# Misaligned hope and conviction in health care

## TL;DR

The paper explores how hope based on personal or religious beliefs affects medical decision-making and patient autonomy.

## Contribution

It proposes a middle ground between libertarian and rational interventionist views on conviction-based hope in healthcare decisions.

## Key findings

- Conviction-based hope can influence medical decisions and raise questions about patient autonomy.
- A middle path is suggested, allowing such hope to inform decisions if aligned with practical rationality norms.
- This approach respects autonomy while avoiding irrational decision-making.

## Abstract

It is often said that it is important for patients to possess hope that their treatment will be successful. We agree, but a widely appealed to type of hope—hope based on conviction (religious or otherwise), renders this assertion problematic. If conviction‐based hope influences patient decisions to undergo medical procedures, then questions are raised about the scope of patient autonomy. Libertarians permit patients to make decisions to undergo medical procedures on the basis of any considerations, including conviction‐based hopes, on grounds of respect for freedom of choice. Rational interventionists want to restrict choices made on the basis of conviction‐based hope on the grounds that choices based on hope incorporate irrationality of a sort incompatible with autonomous decision‐making. In this article, we navigate a middle path between these extremes, arguing that patient decision‐making based on conviction‐based hope ought to be acceptable and permitted in health care when it conforms to norms of practical rationality. These norms allow patients some room to make decisions to consent to undergo medical procedures informed by conviction‐based hope.