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      Where There’s Hope, There’s Life 1 : On the Importance of Hope in Health Care

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          Abstract

          It is widely supposed that it is important to ensure that patients undergoing medical procedures hope that their treatments will be successful. But why is hope so important, if indeed it is? After examining the answers currently on offer in the literature, we identify a hitherto unrecognized reason for supposing that it is important that patients possess hope for a successful treatment, which draws on prospect theory, Kahneman and Tversky’s hugely influential descriptive theory about decision-making in situations of risk and uncertainty. We also consider some concerns about patient consent and the potential manipulation of patients that are raised by our account.

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          The framing of decisions and the psychology of choice

          A Tversky, D Kahneman (1981)
          The psychological principles that govern the perception of decision problems and the evaluation of probabilities and outcomes produce predictable shifts of preference when the same problem is framed in different ways. Reversals of preference are demonstrated in choices regarding monetary outcomes, both hypothetical and real, and in questions pertaining to the loss of human lives. The effects of frames on preferences are compared to the effects of perspectives on perceptual appearance. The dependence of preferences on the formulation of decision problems is a significant concern for the theory of rational choice.
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            How unrealistic optimism is maintained in the face of reality

            Ray Dolan, Tali Sharot, Christoph W. Korn … (2011)
            Unrealistic optimism is a pervasive human trait influencing domains ranging from personal relationships to politics and finance. How people maintain unrealistic optimism, despite frequently encountering information that challenges those biased beliefs, is unknown. Here, we provide an explanation. Specifically, we show a striking asymmetry, whereby people updated their beliefs more in response to information that was better than expected compared to information that was worse. This selectivity was mediated by a relative failure to code for errors that should reduce optimism. Distinct regions of the prefrontal cortex tracked estimation errors when those called for positive update, both in highly optimistic and low optimistic individuals. However, highly optimistic individuals exhibited reduced tracking of estimation errors that called for negative update within right inferior prefrontal gyrus. These findings show that optimism is tied to a selective update failure, and diminished neural coding, of undesirable information regarding the future.
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              Dispositional optimism and recovery from coronary artery bypass surgery: the beneficial effects on physical and psychological well-being.

              Benjamin M J Owens, R Lefebvre, R Abbott … (1989)
              The effect of dispositional optimism on recovery from coronary artery bypass surgery was examined in a group of 51 middle-aged men. Patients provided information at three points in time--(a) on the day before surgery, (b) 6-8 days postoperatively, and (c) 6 months postoperatively. Information was obtained relating to the patient's rate of physical recovery, mood, and postsurgical quality of life. Information was also gathered regarding the manner in which the patients attempted to cope with the stress of the surgery and its aftermath. As expected, dispositional optimism proved to be an important predictor of coping efforts and of surgical outcomes. More specifically, dispositional optimism (as assessed prior to surgery) correlated positively with manifestations of problem-focused coping and negatively with the use of denial. Dispositional optimism was also associated with a faster rate of physical recovery during the period of hospitalization and with a faster rate of return to normal life activities subsequent to discharge. Finally, there was a strong positive association between level of optimism and postsurgical quality of life at 6 months.
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                Author and article information

                Contributors
                Steve Clarke
                Justin Oakley
                Journal
                Journal ID (nlm-ta): J Med Philos
                Journal ID (iso-abbrev): J Med Philos
                Journal ID (publisher-id): jmp
                Title: The Journal of Medicine and Philosophy
                Publisher: Oxford University Press (US )
                ISSN (Print): 0360-5310
                ISSN (Electronic): 1744-5019
                Publication date Collection: February 2025
                Publication date (Electronic): 01 November 2024
                Publication date PMC-release: 01 November 2024
                Volume: 50
                Issue: 1
                Pages: 13-24
                Affiliations
                Charles Sturt University , Wagga Wagga, New South Wales, Australia
                Monash University , Melbourne, Victoria, Australia
                Author notes
                Address correspondence to: Steve Clarke, PhD, School of Social Work and Arts, Charles Sturt University, Wagga Wagga, New South Wales, Australia. E-mail: stclarke@ 123456csu.edu.au
                Article
                Publisher ID: jhae037
                DOI: 10.1093/jmp/jhae037
                PMC ID: 11802475
                PubMed ID: 39485997
                SO-VID: 0056f756-e4a5-46de-bf8a-6cde86d26b00
                Copyright © © The Author(s) 2024. Published by Oxford University Press on behalf of the Journal of Medicine and Philosophy Inc.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Page count
                Pages: 12
                Categories
                Subject: Original Research
                Subject: AcademicSubjects/MED00520
                Subject: AcademicSubjects/SCI01050
                Subject: AcademicSubjects/AHU02860

                Keywords: goal,hope,manipulation,patient decision-making,prospect theory
                Data availability:
                Keywords: goal, hope, manipulation, patient decision-making, prospect theory

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