HealthClaw Guardrails provides a vendor-neutral, open-source security proxy for interactions between AI agents and FHIR servers. It implements critical safeguards such as automatic PHI redaction, a comprehensive immutable audit trail for all data access and modifications, and step-up authorization for write operations. The system also includes human-in-the-loop confirmation for clinical writes, tenant isolation, and medical disclaimers, ensuring responsible and compliant use of sensitive health data by AI agents. This project aims to standardize the essential security and compliance guardrails often overlooked in AI-driven healthcare solutions.