Hope, positive illusions and palliative rehabilitation

Abstract

In ordinary usage, the word ‘hope’ is clear and unambiguous. But in the palliative care context it has been amplified, dramatized, glamorized, and spiritualized to the extent that it is no more than a piece of inflated rhetoric. In this paper, I will offer a simple analysis of a simple word; explain why the inflated sense is unhelpful; show why hope does not have a straightforward ‘opposite’; and argue that ‘hope’ is not a name for a metaphysical, psychological, or spiritual something-or-other. However, bewitched by their inflated understanding of ‘hope’, some palliative care professionals apparently tell patients and carers what they should hope for – which could hardly be more patronizing – while others use it as a portmanteau term to describe whatever positive health care outcomes take their fancy. My suggestion is that palliative rehabilitation specialists should resist the temptations of inflation and glamorisation, and begin to use the word more precisely, modestly, and transparently. There is no such thing as ‘hope’ the life force, ‘hope’ the inner power, ‘hope’ the universal human phenomenon, or ‘hope’ the theological virtue.