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J Pain Symptom Manage. 2018 Feb;55(2):535-539. doi: 10.1016/j.jpainsymman.2017.10.002. Epub 2017 Oct 10.

Addressing a Patient's Hope for a Miracle.

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Vanderbilt University Medical Center Section of Palliative Care, Nashville, Tennessee, USA. Electronic address:
Michigan State University Center for Ethics and Humanities in the Life Sciences, East Lansing, Michigan, USA.
Baylor College of Medicine, Houston, Texas, USA.


Ill patients may make decisions to continue aggressive life-prolonging care based on hope for a miraculous recovery, and clinicians can find goals of care discussions with these patients extremely challenging. Thus, palliative care providers may be asked to help in these discussions. The concept of "miracle" can express a multitude of hopes, fears, and religious commitments. Effective, sensitive engagement requires the palliative care provider to attend to these variegated hopes, fears, and commitments. This case presents a typology of ways patients express hope for a miracle along with analysis of the motivations and beliefs underlying such hopes and suggestions for tailored responses by palliative care providers.


end of life; miracle; palliative care; religion; spirituality; terminal care

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