Having witnessed the slow death of both my parents from cancer while being denied effective (and addictive) pain treatment; seen the descent to helplessness of a grandparent from Alzheimer's while begging for death in those rare moments of lucidity; experienced the medical establishments efforts to sustain life when all reasonable hope was lost; and viewed the dungeons of hospices absent effective medical treatment to ease the journey to death; one is forced to conclude that the medical and legal doctrines of North American society are completely at odds with granting unconditional determination to patients. So much so that even the truth can not be discussed and inevitabilities planned for. Therefore, at least in America, to even ask the question is an oxymoron.