Original Text: We opted to include the Sex for Clinical Use value in-line rather than as a reference to Observation after discussion on tradeoffs between two options. We felt that the in-line option was simpler while being sufficiently expressive. An extension with a reference to Observation allows for the expression of complex metadata associated with the value, however we expect the need for that complex metadata would be sufficiently rare to not outweigh the benefits of the simpler in-line extension option. Note to balloters: Input on the approach of an extension with an in-line value vs. an extension with a reference to an Observation is appreciated.   New Text: We opted to include the Sex Parameter for Clinical Use value in-line rather than as a reference to Observation after discussion on tradeoffs between two options. We felt that the in-line option was simpler while being sufficiently expressive. An extension with a reference to Observation allows for the expression of complex metadata associated with the value, however we expect the need for that complex metadata would be sufficiently rare to not outweigh the benefits of the simpler in-line extension option. Note that in this discussion, there are two types of relevant observations: The Observation which describes the SPCU. Any Observations such as organ inventory or lab results that is supporting info for the SPCU.  This information may be communicated as supportingInfo.