Normally, an emergency contact of a patient is indicated by adding a contact in the Patient instance and setting contact.relationship.coding.code equal to "C" in http://terminology.hl7.org/CodeSystem/v2-0131 (see e.g. this discussion in Zulip). This code is part of the ValueSet ()that is bound (as "extensible") to contact.relationship` (http://hl7.org/fhir/ValueSet/patient-contactrelationship).

However, the current IPS Patient profile overwrites this binding with a different, required binding to http://hl7.org/fhir/uv/ips/ValueSet/personal-relationship-uv-ips. The latter value set contains only code for familial/social relationship and contains no code for indicating an emergency contact. Hence, one can no longer use it to indicate an emergency contact. Indeed, the IPS binding is quite different in nature from the base spec one, e.g. the latter also contains authorities and insurance companies. Indeed, since the IPS ValueSet does not contain the values bound in the base spec, it arguably does not honor the "extensible" binding of the latter.

The key request here is that the binding of {{Patient.contact.relationship}} be changed to allow the codes from http://hl7.org/fhir/ValueSet/patient-contactrelationship (an hence, in particular, the relationship "emergency contact").

As pointed out by giorgio in the Zulip thread linked below, the CDA IPS IG contains two distinct concepts for the relationship. This could be taken into account for the resolution.

For further background, see this Zulip thread.