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The following is an example of a Health Care Directive (many people still refer to this as a Living Will).   It is broken down into 3 basic parts.  1) Appointment of the Health Care Agent.  2) Health Care Instructions.  3) Making the Document Legal.   Like most legal documents, it can be a bit confusing and overwhelming.  The purpose for making this easily available to the public is simple.  To help people know what to expect before contacting a lawyer and having him or her draft a directive for them.   Nobody likes thinking about their demise or incapacity.  However, dealing with such issues is a necessary part of life. 

 

This example should not be used as a substitute for getting solid legal advice from a licensed attorney.  Every individual is different.  Please consult a lawyer in your area to discuss your specific estate planning needs.

 

 

HEALTH CARE DIRECTIVE

 

I, ___________________________________, understand this document allows me to do One or both of the following:

 

PART I: Name another person (called the health care agent) to make health care decisions for me if I am unable to decide or speak for myself. My health care agent must make health care decisions for me based on the instructions I provide in this document (Part II), if any, the wishes I have made known to him or her, or must act in my best interest if I have not made my health care wishes known.

 

And/or

 

PART II: Give health care instructions to guide others making health care decisions for me. If I have named a health care agent, these instructions are to be used by the agent. These instructions may also be used by my health care providers, others assisting with my health care and my family, in the event I cannot make decisions for myself.

 

 

PART I: APPOINTMENT OF HEALTH CARE AGENT

 

This is who I want to make health care decisions for me if I am unable to decide or speak for myself  (I know I can change my agent or alternate agent at any time and I know I do not have to appoint an agent or an alternate agent)

 

NOTE: If you appoint an agent, you should discuss this health care directive with your agent and give your agent a copy. If you do not wish to appoint an agent, you may leave Part I blank and go to Part II.

 

 

When I am unable to decide or speak for myself, I trust and appoint ___________________ to make health care decisions for me. This person is called my health care agent.  Relationship of my health care agent to me: ___________________

Telephone number of my health care agent: _________________________

Address of my health care agent: _________________________
 

(OPTIONAL) APPOINTMENT OF ALTERNATE HEALTH CARE AGENT: If my health care agent is not reasonably available, I trust and appoint _________________ to be my health care agent instead.  Relationship of my alternate health care agent to me: ___________________________Telephone number of my alternate health care agent: ___________________________ Address of my alternate health care agent: ___________________________

 

THIS IS WHAT I WANT MY HEALTH CARE AGENT TO BE ABLE TO

DO IF I AM UNABLE TO DECIDE OR SPEAK FOR MYSELF (I know I can change these choices)

 

My health care agent is automatically given the powers listed below in (A) through (D).

My health care agent must follow my health care instructions in this document or any other instructions I have given to my agent. If I have not given health care instructions, then my agent must act in my best interest. Whenever I am unable to decide or speak for myself, my health care agent has the power to:

 

(A) Make any health care decision for me. This includes the power to give, refuse, or

withdraw consent to any care, treatment, service, or procedures. This includes deciding whether to stop or not start health care that is keeping me or might keep me alive, and deciding about intrusive mental health treatment.

 

(B) Choose my health care providers.

 

(C) Choose where I live and receive care and support when those choices relate to my

health care needs.

 

(D) Review my medical records and have the same rights that I would have to give my

medical records to other people.

 

If I DO NOT want my health care agent to have a power listed above in (A) through (D) OR if I want to LIMIT any power in (A) through (D), I MUST say that here:

 

______________________________________________________________________

 

My health care agent is NOT automatically given the powers listed below in (1) and (2). If I WANT my agent to have any of the powers in (1) and (2), I must INITIAL the line in front of the power; then my agent WILL HAVE that power.

 

______   (1)  To decide whether to donate any parts of my body, including organs, tissues, and eyes, when I die.

 

______ (2)  To decide what will happen with my body when I die (burial, cremation).

 

If I want to say anything more about my health care agent’s powers or limits on the powers, I can say it here:  ________________________________________________________________________

 

 

 

 

PART II: HEALTH CARE INSTRUCTIONS

 

NOTE: Complete this Part II if you wish to give health care instructions. If you appointed an agent in Part I, completing this Part II is optional but would be very helpful to your agent. However, if you chose not to appoint an agent in Part I, you MUST complete some or all of this Part II if you wish to make a valid health care directive.

 

These are instructions for my health care when I am unable to decide or speak for myself.

These instructions must be followed (so long as they address my needs).

 

THESE ARE MY BELIEFS AND VALUES ABOUT MY HEALTH CARE

(I know I can change these choices or leave any of them blank)

 

I want you to know these things about me to help you make decisions about my health care:

 

My goals for my health care: ________________________________________________________________________________________________________________________________________________

 

 

 

My fears about my health care: ________________________________________________________________________________________________________________________________________________

 

 

My spiritual or religious beliefs and traditions: ________________________________________________________________________________________________________________________________________________

 

 

 

My beliefs about when life would be no longer worth living:

 

________________________________________________________________________________________________________________________________________________

 

My thoughts about how my medical condition might affect my family:

 

________________________________________________________________________________________________________________________________________________

 

THIS IS WHAT I WANT AND DO NOT WANT FOR MY HEALTH CARE

 

(I know I can change these choices or leave any of them blank)  Many medical treatments may be used to try to improve my medical condition or to prolong my life. Examples include artificial breathing by a machine connected to a tube in the lungs, artificial feeding or fluids through tubes, attempts to start a stopped heart, surgeries, dialysis, antibiotics, and blood transfusions. Most medical treatments can be tried for a while and then stopped if they do not help.  I have these views about my health care in these situations:  (Note: You can discuss general feelings, specific treatments, or leave any of them blank)

 

If I had a reasonable chance of recovery, and were temporarily unable to decide or speak

for myself, I would want:

 

________________________________________________________________________________________________________________________________________________

 

 

If I were dying and unable to decide or speak for myself, I would want:

 

________________________________________________________________________________________________________________________________________________

 

 

If I were permanently unconscious and unable to decide or speak for myself, I would want:

 

________________________________________________________________________________________________________________________________________________

 

 

 

 

If I were completely dependent on others for my care and unable to decide or speak for

myself, I would want: …..

 

________________________________________________________________________________________________________________________________________________

 

 

In all circumstances, my doctors will try to keep me comfortable and reduce my pain. This is how I feel about pain relief if it would affect my alertness or if it could shorten my life:

 

________________________________________________________________________________________________________________________________________________

 

 

There are other things that I want or do not want for my health care, if possible:

 

Who I would like to be my doctor:

 

________________________________________________________________________________________________________________________________________________

 

 

 

 

Where I would like to live to receive health care:

 

________________________________________________________________________________________________________________________________________________

 

 

 

Where I would like to die and other wishes I have about dying:

 

________________________________________________________________________________________________________________________________________________

 

My wishes about donating parts of my body when I die:

 

________________________________________________________________________________________________________________________________________________

My wishes about what happens to my body when I die (cremation, burial):

 

________________________________________________________________________________________________________________________________________________

 

 

Any other things:

 

________________________________________________________________________________________________________________________________________________

 

 

PART III: MAKING THE DOCUMENT LEGAL

 

This document must be signed by me. It also must either be verified by a notary public

(Option 1) OR witnessed by two witnesses (Option 2). It must be dated when it is verified or witnessed.I am thinking clearly, I agree with everything that is written in this document, and I have made this document willingly.

 

 

___________________________________

My Signature

  

___________________________________

Date signed:

 

___________________________________ 

Date of birth:

 

___________________________________ 

Address:

 

 

If I cannot sign my name, I can ask someone to sign this document for me.

 

 

_____________________________________________________

Signature of the person who I asked to sign this document for me.

 

________________________________________________________

Printed name of the person who I asked to sign this document for me.

 

 

Option 1: Notary Public

 

In my presence on___________________________________ (date), __________________________________________ (name) acknowledged his/her

signature on this document or acknowledged that he/she authorized the person signing this document to sign on his/her behalf. I am not named as a health care agent or alternate health care agent in this document.

 

___________________________________________ 

(Signature of Notary)

 (Notary Stamp)

 

 

Option 2: Two Witnesses

 

Two witnesses must sign. Only one of the two witnesses can be a health care provider or an employee of a health care provider giving direct care to me on the day I sign this document.

 

Witness One:

(i) In my presence on _______________________ (date), ________________ (name) acknowledged his/her signature on this document or acknowledged that he/she authorized the person signing this document to sign on his/her behalf.

(ii) I am at least 18 years of age.

(iii) I am not named as a health care agent or an alternate health care agent in this document.

(iv) If I am a health care provider or an employee of a health care provider giving direct

care to the person listed above in (A), I must initial this box: [   ]

I certify that the information in (i) through (iv) is true and correct.

 

______________________________________ 

(Signature of Witness One)

 

Address:  ________________________________________________________________________________________________________________________________________________

 

 

Witness Two:

(i) In my presence on ________________________ (date), _________________ (name) acknowledged his/her signature on this document or acknowledged that he/she authorized the person signing this document to sign on his/her behalf.

(ii) I am at least 18 years of age.

(iii) I am not named as a health care agent or an alternate health care agent in this document.

(iv) If I am a health care provider or an employee of a health care provider giving direct

care to the person listed above in (A), I must initial this box: [   ]

I certify that the information in (i) through (iv) is true and correct.

 

________________________________________ 

(Signature of Witness Two)

 

Address:

________________________________________________________________________________________________________________________________________________

 

REMINDER: Keep this document with your personal papers in a safe place (not in a safe deposit box). Give signed copies to your doctors, family, close friends, health care agent, and alternate health care agent. Make sure your doctor is willing to follow your wishes. This document should be part of your medical record at your physician’s office and at the hospital, home care agency, hospice, or nursing facility where you receive your care.

 

Some of this information was taken from Minnesota statute section 145C.16.  This should not be considered legal advice, it is provided as a public service.

(Miniseries; CBS, Sun. Nov. 12, Wed. Nov. 15, 9 p.m.)

Filmed in Los Angeles by Lawrence Schiller Prods. in association with Fox Television Studios. Executive producers, Barry Levinson, Lawrence Schiller, Tom Fontana; producers, Lynn Raynor, Schiller; director, Schiller; writer, Norman Mailer, based on the book by Schiller, James Willwerth; director of photography, Bruce Surtees; production designer, Michael Baugh; editor, Peter Zinner, Katina Zinner; music, Bill Conti; casting, Judith Holstra. 4 hours.

Johnnie Cochran …. Ving Rhames

Bob Shapiro …. Ron Silver

Barry Scheck …. Bruno Kirby
Carl Douglas …. Darryl Alan Reed

Gerry Uelman …. Nicolas Pryor

Bob Kardashian …. Robert LuPone

Chris Darden …. Ruben Santiago-Hudson

Marcia Clark …. Diana LaMar

Shawn Chapman …. Sandra Prosper

Judge Ito …. Clyde Kusatsu

F. Lee Bailey …. Christopher Plummer

Alan Dershowitz …. Richard Cox

Jeanette Harris …. Sandra Thigpen

Jo-Ellan Dimitrius …. Cordelia Richards

Bill Hodgman …. Francis Guinan

Bill Pavelic …. Jeff Kober

Bill Blasier …. Peter Mackenzie

With: Raymond Forchion, Jim Lau, Barry Sigismondi, Charmaine Cruz, Larry Car-roll, Leah Sanders, Jean-Paul Vignon, Meeghan Holaway, Davenia McFadden, Bee-Be Smith, Amanda Rogers, Mary Grady, Judith Montgomery, David Margolick, Kate McNeil, Rick Shuman, Andre Rosey Brown, James Burke, Betsy C. Spear, Seth C. Abero, Robert Pike Daniel, Jennifer Echols, Cheryl Francis Harrington, Cee-Cee Harshaw, Jean-Carlos Felix, Mike

Walker, Ian Patrick Williams, Sylvia S. James.

First rule of thumb in courtroom dramas, most writing coaches would say, is to avoid courtroom scenes. They tend to make the action static and limit the drama that can better be explained through re-enactments and flashbacks that re-late to testimony. But this CBS mini is in the adept hands of Lawrence Schiller and writer Norman Mailer who manage to craft this story with an impeccable eye for detail and a flair for nuanced drama. Greatly

enhanced by Christopher Plummer’s Emmy-worthy turn as F. Lee Bailey, “American Tragedy” is about as good as TV gets in retelling a story where the entire audience already knows the ins, the outs and the outcome.

To a certain extent, the O.J. Simpson trial rewrote the book on how to set a compelling drama within the halls of justice; in its wake have been a series of well-received shows and films that rely on a newfound patience for and, possi-bly, a comprehension of law. Court dramas, particularly TV’s “Law & Order” and “The Practice” and the films “The Insider,” “Erin Brockovich” and “A Civil Ac-tion,” are of a considerably different tone than their

predecessors. “American Tragedy” follows a story arc not unlike that of “A Civil Action.”

Subtext of this tragedy is the battle of wits and ego as attorneys Johnnie Cochran (Ving Rhames) and Robert Shapiro (Ron Silver) evolve into publicity-craving grandstanders, hungry for positions of power in social and legal cir-cles. Shapiro starts strong and fades to the background as the story moves from the planning to the execution; Cochran grows from an aw-shucks innocent into a media-savvy bully, suggesting Shapiro gave him a stage to become a star.

Schiller stands alone as a director of screenplays based on his books, his last being the JonBenet Ramsey saga “Perfect Murder, Perfect Town.” In “American Tragedy” he takes part one to dissect the pretrial legal strategy from the first phone call placed to Shapiro up to the jurors’ tour of Simpson’s Brentwood es-tate. Part two starts with L.A. police detective Mark Fuhrman taking the stand and closes with the real Simpson mouthing

“thank you” to the jury as he stands between the superimposed fictional Cochran and Barry Scheck (Bruno Kirby).

Mini sheds little light on anything that might not have been known before, though viewers will certainly bring their own recollections to bear in judging show’s veracity. Where, for example, is Cochran donning the knit cap or Nicole Brown’s relatives or Kato Kaelin? Actual footage of the father of the murdered Ronald Goldman reminds that two people lost their lives, but the media barrage from the Goldmans and Browns that reverberated through Los Angeles seems, at most, to be background noise in these lawyers’ lives.

All views of Simpson are obscured by scenery or darkness, though his presence is felt constantly through the speaker phone. He advises his lawyers about their conduct, tactics and even diction, but mostly he exclaims “I didn’t do it” over and over and over.

The real trial brought this legal dream team into America’s homes for so long that the actors’ physical traits work for and against them. Plummer fully enve-lopes Bailey’s determination and the pride-swallowing he has to do as his tac-tics and advice are shot down by the two other big cheeses. As DNA expert Barry Scheck, Kirby benefits from a reasonably close resemblance and Kirby’s naturally squirrely acting style.

The two leads are problematic, though. Rhames is far bigger than the lean Cochran, and his presence is far more in-your-face intimidating than the real-life Cochran ever appeared to be. Cochran, from most accounts, was slick and calculated. In “American Tragedy,” he is driven by anger and blind ambition.

Silver’s Shapiro is all too familiar, his portrayal disturbingly similar to the way he played Alan Dershowitz in the pic “Reversal of Fortune” and the late concert promoter Bill Graham in the one-man stage show “Bill Graham Presents.” He handles pomposity and deviousness well — enough to make one wonder if his Shapiro portrayal isn’t the one that’s most dead-on.

Clyde Kusatsu makes for a fine Judge Ito, and Darryl Alan Reed admirably makes the most of the thankless role lawyer Carl Douglas played during the trial. Robert LuPone is constrained by the way Bob Kardashian is written — as an uncouth yes-man — and Ruben Santiago-Hudson has to play prosecutor Chris Darden as enemy to all. Diana LaMar’s Marcia Clark is effective but limited.

Technically, the pic is remarkably sharp as Schiller’s direction is clean and pointed. Editing by Peter and Katina Zinner is seamless, briskly moving the ac-tion on the first night and enhancing the collapse of the various relationships on the second. One well-done aspect is the marriage of new footage with actual cross-examination of witnesses such as Fuhrman.

Mini makes extensive use of downtown L.A. and Westside locales, from restau-rants to law offices to homes. It’s all as real as a 45 mph ride down the San Diego Freeway.

The “legal system” is a trillion dollar enterprise and knowing how “the system” operates does make a difference. During the past 15 years Bill Pavelic has consulted on many high profile cases, including, but not limited to;THE OJ SIMPSON DOUBLE MURDER CASE
THE MICHAEL JACKSON CHILD MOLESTATION CASE

THE PHIL SPECTOR MURDER CASE

THE ROBERT BLAKE MURDER CASE

THE SCOTT PETERSON MURDER CASE

THE MAX FACTOR (ANDREW LUSTER) RAPE CASE

THE MURDER AT CHAKA KHAN’S RESIDENCE

THE LOS ANGELES RIOTS CASESDetective Bill Pavelic retired from the Los Angeles Police Department in December of 1992. During his nineteen year tenure with LAPD, Bill Pavelic earned a Master’s Degree from Pepperdine University and acquired an extensive background in administrative and criminal investigations. Pavelic has investigated every conceivable crime and he is considered an expert in police procedures, interrogations and case biopsies. Detective Pavelic received over 200 commendations and letters of appreciation from private and governmental institutions, including the United States Department of Justice. Prior to his retirement, Pavelic was honored by the City of Los Angeles as the Detective Supervisor of the Year for his professional competence, unimpeachable integrity, and for serving the civilian community with distinction, courtesy, and honor.