So https://openehr.atlassian.net/browse/SPECAM-68 adds a constraint_status, which corresponds to the fhir value set binding strength.
I wonder if that can be used in a new validation rule, something like: if a DV_CODED_TEXT constraint is present and its constraint_status is required, it is not allowed to create any other DV_CODED_TEXT in a child archetype or in corresponding RM data that does not conform to that DV_CODED_TEXT, unless that new DV_CODED_TEXT is a specialisation of the parent DV_CODED_TEXT.
That would mean you could create different constraint_status of DV_CODED_TEXT/DV_TEXT combinations to solve the different use cases.
Note for currently all DV_CODED_TEXT have required constraint_status by default because it is the only supported binding strength currently, so not sure what that would mean for current archetypes and specializations.
If this does not solve it, or perhaps is a bit ugly solution, I would prefer the final keyword here 