This article deals with the phenomenon of hope in seriously ill and dying patients. Uncertainty is seen as a prerequisite for hope, fear as the "negative" side of hope. A scheme involving three particular kinds of hope is introduced: Hope on a daily basis; hope concerning a possible eternity; and hope based upon unrealistic premises. In a clinical setting, the question is: Taking into consideration the issues of how to inform and communicate with patients, how may the physician help the patient to express hope, and how may the physician contribute to reinforcing the patient's hope? Within palliative medicine, treatment may involve many aspects of a patient's life. It should be directed against the physical aspects of the disease, as well as the psychological, social, spiritual and existential dimensions of life. There are two fundamental questions patients with terminal cancer disease almost always ask: "Will the disease eventually cause my death?"; and, "Am I going to experience great pain and suffering?" These questions are clearly marked by hope. The hope that there will be little pain, for example, may not only relate to physical pain but to psychological and social pain as well.