Hope Work in the Care of Seriously Ill Patients

The interactional practices through which staff members and patients shape their medical identities as the patient approaches death in hospital are examined in this article. A recurrent conversational "Activity, whereby the medical identities of the patient and the staff are explicated in terms of the hopefulness of the situation, is identified and defined as "hope work." Hope work has three variants: in curative hope work, the patient is defined as "getting better"; in palliative hope work, he or she is defined as "feeling better"; and in the work to dismantle hope, the patient is defined as being "past recovery. " Conflicts arise when different parties employ different types of hope work. All variants of hope work are linked to the maintenance of the legitimacy of medicine in relation to the death of the patients.