When, in a given patient, there has been established a firm diagnosis of a relatively chronic condition that may be expected to terminate fatally because curative treatment is either not known or not applicable, the case may properly be considered "hopeless." Under these circumstances medicomoral problems are almost inevitable; they are accentuated when the pathogenesis is obscure, when remission is rare, and when the general health of the patient is apparently good. Almost by common acceptance the prototype "hopeless case" is the patient with incurable malignancy. Unfortunately there are many other diseases, such as central nervous system neuropathies, that may readily be included in this baleful category. It is evident, but nevertheless of considerable significance, that the term "hopeless" in this context is relative—its limits are defined by the current state of medical knowledge. Scientific progress has narrowed these boundaries in some areas and expanded them in others. Pernicious
Thank you for submitting a comment on this article. It will be reviewed by JAMA Internal Medicine editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest*
Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 4
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.