Hope and the Act of Informed Dialogue: A Delicate Balance at End of Life

As a scholar who has focused on health communication, including end-of-life issues, for over 25 years, I found myself confronted by serious ethical dilemmas when I spent time with my sister-in-law and family as she was dying from ovarian cancer. The guidelines provided to me in the past research with which I was familiar, as well as my personal experiences regarding end-of-life discussion with family and friends, did not prepare me well to handle the dialectical tensions between maintaining hope and open discussion of end of life in this situation. In this article, I focus on an examination of the research on hope at end of life and try to reconcile it with the concomitant need for acknowledgment of impending terminality and the communication that should accompany this.