When we speak of choice, what we mean is the ability to exercise control over ourselves and our environment. In order to choose, we must first perceive that control is possible.

People don't put as much of an emphasis in expanding their choices, so that, you know, one of the things that I learned when I was in Japan way back in the 1990's and there were all these quarrels happening between the U.S. and Japan about allowing more American products into the Japanese market.

This is at a time when you know most of us drank tap water, so I used to go to this store and examine all the varieties and we used to marvel at all the choices out there, but I found that I rarely bought anything and I kind of thought that was kind of curious. I mean, they had things that the other grocery stores didn't have and yet I never bought anything.

So on the one hand in school you're teachers are constantly telling you that you can be whatever it is you want to be as long as you put your mind and heart to it, and yet at the same time I was also getting the clear message of, well, what can you do really?

When we speak of choice, what we mean is the ability to exercise control over ourselves and our environment. In order to choose, we must first perceive that control is possible.

Now to what...? How we teach people to make choices and the things they're going to make choices over - that is culturally learned.

The quality of health care continues to improve, and people are living longer, but these developments mean that we're likely to eventually find ourselves in a situation in which we're forced to make difficult choices about our parents, other loved ones, or even ourselves that ultimately boil down to calculations of worth and value.