The cardinality of designation.use (in CodeSystem and ValueSet resources) might be considered given the extension of the (extensible binding) value set which is proposed.
If the value set includes "consumer", "preferred for language", "display", and "synonym" (which are likely overlapping significantly) if users need to select only one for a consumer preferred display synonym, it will be random which is selected.

(this is a manual "move" of UP-155 opened by Daniel Karlsson, which has been closed)