A few years ago, it was common for philosophers to begin inquiry into hope by noting that the subject has received little attention in the philosophical literature. But our ability to make this claim is quickly coming to an end; hope has been earning increasing recognition in the discipline, with philosophers exploring important questions related to the nature of hope, what makes hope rational, and how hope is connected to human wellbeing and agency. Despite this recent interest, however, there remains (...) very little discussion of the social and political dimensions of hope. My aim in this paper is to demonstrate the importance of a feminist perspective in bringing these dimensions into fuller view. I argue that feminist insights into the relational nature of the self, which call attention to where selves are socially situated in relation to others, enable a richer understanding of the nature and value of hope. (shrink)

Hope is often seen as at once valuable and dangerous: it can fuel our motivation in the face of challenges, but can also distract us from reality and lead us to irrationality. How can we learn to “hope well,” and what does “hoping well” involve? Contemporary philosophers disagree on such normative questions about hope and also on how to define hope as a mental state. This article explores recent philosophical debates surrounding the concept of hope and the norms governing hope. (...) It also underlies hope's significance for the philosophy of emotion and the ethics of interpersonal relations. (shrink)

Low opportunity cost, weak influence of quality of life in the face of death, the social value of life extension to others, shifting psychological reference points, and hope have been proposed as factors to explain why people apparently perceive marginal life extension at the end of life to have disproportionately greater value than its length. Such value may help to explain why medical spending to extend life at the end of life is as high as it is, and the various (...) factors behind this value might provide normative rationale for that spending. Upon critical analysis, however, most of these factors turn out to be questionable or incompletely conceived; this includes hope, which is examined here in special detail. These factors help to explain complexity and nuance in the normative issues, but they do not provide adequate justification for spending as high as it often is. In any case, two additional factors must be added to the descriptive explanation of high spending, and they throw its normative justification into further doubt: the “insurance effect” and provider-created demand. Overall, the perception of especially high value of life at the end of life provides some normative justification for high spending, but seldom strong justification, and not for spending as high as it often is. (shrink)

“The thing about life is that one day you’ll be dead.” Indeed. But even total and honest acceptance of this brute fact about our relationship to death does not diminish the value we see in short remaining life at the end of life. Few just “give in” and no more fight for life because death is seen as an inherent part of life. They still invest small amounts of additional life with huge value. How high may that value plausibly be? (...) What is the value of a relatively short extension of life when death is inevitably near? (shrink)

Ethical concerns about therapeutic misconception have been raised since the early 1980s. This concept was originally described as research participants' assumptions that decisions relating to research interventions are made on the basis of their individual therapeutic needs. The term has since been used to refer to a range of ‘misunderstandings’ that research participants may have. In this paper, we describe a new concept—therapeutic appropriation. Therapeutic appropriation occurs when patients, or clinicians, actively reframe research participation as an opportunity to enhance patients' (...) clinical care, while simultaneously acknowledging the generalised research aims. To illustrate the concept of therapeutic appropriation, we draw on data from an interview study which we conducted to investigate the experiences of patients and general practitioners involved in clinical trials in primary care. We argue that therapeutic appropriation has two key elements: comprehension that the research project is not necessarily aiming to benefit participants and the deliberate use of incidental features of the research for personal therapeutic benefit of various kinds. We conclude that therapeutic appropriation is a useful concept that refines understanding of potential ethical problems in clinical research, and points to strategies to address them. (shrink)

Researchers and ethicists have long been concerned about the expectations for direct medical benefit expressed by participants in early phase clinical trials. Early work on the issue considered the possibility that participants misunderstand the purpose of clinical research or that they are misinformed about the prospects for medical benefit from these trials. Recently, however, attention has turned to the possibility that research participants are simply expressing optimism or hope about their participation in these trials. The ethical significance of this therapeutic (...) optimism remains unclear. This paper argues that there are two distinct phenomena that can be associated with the term ‘therapeutic optimism’—one is ethically benign and the other is potentially worrisome. Distinguishing these two phenomena is crucial for understanding the nature and ethical significance of therapeutic optimism. The failure to draw a distinction between these phenomena also helps to explain why different writers on the topic often speak past one another. (shrink)

This article discussed Jeremy Snyder’s book “Exploiting Hope. How the Promise of New Medical Interventions Sustains Us—and Makes Us Vulnerable”, 2021, Oxford University Press.

Sustaining hope in patients is an important element of health care, allowing improvement in patient welfare and quality of life. However in the palliative care context, with patients who are terminally ill, it might seem that in order to maintain hope the palliative care practitioner would sometimes have to deceive the patient about the full nature or prospects of their condition by providing a ‘false hope’. This possibility creates an ethical tension in palliative practice, where the beneficent desire to improve (...) patient welfare through sustaining hope appears to be in conflict with an autonomy-based requirement not to deceive patients about their condition. In order to resolve this ethical tension, we provide an analysis of the concept of hope and argue that there is at least one conception – the ‘absolute’ conception of hope – which when properly understood allows practitioners to foster hope in terminally-ill patients while avoiding any need to deceive them about their condition. Practitioners therefore do not need to shy away from using the language of hope in the palliative setting, as on this understanding of hope it can be used in a way that both promotes patient welfare and respects patient autonomy. (shrink)

This article motivates a shift in certain strands of the debate over legitimate roles for nonepistemic values in scientific practice from investigating what is involved in taking cognitive attitudes like acceptance toward an empirical hypothesis to looking at a social understanding of assertion, the act of communicating that hypothesis. I argue that speech act theory’s account of assertion as a type of doing makes salient legitimate roles nonepistemic values can play in scientific practice. The article also shows how speech act (...) theory might provide a framework for fruitfully extending aspects of the social and pragmatic turns in the philosophy of science. (shrink)

Hope is crucial human agency, but its fragility grounds a substantive challenge to Christian belief. It is not clear how a perfectly loving God could permit despairinducing experiences of divine silence. Drawing upon a distinctively Christian psychology of hope, this paper seeks to address this challenge. I contend that divine silence can act as a corrective to misplaced natural hopes. But there are risks in God’s choice to allow a person to lose all natural hope. Thus, if God is perfectly (...) loving, God ought to find a way to demonstrate goodness to those who are tempted by theological despair. I argue that the Church demonstrates God’s goodness through its merciful care and hope for the afflicted. The local community can act to sustain or recover a person’s capacity to remain open to the gift of hope even in the midst of divine silence. (shrink)

Analyses of the theological virtue of hope tend to focus on its interior dispositional structure, shifting attention away from the social dimensions crucial to its formation and exercise. We argue that one can better appreciate the place of hope in Christian thought by attending to communal features that have been peripheral to or excluded from traditional analyses. To this end, we employ resources from the literature on the extended mind and group agency to develop an account of the theological virtue (...) of hope as a socially extended virtue—that is, a virtue scaffolded by and enacted within a community whose practices are ordered toward a shared conception of human flourishing. (shrink)

Hope is a ubiquitous feature of human experience, but there has been relatively little scholarship within contemporary analytic philosophy devoted to the systematic analysis of its nature and value. In the last decade, however, there has been a resurgence of interest in the study of hope and, in particular, its role in human agency. This scholarly attention reflects an ambivalence about hope's effects. While the possession of hope can have salutary consequences, it can also make the agent vulnerable to certain (...) kinds of personal risk. The pervasiveness of hope is not a sign of its quality; only a well‐tuned hope can be a virtue. Recently, Nancy Snow has argued that hope can be an intellectual virtue. Framing her account as a contribution to regulative epistemology, she contends that the intellectual virtue of hope can (i) motivate the pursuit of important epistemic ends, (ii) create dispositions that enable the successful pursuit of these aims, and (iii) generate a method for enduring intellectual projects. In this paper, I provide a critical appraisal of Snow's account of hope as an intellectual virtue. One important implication of this critique is that hope can function as an intellectual virtue only to the extent that it has benefitted from the correcting and perfecting influence of other cognitive excellences. (shrink)