After much discussion on the various "linkage" type resources including patient.link, person.link, linkage.item, the discussion concluded that the linkage resource should not be used for relating "person" type resource together. Patient: When a patient resource instance has been linked/merged, it should have some internal indication that there is another patient resource that should also be considered. Not detecting/checking for a potential linkage could mean that related clinical records are not discovered, potentially impacting patient safety. Person: The Person resource is not just a linkage resource, it may be used as a central person demographic registry of information, potentially as the master of those core details. By just using the linkage resource we would need to recommend ALL uses of Patient to use the reverse include functionality to test if there are any linkages to other patients to be considered. Section 8.1.4 on Patient Linkage will include additional text to indicate why not to use the Linkage resource. And we will also update the linkage resource to include these reasons also. We also recommend that an invariant be added to the linkage resource to prevent using it on patient/practitioner/person/relatedperson resources.