Is hope an emotion or a virtue? Is a patient's hope measurable? Philosophers and healthcare researcher have differed in their approaches and answers to such questions, but some areas of greater clarity and convergence seem to be emerging. The dynamics of hope, despair, and hopelessness have been more clearly delineated. Hope is neither simply an emotion nor a propositional attitude. It may be understood by patients either as determined by the doctor or in the power of the patient. The clinical and therapeutic relevance of hope and despair depend less on measuring hope in patients than on listening to the individual patient.