ARCHETYPE Advance care directive (openEHR-EHR-EVALUATION.advance_care_directive.v1)

ARCHETYPE IDopenEHR-EHR-EVALUATION.advance_care_directive.v1
ConceptAdvance care directive
DescriptionA framework to communicate the preferences of an individual for future medical treatment and care.
UseUse to record the preferences of an individual for future medical treatment and care. Advance care directive may also be known as living will, advance directive, advance decision, advance decision to refuse treatment, personal directive, advance healthcare directive, or medical directive. An advance care directive is commonly used to refuse life-sustaining treatment which may include, but is not limited to: cardiopulmonary resuscitation (CPR); clinically assisted nutrition and hydration; assisted ventilation; and antibiotics for life-threatening infections. It could also include positive preferences and instructions for future health care priorities, living arrangements and personal matters. An individual with capacity may create an advance care directive to record their preferences for medical care and treatment in advance, which is intended to guide decision-making in future situations in which the individual is unable to make or communicate decisions. This archetype has been specifically designed as a framework or structure that can be extended for the complex range of use cases and local requirements by nesting a variety of possible CLUSTER archetypes which will contain specific details as per national or other local requirements. In some countries, an advance care directive is legally persuasive without having an official legal status. In others it is a legally-binding document, and it MUST be ensured that the advance care directive archetype and any nested archetypes adhere to relevant legal requirements.
MisuseNot to be used to record organ donation preferences. Use a specific archetype for this purpose. Not to be used to record details about a Power of Attorney or other legal representative/proxy. Use a specific archetype for this purpose. Not to be used to record anticipatory decisions about CPR decisions, other possible intervention decisions, and intent of care as asserted by a clinician in a health record. Use the EVALUATION.advance_intervention_decisions archetype for this purpose.
PurposeTo record the preferences of an individual for future medical treatment and care.
ReferencesAdvance Care Planning Australia [Internet]. Melbourne: Austin Health; 2018 [cited 2020 Apr 07]. Available from: https://www.advancecareplanning.org.au/.

Alberta Health Services [Internet]. Edmonton: Alberta Health Services; 2020. Goals of Care Designation (GCD) Order. 2014 Jan [cited 2020 Feb 17]. Available from: https://www.albertahealthservices.ca/frm-103547.pdf.

Compassion in Dying [Internet]. London: Compassion in Dying; 2018. Advance Decision (Living Will) pack; 2018 Jul [cited 2019 Nov 28]. Available from: https://compassionindying.org.uk/library/advance-decision-pack/.

Health and Care information models [Internet]. The Hague: NICTIZ; 2019. AdvanceDirective-v3.1(2019EN); 2020 Feb 03 [cited 2020 Feb 17]. Available from: https://zibs.nl/wiki/AdvanceDirective-v3.1(2019EN).

health.vic [Internet]. Melbourne: Department of Health & Human Services; 2017-2020. Advance care planning forms [cited 2020 04 07]. Available from: https://www2.health.vic.gov.au/hospitals-and-health-services/patient-care/end-of-life-care/advance-care-planning/acp-forms.

LeBlanc TW, Tulsky J. Discussing goals of care [Internet]. Wolters Kluwer; 2018 Oct 29 [cited 2020 Feb 17]. Available from: https://www.uptodate.com/contents/discussing-goals-of-care.
Copyright© openEHR Foundation
AuthorsAuthor name: Heidi Koikkalainen
Organisation: NES Digital Service, Edinburgh Napier University
Email: hk.koikkalainen@gmail.com
Date originally authored: 2019-10-23
Other Details LanguageAuthor name: Heidi Koikkalainen
Organisation: NES Digital Service, Edinburgh Napier University
Email: hk.koikkalainen@gmail.com
Date originally authored: 2019-10-23
OtherDetails Language Independent{licence=This work is licensed under the Creative Commons Attribution-ShareAlike 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/4.0/., custodian_organisation=openEHR Foundation, references=Advance Care Planning Australia [Internet]. Melbourne: Austin Health; 2018 [cited 2020 Apr 07]. Available from: https://www.advancecareplanning.org.au/. Alberta Health Services [Internet]. Edmonton: Alberta Health Services; 2020. Goals of Care Designation (GCD) Order. 2014 Jan [cited 2020 Feb 17]. Available from: https://www.albertahealthservices.ca/frm-103547.pdf. Compassion in Dying [Internet]. London: Compassion in Dying; 2018. Advance Decision (Living Will) pack; 2018 Jul [cited 2019 Nov 28]. Available from: https://compassionindying.org.uk/library/advance-decision-pack/. Health and Care information models [Internet]. The Hague: NICTIZ; 2019. AdvanceDirective-v3.1(2019EN); 2020 Feb 03 [cited 2020 Feb 17]. Available from: https://zibs.nl/wiki/AdvanceDirective-v3.1(2019EN). health.vic [Internet]. Melbourne: Department of Health & Human Services; 2017-2020. Advance care planning forms [cited 2020 04 07]. Available from: https://www2.health.vic.gov.au/hospitals-and-health-services/patient-care/end-of-life-care/advance-care-planning/acp-forms. LeBlanc TW, Tulsky J. Discussing goals of care [Internet]. Wolters Kluwer; 2018 Oct 29 [cited 2020 Feb 17]. Available from: https://www.uptodate.com/contents/discussing-goals-of-care., current_contact=Heidi Koikkalainen, hk.koikkalainen@gmail.com, original_namespace=org.openehr, original_publisher=openEHR Foundation, custodian_namespace=org.openehr, MD5-CAM-1.0.1=79A1A609FF411F07CF4E4358C653BF05, build_uid=b21c7d32-fb43-4f9a-8dfc-96757f116846, ip_acknowledgements=This artefact includes content from SNOMED Clinical Terms® (SNOMED CT®) which is copyrighted material of the International Health Terminology Standards Development Organisation (IHTSDO). Where an implementation of this artefact makes use of SNOMED CT content, the implementer must have the appropriate SNOMED CT Affiliate license - for more information contact http://www.snomed.org/snomed-ct/get-snomedct or info@snomed.org., revision=1.2.1}
Keywordsliving, will, advance, advanced, directive, decision, legal, preference, EoL, DNR, DNACPR, resuscitation,
Lifecycledeprecated
UID43ab1f51-7ffe-4fe8-a3cb-c956f6a31a82
Language useden
Citeable Identifier1013.1.4274
Revision Number1.2.1
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Vebjørn Arntzen, Oslo University Hospital, Norway (openEHR Editor)
steve baguley, NDS, United Kingdom
Silje Ljosland Bakke, Helse Vest IKT AS, Norway (openEHR Editor)
Marcos Barreto, Universidade Federal da Bahia (UFBA), Brazil
Ivar Berge, Oslo Universitetssykehus, Norway
SB Bhattacharyya, Sudisa Consultancy Services, India
Greg Burch, Tiny Medical Apps, United Kingdom
Santiago Cammi, Argentina
Ady Angelica Castro Acosta, CIBERES-Hospital 12 de Octubre, Spain
Kåre Flø, DIPS ASA, Norway
Grant Forrest, NHS Scotland, United Kingdom
Mikkel Gaup Grønmo, FSE, Helse Nord, Norway (Nasjonal IKT redaktør)
Anne Grimstvedt Kvalvik, Haraldsplass Diakonale sykehus, Norway
Joost Holslag, Nedap, Netherlands
Evelyn Hovenga, EJSH Consulting, Australia
Keltie Jamieson, NSHA, Canada
Gorazd Kalan, University Medical Centre Ljubljana, Slovenia
Lars Morgan Karlsen, DIPS ASA, Norway
Heidi Koikkalainen, United Kingdom (openEHR Editor)
Tomi Laptoš, Marand, Slovenia
Liv Laugen, ​Oslo University Hospital, Norway, Norway (openEHR Editor)
Heather Leslie, Atomica Informatics, Australia (openEHR Editor)
Neranga Liyanaarachchi, Ministry of Health, Postgraduate Institute of Medicine, Sri Lanka
Manisha Mantri, C-DAC, India
Ian McNicoll, freshEHR Clinical Informatics, United Kingdom (openEHR Editor)
Paul Miller, SCIMP NHS Scotland, United Kingdom
Bjoern Naess, DIPS ASA, Norway
Arunakiry Natarajan, management4health, Germany
Svenne Naumann, Finnmarkssykehuset, Norway
Andrej Orel, Marand d.o.o., Slovenia
Jayashree Panickar, Karolinska Institute, Sweden
Martin Paulson, Sykehuset i Vestfold, Norway
Vanessa Pereira, Better, Portugal
SARA PRETE, Abinsula, Italy
clovis puttini, Core Consulting, Brazil
Gro-Hilde Severinsen, Norwegian center for ehealthresearch, Norway
Line Silsand, Universitetssykehuset i Nord-Norge, Norway
Laila Storesund, Haraldsplass diakonale sykehus, Norway
Norwegian Review Summary, Nasjonal IKT HF, Norway
Carita Teien, Retten til en verdig død, Norge
Rowan Thomas, St. Vincent's Hospital Melbourne, Australia
Katrin Troeltzsch, Nationales Centrum für Tumorerkrankungen (NCT); Universitätsklinikum Heidelberg, Germany
John Tore Valand, Helse Bergen, Norway (openEHR Editor)
Marit Alice Venheim, Helse Vest IKT, Norway
Olav Weyergang-Nielsen, Retten til en verdig død, Norge
Wouter Zanen, Eurotranplant, Netherlands
Lin Zhang, Taikang Insurance Group, China, originalLanguage=en, translators=
  • German: Sarah Ballout, MHH-Hannover, ballout.sarah@mh-hannover.de
  • Norwegian Bokmål: Vebjørn Arntzen, Silje Ljosland Bakke, Liv Laugen, Oslo University Hospital, Helse Vest IKT AS, ​Oslo University Hospital, Norway, varntzen@ous-hf.no, silje.ljosland.bakke@helse-vest-ikt.no, liv.laugen@ous-hf.no
  • Portuguese (Brazil): Vladimir Pizzo, Royal Philips, vrppizzo@gmail.com
  • Dutch: Joost Holslag, Nedap, joost.holslag@nedap.com
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openEHR-EHR-CLUSTER.person.v0 and specialisations or
openEHR-EHR-CLUSTER.person.v1 and specialisations, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/protocol[at0010]/items[at0061], code=at0061, itemType=SLOT, level=2, text=Extension, description=Additional information required to extend the model with local content or to align with other reference models/formalisms., comment=For example: local information requirements; or additional metadata to align with FHIR., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:
All not explicitly excluded archetypes, extendedValues=null]], minIndents={}, termBindingRetrievalErrorMessage=null]