ABSTRACT
This chapter focuses on the ways a diagnosis of a significantly life-limiting condition creates a need for meaning in the face of almost certain disappointment and sorrow. It aims to show that perinatal palliative and hospice care can scaffold a family’s well-tuned capacity for hope in circumstances that threaten their sense of meaning or value. Section II describes a tension in medical practice that emerges from a patient’s need for hope. Inadequate attempts to address this tension can create an institutional ethos that diminishes a family’s capacity for well-tuned, or virtuous, hope. Section III develops an account of the virtue of hope, contrasting it with related anticipatory emotional expressions and some opposing vices including presumption and despair. It also offers a novel profile of allocentric hope—an exercise of the virtue of hope on behalf of a person who is danger of losing all hope. Section IV shows how healthcare providers and institutions can subtend the well-tuned hopes of families following an adverse diagnosis through a commitment to a common project of care. Section V describes some reforms to contemporary practices and social structures that might foster a more hopeful institutional culture for families in need.
