sở khám chữa bệnh — bên kiểm soát dữ liệu (Luật 91/2025/QH15 Điều 2 khoản 7) hoặc bên kiểm soát và xử lý dữ liệu (Điều 2 khoản 9) khi tự vận hành hệ thống. Chịu nghĩa vụ lưu trữ và chứng minh sự đồng ý theo NĐ 356/2025/NĐ-CP Điều 6 khoản 2.

Tài liệu gốc: bản scan chữ ký, phiếu đồng ý điện tử, hoặc ghi nhận khác kiểm chứng được (5 phương thức theo NĐ 356/2025/NĐ-CP Điều 6 khoản 1 — xem vn-ext-consent-method). Bên kiểm soát PHẢI lưu trữ sự đồng ý và chịu trách nhiệm chứng minh khi tranh chấp (NĐ 356/2025/NĐ-CP Điều 6 khoản 2). Im lặng/không phản hồi không được coi là đồng ý (Luật 91/2025/QH15 Điều 9 khoản 4 điểm d); cấm thiết lập mặc định đồng ý (NĐ 356/2025/NĐ-CP Điều 6 khoản 3).

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.

Tham chiếu đến văn bản pháp luật làm căn cứ cho đồng ý.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Entity or Organization having regulatory jurisdiction or accountability for enforcing policies pertaining to Consent Directives.

URL/URI văn bản pháp luật (VD: Luật 91/2025/QH15, NĐ 356/2025/NĐ-CP, TT 13/2025/TT-BYT).

This element is for discoverability / documentation and does not modify or qualify the policy rules.

A reference to the specific base computable regulation or policy.

If the policyRule is absent, computable consent would need to be constructed from the elements of the Consent resource.

Regulatory policy examples.

Might be a unique identifier of a policy set in XACML, or other rules engine.

Whether a treatment instruction (e.g. artificial respiration yes or no) was verified with the patient, his/her family or another authorized person.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Has the instruction been verified.

Who verified the instruction (Patient, Relative or other Authorized Person).

Date verification was collected.

Quy tắc cho phép/từ chối xử lý dữ liệu theo mục đích, đối tượng, thời hạn cụ thể.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Action to take - permit or deny - when the rule conditions are met. Not permitted in root rule, required in all nested rules.

R4: type không được dùng ở root rule — root chỉ là khung; mọi rule permit/deny nằm ở provision.provision (vn-consent-provision-structure).

How a rule statement is applied, such as adding additional consent or removing consent.

Thời hạn đồng ý (nếu chủ thể ấn định). Chủ thể có quyền yêu cầu rút lại/hạn chế xử lý theo Luật 91/2025/QH15 Điều 10 (trừ trường hợp Điều 19 hoặc pháp luật quy định khác); hệ thống lưu bằng chứng thời hạn và việc rút lại theo NĐ 356/2025/NĐ-CP Điều 6 khoản 2.

KHÔNG bắt buộc period.end: sự đồng ý vô thời hạn là hợp pháp — có hiệu lực cho đến khi chủ thể thay đổi (Luật 91/2025/QH15 Điều 9 khoản 4 điểm c). Invariant vn-consent-period-end-required (≤0.7.0) đã gỡ vì mâu thuẫn điều khoản này.

Bên được phép/từ chối xử lý: CSKCB, BHXH, cơ quan y tế dự phòng, người đại diện, v.v. LƯU Ý Điều 26 khoản 2 Luật 91/2025/QH15: cấm cung cấp DLCN cho bên thứ ba là tổ chức CSSK/bảo hiểm khác trừ khi chủ thể yêu cầu bằng văn bản hoặc thuộc Điều 19 khoản 1 — mô hình mặc định là deny với bên thứ ba.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

How the individual is involved in the resources content that is described in the exception.

How an actor is involved in the consent considerations.

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

Actions controlled by this Rule.

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'.

Detailed codes for the consent action.

A security label, comprised of 0..* security label fields (Privacy tags), which define which resources are controlled by this exception.

If the consent specifies a security label of "R" then it applies to all resources that are labeled "R" or lower. E.g. for Confidentiality, it's a high water mark. For other kinds of security labels, subsumption logic applies. When the purpose of use tag is on the data, access request purpose of use shall not conflict.

Security Labels from the Healthcare Privacy and Security Classification System.

Mục đích cụ thể: khám chữa bệnh, BHYT, y tế công cộng, nghiên cứu, bệnh án điện tử, chia sẻ hồ sơ. Sự đồng ý thể hiện theo TỪNG mục đích — Luật 91/2025/QH15 Điều 9 khoản 4 điểm a; không được kèm điều kiện ép đồng ý mục đích khác (điểm b).

When the purpose of use tag is on the data, access request purpose of use shall not conflict.

Loại resource FHIR được phép/từ chối: Condition, Observation, Claim, v.v.

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.

The class (type) of information a consent rule covers.

If this code is found in an instance, then the rule applies.

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

If this code is found in an instance, then the exception applies.

Clinical or Operational Relevant period of time that bounds the data controlled by this rule.

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.

The resources controlled by this rule if specific resources are referenced.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

How the resource reference is interpreted when testing consent restrictions.

How a resource reference is interpreted when testing consent restrictions.

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

Rules which provide exceptions to the base rule or subrules.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

permit = cho phép xử lý, deny = từ chối xử lý. Quyền đồng ý/không đồng ý/rút lại theo Luật 91/2025/QH15 Điều 4 khoản 1 điểm b; với thông tin sức khỏe, đồng ý là bắt buộc trừ Điều 19 khoản 1 (Điều 26 khoản 1 điểm a). Từ chối đang hiệu lực = status active + rule deny (nested).

How a rule statement is applied, such as adding additional consent or removing consent.

The timeframe in this rule is valid.

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

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

How the individual is involved in the resources content that is described in the exception.

How an actor is involved in the consent considerations.

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

Actor là người đại diện theo pháp luật/giám hộ/được ủy quyền (Luật 91/2025/QH15 Điều 24 khoản 2). BẮT BUỘC gắn extension vn-ext-representation-authority ngay tại actor này — PDP resolve token thẩm quyền (type/source/verifiedDate/period) và quyết định permit/deny THEO rule chứa actor: hạn chế lớp dữ liệu biểu diễn bằng rule type=deny + securityLabel (vn-data-sensitivity-class-vs), thay cho sub-extension restrictedSensitivity đã xóa ở 0.8.0.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

An Extension

Extension ghi nhận THẨM QUYỀN PHÁP LÝ để một người đại diện/giám hộ/được uỷ quyền truy cập dữ liệu y tế thay người khác (vd cha/mẹ xem Sổ SKĐT của con qua VNeID). Mô hình hoá 'token đại diện' phục vụ Policy Decision Point (PDP): loại thẩm quyền, nguồn xác minh, thời điểm xác minh, thời hạn. PDP deny-by-default khi quan hệ mâu thuẫn/hết hạn. THAY ĐỔI 0.8.0 (breaking — hậu kiểm toán Codex): sub-extension restrictedSensitivity đã XÓA — ngữ nghĩa hạn chế truy cập là QUYẾT ĐỊNH CHÍNH SÁCH, không phải thuộc tính token: biểu diễn bằng VNCoreConsent.provision (type=deny + securityLabel theo vn-data-sensitivity-class-vs + actor[representative] gắn chính extension này để link token↔consent — PDP resolve một chiều qua Consent). Căn cứ: Bộ luật Dân sự 2015 (đại diện/giám hộ/uỷ quyền); Luật Căn cước 2023 (quan hệ nhân thân CSDLQGDC); Luật 91/2025/QH15 Điều 24 (đại diện theo pháp luật) + Luật Trẻ em 2016 (dữ liệu trẻ em, lớp nhạy cảm).

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

How the individual is involved in the resources content that is described in the exception.

How an actor is involved in the consent considerations.

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

Actions controlled by this Rule.

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'.

Detailed codes for the consent action.

Lớp nhạy cảm dữ liệu (vn-data-sensitivity-class-vs) mà rule áp dụng. Mô hình hạn chế theo lớp: permit theo lớp cơ bản + provision con type=deny với securityLabel lớp bị hạn chế (vd special-protection với người đại diện của vị thành niên — thay sub-extension restrictedSensitivity đã xóa 0.8.0). PDP deny-by-default: không có provision permit phủ lớp dữ liệu → từ chối.

If the consent specifies a security label of "R" then it applies to all resources that are labeled "R" or lower. E.g. for Confidentiality, it's a high water mark. For other kinds of security labels, subsumption logic applies. When the purpose of use tag is on the data, access request purpose of use shall not conflict.

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

When the purpose of use tag is on the data, access request purpose of use shall not conflict.

What purposes of use are controlled by this exception. If more than one label is specified, operations must have all the specified labels.

The class of information covered by this rule. 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.

The class (type) of information a consent rule covers.

If this code is found in an instance, then the rule applies.

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

If this code is found in an instance, then the exception applies.

Clinical or Operational Relevant period of time that bounds the data controlled by this rule.

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.

The resources controlled by this rule if specific resources are referenced.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

How the resource reference is interpreted when testing consent restrictions.

How a resource reference is interpreted when testing consent restrictions.

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

Rules which provide exceptions to the base rule or subrules.