| name | healthcare-agent-instruction-letter |
| title | Healthcare Agent Instruction Letter |
| description | Drafts a non-binding healthcare values/instruction letter for a designated health care agent to guide substituted-judgment decisions during incapacity. Use when a client needs a bedside document that harmonizes with a health care power of attorney, healthcare proxy, or advance directive and captures quality-of-life thresholds, treatment preferences, and conflict guidance. Trigger on requests for "instruction letter," "health care agent letter," "values letter," "legacy letter," "healthcare proxy," or "DPOA health care." |
| author | CaseMark |
| author_url | https://github.com/CaseMark/skills/tree/main/skills/legal/healthcare-agent-instruction-letter |
| license | Apache-2.0 |
| version | 0.1.0 |
| execution_mode | open |
| jurisdiction | us |
| practice | trusts-and-estates |
| language | en |
| tags | ["drafting","letter","regulatory","transactional"] |
Healthcare Agent Instruction Letter
Drafts a scenario-based, non-binding values letter in the client's voice to empower the health care agent and reduce ambiguity at the bedside. Output supplements—never replaces—operative legal directives.
Quick Start
- Confirm client identity, preferred name, and jurisdiction.
- Collect executed documents (name/date/type): health care POA or proxy, advance directive, POLST/MOLST, HIPAA release.
- Identify primary agent and alternates (full names, roles, contact preferences).
- Capture core values: quality-of-life thresholds, cognition-loss tolerance, dependence, pain, institutional care.
- Capture clinical preferences: CPR, ventilation, artificial nutrition/hydration, antibiotics, surgery, time-limited trials, hospice, comfort care.
- Capture spiritual/cultural commitments affecting care decisions.
- Identify conflict vectors and family communication plan.
- Capture tone preference, distribution timing, and document-storage locations.
- Never invent names, dates, diagnoses, or beliefs—ask for missing facts and use
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Core Workflow
| Phase | Action | Output |
|---|
| 1 | Validate non-binding status | Opening disclaimer: guidance only, not a substitute for operative directives |
| 2 | Harmonize documents | List governing document titles/dates; note instruction hierarchy |
| 3 | Elicit decision framework | Big-Three thresholds: cognition, independence, suffering |
| 4 | Draft scenario logic | Treatment sections with conditional "if/when…then…" examples |
| 5 | Add faith/culture mechanics | Practical care requests tied to beliefs, without legal overstatement |
| 6 | Address conflict protocol | Disagreement scripts, consult triggers, clinician communication |
| 7 | Add logistics | Distribution plan: who receives, when, storage locations |
| 8 | Run quality controls | Mismatch flags, ambiguity reduction, attorney-review gate |
Writing Constraints
- Client voice, plain language, short headings, 1–3 pages.
- Conditional framing throughout: "if/when…then…" with scenario examples.
- No medical orders or statutory language belonging in POLST/MOLST/clinic forms.
