| name | advance-directive-vs-polst |
| title | Advance Directive vs. POLST Comparison |
| description | Produces a plain-language comparison of advance directives and POLST/MOLST forms, covering legal status, clinician signatures, emergency precedence, clinical appropriateness, and document coordination. Use when the user asks about advance directive vs. POLST, living will vs. DNR, which document EMS follows, POLST vs. MOLST vs. POST, whether a healthy person needs a POLST, or document coordination in elder law, estate planning, or serious illness contexts. |
| author | CaseMark |
| author_url | https://github.com/CaseMark/skills/tree/main/skills/legal/advance-directive-vs-polst |
| license | Apache-2.0 |
| version | 0.1.0 |
| execution_mode | open |
| jurisdiction | us |
| practice | trusts-and-estates |
| language | en |
Advance Directive vs. POLST Comparison
Compares advance directives (legal planning documents) with POLST/MOLST forms (clinician-signed medical orders). These occupy different legal and clinical lanes — confusing them creates dangerous gaps in emergency care.
Quick Start
Gather before drafting (skip if user says "use defaults"):
- State(s) of residence — required before any jurisdiction-specific claim
- Existing documents — current advance directive, POLST/MOLST, or neither
- Health status — healthy / chronic illness / serious illness / advanced frailty / terminal
- Care setting — home, hospital, SNF, assisted living
- Named healthcare agent — appointed? successors?
- Primary question — e.g., "Which form wins in an emergency?"
Defaults if no response: general comparison, no state-specific claims, healthy adult context, educational memo format.
Core Distinction Table
| Feature | Advance Directive | POLST / MOLST |
|---|
| Nature | Legal planning document | Clinician-signed medical order |
| Purpose | Appoints agent; expresses values | Translates preferences into actionable orders |
| Who signs | Principal (+ witnesses/notary per state) | Clinician + patient or rep |
| Who it instructs | Agents, families, downstream clinicians | EMS, hospitals, facilities — immediately actionable |
| Scope | Broad: values, agent authority, end-of-life wishes | Specific: CPR, hospitalization, ventilation, nutrition |
| Appropriate for | All competent adults | Serious illness, advanced frailty, limited life expectancy |
| EMS usability | Generally not actionable at scene | Yes — designed for field portability |
| Clinician signature? | No | Yes — invalid without it |
Emergency Precedence
POLST takes practical precedence in the field. EMS looks for medical orders, not legal documents.
