caa a22 4500 445798262 CHVBK 20180317145132.0 cr unu---uuuuu 170323e20110601xx s 000 0 eng 10.1007/s11017-011-9172-2 doi (NATIONALLICENCE)springer-10.1007/s11017-011-9172-2 Coulehan Jack Center for Medical Humanities, Compassionate Care, and Bioethics, Stony Brook University, 11794-8335, Stony Brook, NY, USA aut Deep hope: A song without words [Elektronische Daten] [Jack Coulehan] Hope helps alleviate suffering. In the case of terminal illness, recent experience in palliative medicine has taught physicians that hope is durable and often thrives even in the face of imminent death. In this article, I examine the perspectives of philosophers, theologians, psychologists, clinicians, neuroscientists, and poets, and provide a series of observations, connections, and gestures about hope, particularly about what I call "deep hope.” I end with some proposals about how such hope can be sustained and enhanced at the end of life. Studies of terminally ill patients have revealed clusters of personal and situational factors associated with enhancement or suppression of hope at the end of life. Interpersonal connectedness, attainable goals, spiritual beliefs and practices, personal attributes of determination, courage, and serenity, lightheartedness, uplifting memories, and affirmation of personal worth enhance hope, while uncontrollable pain and discomfort, abandonment and isolation, and devaluation of personhood suppress hope. I suggest that most of these factors can be modulated by good medical care, utilizing basic interpersonal techniques that demonstrate kindness, humanity, and respect. Springer Science+Business Media B.V., 2011 Hope nationallicence Palliative care nationallicence End-of-life care nationallicence Physician-patient relationship nationallicence Theoretical Medicine and Bioethics Springer Netherlands 32/3(2011-06-01), 143-160 1386-7415 32:3<143 2011 32 11017 https://doi.org/10.1007/s11017-011-9172-2 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s11017-011-9172-2 text/html Onlinezugriff via DOI NATIONALLICENCE 100 1- Coulehan Jack Center for Medical Humanities, Compassionate Care, and Bioethics, Stony Brook University, 11794-8335, Stony Brook, NY, USA aut NATIONALLICENCE 773 0- Theoretical Medicine and Bioethics Springer Netherlands 32/3(2011-06-01), 143-160 1386-7415 32:3<143 2011 32 11017 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer