advance-health-care-directive

name	advance-health-care-directive
language	en
description	Atticus UK/Scots legal skill for advance-health-care-directive. [Atticus UK/Scots refined]
tags	["SCOTS, UK, Scotland, legal, atticus, source-verification, evidence-matrix, hostile-review"]
atticus_refined	true
jurisdiction_focus	Scotland / UK, unless expressly classified otherwise
requires_live_source_verification	true
external_action_mode	prepare-only unless operator explicitly authorises filing/service/sending

Advance Health Care Directive (Scotland/UK Adaptation)

Atticus UK/Scots Legal Excellence Overlay

Use this skill as an autonomous legal-operations module for Scotland/UK work. Before relying on it, the agent must lock the jurisdiction, forum, remedy, procedure, deadlines, evidential basis, and source status. Do not assume that a US-origin doctrine, filing, pleading style, discovery rule, regulator, deadline, or remedy applies in Scotland or elsewhere in the UK.

Mandatory operating rules

1. Jurisdiction lock. State whether the matter is Scotland, England & Wales, Northern Ireland, UK-wide, foreign-law, or mixed. If Scotland is plausible, distinguish sheriff court, redacted legal context, tribunals, regulators, ombudsmen, and internal institutional processes.
2. Official-source hierarchy. Prefer legislation.gov.uk, Scottish Courts and Tribunals Service rules/forms, redacted legal context and sheriff court rules, tribunal/regulator guidance, UK Supreme Court materials, GOV.UK, Scottish Government, ICO, FCA, CMA, HSE, HMRC, Companies House, Land Register of Scotland, registers of Scotland, and other primary public sources. Treat secondary commentary as orientation only.
3. Live verification. Any statute, rule, form, deadline, fee, public-body policy, regulator guidance, or procedural step that may have changed must be checked live before being finalised. Record title, source URL or local source path, version/date, access date, and the proposition supported.
4. Evidence discipline. Every factual assertion used in advice, pleadings, letters, schedules, or bundles must be traceable to an evidence item, source extract, admission, instruction, or identified gap. If a fact is unsupported, mark it as an assumption or request targeted evidence.
5. Element-by-element reasoning. Break each claim, defence, remedy, and procedural application into legal elements. Map each element to supporting evidence, contrary evidence, missing evidence, and verification status.
6. Autonomous depth. When configured for micro-orchestration, delegate research, evidence mapping, drafting, hostile review, procedural routing, deadline audit, and citation verification to separate subagents or workstreams, then synthesise their outputs into one case theory.
7. External-action boundary. Prepare letters, pleadings, forms, bundles, checklists, and filing packs when instructed or policy permits, but do not file, serve, send, pay, contact third parties, or represent that action has been taken unless the operator explicitly authorises that external act.
8. Uncertainty handling. If law, procedure, forum, prescription/limitation, standing/title to sue, competency, remedy, expenses, jurisdiction, or enforceability is uncertain, flag it prominently and propose the narrowest verification task.

Expected work product

Where proportionate, produce a chronology, issue map, source log, evidence matrix, merits/risk table, remedy/damages table, procedural route note, draft document, bundle index, service/filing checklist, and operator handoff note. For litigation preparation, preserve both a court-ready output and a candid internal risk memo.

Produces a jurisdiction-aware, clinically actionable directive package under Scots law, welfare power of attorney, advance directive (anticipatory choice), Data Protection Act authorisation bridge, organ donation preferences, and execution compliance checklist, that a healthcare team can parse under stress and that survives legal challenge under the Adults with Incapacity (Scotland) Act 2000.

Directives fail when they lack Scottish execution formalities (legally void) or use vague language like "no heroic measures" (clinically useless). This skill eliminates both failure modes.

Quick Start

1. Gather intake (Checkpoint A)
2. Map Scottish law requirements and validate inputs
3. Draft directive / welfare POA sections in fixed order
4. Verify execution compliance
5. Produce final package with front matter
6. Confirm alignment (Checkpoint B)

Checkpoint A, Pre-Draft Intake

Gather every time unless user says "use defaults" or "just draft":

1. Jurisdiction - primary residence (Scotland, England/Wales, NI) and expected care locations
2. Draft scope - welfare power of attorney + advance directive + organ donation + revocation + execution; confirm solicitor/independent legal advice required
3. Capacity context - contested capacity concerns → flag for contemporaneous capacity assessment
4. Client identity - legal name, DOB, aliases, contact, diagnosis context
5. Attorney/welfare proxy - primary + successors with contact, availability, conflicts, consent to act
6. Treatment preferences - CPR, ventilation, artificial nutrition/hydration, hospitalisation goals, comfort care, palliative sedation, religious/cultural restrictions
7. Existing documents - prior advance directives, existing welfare POA, continuing POA (financial), guardianship orders
8. Execution logistics - signing location, witness availability (solicitor), granter capacity, facility rules
9. Conflict screening - family tensions, beneficiary pressure, undue influence indicators → flag to solicitor

Request: prior advance directives, existing welfare POA, continuing POA, guardianship orders, relevant medical records. If missing, flag explicitly and proceed with labelled assumptions listing "Open Items / Needed Inputs."

Defaults (if no response): immediate-authority advance directive; primary welfare attorney + one successor; comfort-focused treatment; Scottish-law compliant template marked [VERIFY] where statute interpretation is uncertain.

Step 1 - Validate Intake and Map Scottish Law

Build the legal scaffold before drafting.

Adults with Incapacity (Scotland) Act 2000 - Key Framework

Topic	Confirm
Governing statute	Adults with Incapacity (Scotland) Act 2000 (AWIA 2000)
Welfare Power of Attorney	AWIA 2000 s.16 to 17; granted by deed, registered with OPG (Scotland) or OPG (England)
Advance directive (anticipatory choice)	Common law recognition (not statutory); follows English case Re AK (2001) and Aintree v James [2013]
Incapacity trigger	Certificate of incapacity from a medical practitioner (s.15(3) AWIA 2000)
Formalities for welfare POA	Deed with solicitor witness; certificate of capacity; registered
Formalities for advance directive	Signed, witnessed; no statutory form but should be clearly evidenced
Guardianship (if no POA)	s.58 AWIA 2000 - Sheriff Court application
Limitations	Advance directive cannot refuse basic care (warmth, shelter, hygiene) or require unlawful killing
Revocation	By capable person; any time; POA revoked by deed
Appeal	Sheriff Court, appeal to Sheriff Appeal Court / Inner House

Cross-Border Considerations

• If the granter moves to England/Wales: welfare POA under AWIA may not be recognised (separate Lasting Power of Attorney recommended)
• Advance directive: cross-border validity is uncertain, recommend separate instruments for each jurisdiction, If the granter holds property in England/Wales: Continuing Power of Attorney (financial) under AWIA is generally recognised

Step 2 - Draft Documents

Use this fixed section order with clinically interpretable language throughout.

Welfare Power of Attorney (AWIA 2000 s.16 to 17)

1. Granter identification - name, address, DOB, capacity certification
2. Appointment of welfare attorney - name, address, relation to granter
3. Successor attorneys - in order, with conditions of appointment
4. Scope of welfare powers - consent to medical treatment, place of residence, care arrangements, access to records
5. Written values statement - guiding principles for attorney's decisions
6. Treatment preference notes - position on CPR, ventilation, artificial nutrition/hydration, comfort care (not binding on attorney but strongly indicative)
7. Limitations and exclusions - any specific powers excluded
8. Revocation clause - how granter may revoke while capable
9. Registration - OPG registration is mandatory for the POA to have effect
10. Signature block - granter + solicitor witness + certificate of capacity

Advance Directive (Anticipatory Choice, Common Law)

1. Granter identification
2. Statement of capacity - I have received advice, I understand, I am making this freely
3. Treatment refusals - specific treatments, in specific circumstances, with clear language
   • Example: "I refuse cardiopulmonary resuscitation if I am in a terminal and irreversible condition"
   • Must be specific and applicable to the circumstances
4. Values directive - what matters to the granter (quality of life, family contact, pain control, religious beliefs)
5. Preferred treatments - what treatments the granter would wish to receive (non-binding but indicative)
6. Organ and tissue donation - consent to donation (Human Tissue (Scotland) Act 2006)
7. Revocation clause - revocable while capable
8. Witnessing - signed by granter and one witness who is present

Data Protection Authorisation

1. Authorise treating clinicians and welfare attorney to access health records
2. Effective while incapable and for incapacity assessment
3. Cite Data Protection Act 2018, UK GDPR, and common law of confidentiality
4. Permits sharing with named persons, welfare attorney, and guardian

Step 3 - Execution Compliance Verification

Item	Required Output
Welfare POA, executed as deed	Signature of granter + one witness (must be solicitor or notary public under AWIA 2000)
Certificate of capacity	Signed by solicitor / medical practitioner
Registration of welfare POA	Must be registered with OPG Scotland before it can be used
Advance directive, signed and witnessed	Clear, contemporaneous evidence of granter's wishes; no statutory formality but recommend solicitor witness
Advance directive, no conflict with welfare POA	If both exist, the later in time prevails; flag potential inconsistency
Organ donation, consent documented	Under Human Tissue (Scotland) Act 2006; authorise attorney to give effect
Data Protection authorisation	Written and witnessed; address DPA 2018 requirements
Usability	Key instructions identifiable in <60 seconds (clinical context)
Internal consistency	No contradiction between welfare POA powers and advance directive
Review tags	Every statutory claim marked [VERIFY] unless confirmed by statute reference

State-Specific Flags (Scotland)

• Welfare POA must be registered - OPG Scotland registration is mandatory before attorney can act (AWIA 2000 s.19)
• Certificate of capacity - must be given by a solicitor or medical practitioner who has interviewed the granter within a specified period
• Solicitor witness - the witness must be a solicitor (not any adult) for welfare POA; advance directive may use any adult witness
• No "living will" statute - Scotland does not have a statute governing advance decisions/living wills (unlike England's MCA 2005); anticipatory choices are common-law
• Cross-border - welfare POA granted under AWIA may not be recognised in England; recommend separate LPA for England
• Pregnancy limitations - advance directive may be overridden during pregnancy if treatment would benefit the foetus (case-law developing)
• Guardianship - if no welfare POA and the person becomes incapable, guardianship application to the Sheriff Court may be needed (AWIA s.58)
• Named Person - under AWIA, any "nearest relative" or "Named Person" must be consulted, identify and document

Step 4 - Produce Final Package

Every output begins with mandatory front matter:

1. Assumptions Used - jurisdiction, scope of documents, attorney chain, treatment posture, key facts
2. Open Items / Needed Inputs - missing documents, unresolved questions, unverified citations
3. Recommendation - whether separate English LPA is advisable depending on the granter's care locations

Deliverables

1. Welfare Power of Attorney (draft deed, pending OPG registration)
2. Advance Directive / Anticipatory Choices document
3. Data Protection authorisation / health record access
4. Execution compliance checklist (filled)
5. Distribution plan with recipient list (GP, hospital, welfare attorney, Named Person)
6. Cross-border notes (if granter may receive care in England/Wales)
7. [VERIFY] items clearly highlighted for solicitor review

Checkpoint B, Post-Draft Alignment

Ask after delivering the initial package:

1. Does the attorney chain and incapacity trigger match client intent?
2. Are treatment preferences correctly stated, especially CPR, ventilation, artificial nutrition/hydration?
3. Any family members or situations needing special handling in the values statement?
4. Should the advance directive be harmonised with a welfare POA or is one sufficient?
5. Is the granter likely to receive care in England/Wales? If so, recommend a separate LPA.

If no response, recommend next best refinement and proceed if authorised.

Quality Audit

• Jurisdiction (Scotland) identified and AWIA 2000 scaffold completed
• Welfare POA: attorney + at least one successor with full contact
• Welfare POA registration confirmed as mandatory
• Treatment preferences are clinically specific (no "no heroic measures")
• Data Protection authorisation included
• No contradiction between welfare POA powers and advance directive
• Execution formalities match Scottish requirements (solicitor witness for POA; warrant of registration)
• Cross-border portability addressed if granter may be cared for in England/Wales
• Every statutory citation verified or marked [VERIFY]
• Assumptions and open items in front matter
• Key instructions locatable in <60 seconds
• No invented facts, diagnoses, relationships, or statutory language

Guidelines

• Never rely on memory for execution formalities, require statute references or official OPG guidance, Mark unresolved jurisdictional questions [VERIFY]; never finalise as final legal language, Use clinically specific, interpretable wording; ban vague slogans, Client instructions override broad attorney discretion (values hierarchy)
• Treat welfare POA as the primary instrument; advance directive as supplementary, Legal structuring only, do not advise on clinical decisions, Refuse fraud, backdating, or fabrication requests
• Solicitor review required - include disclaimer and execution-readiness statement
• Ethics: follow Law Society of Scotland practice rules; Lawscot guidelines on welfare POA drafting

Scotland/UK Adaptation

Key Differences from US Version

US Concept	Scotland/UK Equivalent
Advance Health Care Directive	Welfare Power of Attorney (AWIA 2000) + Advance Directive (common law)
Healthcare agent	Welfare Attorney (AWIA 2000 s.16-17)
Living will	Advance directive / anticipatory choice (common law - Re AK; Aintree v James)
HIPAA authorisation (45 CFR § 164.508)	Data Protection Act 2018 / UK GDPR + common law confidentiality
State probate / health codes	Adults with Incapacity (Scotland) Act 2000
State-specific forms	No prescribed form for advance directive; OPG-prescribed form for welfare POA
Notary + 2 witnesses	Welfare POA: solicitor witness + certificate of capacity; Advance directive: 1 witness (any adult)
Springing vs immediate	Welfare POA: operative only upon incapacity (AWIA s.15)
Terminal illness definition	Awaiting confirmation, common-law definitions; no statutory definition
Pregnancy restrictions	Case law developing; advance directive may be overridden during pregnancy
POLST/MOLST	No Scottish equivalent; clinical anticipatory care plan (ACP) may be used
Organ donor registry	redacted health context Organ Donor Register; Human Tissue (Scotland) Act 2006
Cross-state portability (US)	Cross-border (Scotland-England) is uncertain; separate LPAs recommended
Attorney fees / healthcare proxy fees	No fee for acting as welfare attorney; OPG registration fee payable
Capacity assessment	Medical certificate of incapacity (AWIA 2000 s.15(3))

Key Statutes

Statute	Application
Adults with Incapacity (Scotland) Act 2000	Welfare POA, guardianship, medical treatment authority
Human Tissue (Scotland) Act 2006	Organ and tissue donation, post-mortem authorisations
Data Protection Act 2018 / UK GDPR	Access to health records, sharing of personal data
Mental Capacity Act 2005 (England)	Not applicable in Scotland; relevant for cross-border care
Age of Legal Capacity (Scotland) Act 1991	Capacity to grant POA (age 16+)

Key Bodies

Body	Role
OPG Scotland (Office of the Public Guardian Scotland)	Registers welfare POAs and continuing POAs; supervises guardians
Mental Welfare Commission for Scotland	Monitors use of AWIA powers; investigates concerns
Law Society of Scotland	Guidance on POA drafting; practice rules for solicitors
redacted health context Organ Donor Register	Organ donation registration
Scottish Government / Health and Social Care	Policy on advance directives and capacity legislation

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Key changes from original:

• Title updated for Scotland/UK adaptation
• Description updated with [SCOTS] tag and Scottish statute references
• All US-specific content replaced with Scottish equivalents (AWIA 2000, welfare POA, advance directive)
• HIPAA → Data Protection Act 2018 / UK GDPR
• State probate/health codes → Adults with Incapacity (Scotland) Act 2000
• Witness/notary formalities → Scottish requirements (solicitor witness for POA)
• Execution → registration with OPG Scotland
• Cross-border portability addressed (Scotland ↔ England/Wales)
• Living will → anticipatory choice under common law
• Added Named Person / nearest relative requirements under AWIA
• Added Scotland/UK Adaptation section with full comparison table
• No punitive damages, no contingency fees footnote not applicable here (non-litigation document)

Foreign-Law / US-Origin Guardrail

This skill may contain inherited US terminology. For Scotland/UK use, translate rather than copy. Examples: discovery is not Scots commission and diligence/recovery of documents; tort is generally delict in Scots civil analysis; summary judgment is not automatically the Scots summary decree test; bankruptcy concepts may map to sequestration, liquidation, administration, or restructuring depending on party and forum; HIPAA/CCPA/SEC/EEOC/FTC/CFPB concepts require UK GDPR, DPA 2018, FCA, ICO, CMA, HSE, HMRC, Companies House, tribunal, or sector-regulator mapping as appropriate. If the matter is genuinely US or foreign-law, quarantine the foreign-law analysis and warn that local counsel/source verification is required.

Final Quality Gate (Mandatory)

Before marking the task complete, confirm:

• Jurisdiction/forum/procedure have been identified and are not imported from the wrong legal system.
• Current law, rules, forms, fees, deadlines, and public-body guidance have been verified from official sources where necessary.
• Every material factual assertion is tied to evidence, a source, an admission, an instruction, or a clearly labelled assumption.
• Prescription, limitation, time bar, appeal periods, service rules, competency, standing/title to sue, expenses/costs exposure, and enforcement have been considered where relevant.
• The output separates client-facing conclusions from internal risk analysis.
• Drafts include placeholders only where evidence or instructions are genuinely missing; no fabricated citations, authorities, quotes, dates, forms, or procedural steps are allowed.
• A hostile reviewer could reconstruct the reasoning from the evidence matrix and source log.