emergency-contraception

name: emergency-contraception description: Use when a caller asks about emergency contraception (EC / 緊急避妊) after unprotected intercourse or contraceptive failure, including cases where a partner's method failed or the circumstances around consent are uncertain. Produces a three-way next-action decision — Call (hotline or crisis support in parallel with the medication pathway), Go (open pharmacy participating in the Japan OTC levonorgestrel program), or Wait (context-specific, typically when the time window has already closed and follow-up routing is the useful output) — with the Yorukusu safety boundary on every output. Integrates the caller's Personal Health Context for interacting medications and known contraindications. Never outputs a diagnosis and never recommends prescription medication outside the current Japan OTC-available options.

Emergency Contraception Triage

Yorukusu does not diagnose. Pharmacist-informed, not pharmacist-replacing.

When to invoke this skill

Invoke when the caller's message indicates a need for emergency contraception information after unprotected intercourse or contraceptive failure.

• [TODO-TM: enumerate the trigger keywords and phrasings in Japanese and English, including the common indirect phrasings a caller may use. Include sensitivity to crisis-disclosure signals (assault, coercion, concerns about safety) that should route the flow to a human support resource IN ADDITION to the medication pathway — not instead of it.]

Required inputs

1. Hours elapsed since the incident (this is the dominant stratifier because the pharmacologic window is time-limited).
2. Caller age.
3. Current cycle context if known (days since last menstrual period).
4. Personal Health Context: current medications (enzyme-inducers and other interacting agents in particular), chronic conditions, pregnancy history.
5. Whether a crisis or assault context is present — this may require a parallel routing to a support service regardless of the medication decision.

Red-flag screening — produce CALL and route to support services

• [TODO-TM: define the red-flag conditions that warrant an immediate CALL with explicit routing to crisis and assault support lines, and the exact caller-facing phrasing to use. Ensure the medication information pathway is still surfaced — do not gate the medication decision on crisis disclosure, but do add the support-service routing when the signals are present.]

Decision logic (no red flags)

After red flags are cleared, branch to one of CALL, GO, or WAIT based on:

• Time since incident versus the Japan-approved levonorgestrel window.

• Availability of an open pharmacy participating in the Japan OTC EC program (this is a map-integrated lookup).

• PHC contraindications and drug interactions.

• [TODO-TM: specify the decision tree, including the exact phrasing of the time-window statement, how to handle out-of-window cases (when to route to WAIT with next-day clinic guidance), and PHC modifiers that require a pharmacist conversation at the GO pharmacy. Document the interaction list that must be checked against PHC daily medications.]

OTC guidance (GO branch)

The skill directs the caller to an open pharmacy that participates in the Japan OTC emergency-contraception program. It does NOT surface prescription-only EC regimens.

• [TODO-TM: specify the pre-approved OTC EC option(s), dose and timing guidance phrasing, what the caller should expect at the pharmacy (intake, identification, pharmacist consultation), post-dose monitoring advice, and follow-up guidance — including when a clinic visit is indicated after the dose regardless of apparent success.]

Output format

Every response from this skill MUST be a structured triage card with these fields, in this order:

1. decision: one of CALL, GO, WAIT.
2. reason: 1-2 sentences, caller-facing, in plain language. NEVER contains diagnostic language.
3. next_action: a concrete single step. For GO, the specific participating pharmacy. For CALL with crisis signals, the specific support-service phone number plus the medication pathway as a secondary block.
4. exit_criteria: state explicitly when a clinic follow-up is warranted even on a WAIT or GO branch.
5. safety_boundary: the exact string "Yorukusu does not diagnose. Pharmacist-informed, not pharmacist-replacing."

Non-goals

• Never output a diagnosis.
• Never recommend a prescription medication outside the current Japan OTC-approved options.
• Never gate crisis-support routing on medication decisions, and never gate medication-pathway information on crisis disclosure.
• Never omit the safety_boundary field.
• Never skip red-flag screening.