When a serious illness forces you to rethink your daily life, medical decisions, and your relationships with those close to you, hope is no longer a distant concept. It can be found in a conversation you’ve been putting off, in choosing how you want to be cared for, or in maintaining a small measure of autonomy.
An international study published in Frontiers in Psychology proposes incorporating it into palliative care as a realistic approach that helps maintain meaning, decision-making, and dignity.
In palliative care, talking about hope requires great sensitivity. It can bring comfort to someone dealing with an advanced illness, but it can also be mistaken for denying the prognosis or fueling unrealistic expectations. The authors’ proposal is based on a central idea: hope that helps does not promise a cure; rather, it supports the person when care is focused on their well-being, their relationships, and their decisions.
The research brings together the European University of Rome, the Sant’Anna School of Advanced Studies in Pisa, and the Francisco de Vitoria University. Through this international collaboration, the study connects positive psychology, virtue ethics, and palliative care to examine hope as a concrete form of human support.
A Down-to-Earth Hope
For someone with an advanced illness, waiting doesn’t always mean hoping for a cure. Sometimes it means being able to talk to someone, deciding where they want to be, saying goodbye peacefully, maintaining a routine, or living a day with less fear. Hope becomes part of everyday life, linked to small goals that can continue to give meaning.
“In the face of a serious illness, hope does not mean turning a blind eye to reality. It means finding achievable goals within that reality,” says Elena Ricci, a researcher at the European University of Rome and the Sant’Anna School of Advanced Studies. From this perspective, hope does not eliminate the difficulty, but it helps us prioritize what still matters.
The authors warn that hope disconnected from the truth can be harmful. It can hinder appropriate clinical decisions, lead to frustration, and undermine trust between the patient, family, and healthcare team. That is why hope also requires realism. Providing good support means offering emotional support without withholding information that the person needs.
Support Without Imposing
Palliative care addresses physical pain, but also fear, dependence, loneliness, and questions about the meaning of life. In this context, hope can function as a moral virtue: a disposition that helps organize desires, emotions, and decisions in the face of uncertainty.
For Verónica Fernández-Espinosa, director of the UFV Center for Education in Virtues and Values and corresponding author of the article, this proposal is directly linked to virtue education. “Hope means accompanying others with truth, prudence, and presence,” she says.
This approach views palliative care as a sustained presence. Accompanying a patient does not mean making decisions for them or pressuring them to feel a certain way. It means helping them recognize which goals still hold meaning for them.
In some cases, these will be medical goals. In others, they will be family-related, spiritual, or personal. To accompany someone is to help them recognize what is valuable, without imposing from the outside what that person should expect.
Hope as a Virtue That Can Be Cultivated
The proposal is based on the model developed by psychologist Charles Snyder, one of the leading figures in the study of hope. His theory views hope as a combination of two elements: the motivation to pursue goals and the ability to find ways to achieve them. Simply put, having hope means wanting to move forward and knowing how to do so.
When applied to a serious illness, this model shifts the focus of the question. Instead of looking solely at what the patient hopes for in terms of a cure, the medical team can explore what the patient still wants to cherish: a relationship, a conversation, a farewell, a decision, or a way to be with loved ones.
Claudia Navarini, a researcher at the European University of Rome, brings the ethical dimension of this interpretation to the article. “Hope sustains dignity when autonomy becomes more fragile,” she notes. For the authors, this virtue helps preserve the ability to tell one’s own life story and to act meaningfully even in moments of great vulnerability.
Professionals Trained to Provide Better Care
The most practical aspect of the research is aimed at healthcare professionals. The authors suggest that hope can be integrated into routine care: consultations, family meetings, care plans, and coordination among doctors, nurses, psychologists, social workers, and spiritual care professionals.
For Fernández-Espinosa, the key lies in training professionals who are capable of identifying realistic goals, mapping out feasible paths with the patient, and having difficult conversations without dampening the patient’s sense of hope for the future. **“Nurturing hope **does not mean saying that everything will be fine, but rather learning to provide support in a way that helps the patient recognize real possibilities for meaning, support, and a future,” says the UFV researcher.
Hope Can Also Be Taught
The article on hope as moral support notes that this is a theoretical proposal, not a clinical trial involving patients. For this reason, the authors call for evaluating adaptations of hope therapy in more diverse palliative care populations, comparing brief and structured formats, and measuring its impact on well-being, communication, decision-making, caregiver resilience, and team functioning.
The experts present hope as part of a culture of care. In practice, this involves providing better training to caregivers and offering tools to support patients without false expectations—with honesty, meaning, and respect for their dignity.
When medicine can no longer promise a cure, “we can still care for how a person lives out the time they have left.” This approach views hope without naivety and without clichés: as a concrete way to accompany human frailty until the very end.
