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October 24, 1990

Hope Hype Hit-Reply

Author Affiliations

Los Altos, Calif

Los Altos, Calif

JAMA. 1990;264(16):2076. doi:10.1001/jama.1990.03450160043023

In Reply.—  The first recorded medical reference is in the biblical Proverbs: "Hope deferred maketh the heart sick." And: "A merry heart doeth good like medicine." Hope's use as a panacea was documented by Cicero: "While the sick man has life there is hope,"1 and again by Shakespeare: "The miserable have no other medicine/But only hope."2The most current scientific literature on hope is found in studies of the placebo effect, where there is a consistent 30% to 40% response to placebo treatments regardless of the disease or nature of treatment.3 The intentional use of placebo, however, raises questions on the ethics of false hope. As befitting a folk remedy, the most exhaustive study of the uses of hope is in the popular press.4The very nature of chronic disease requires multimodality therapy that is tailored to the individual patient. Hope should not be used