In Defense of “Denial”: Difficulty Knowing When Beliefs Are Unrealistic and Whether Unrealistic Beliefs Are Bad

American Journal of Bioethics 18 (9):4-15 (2018)
  Copy   BIBTEX


Bioethicists often draw sharp distinctions between hope and states like denial, self-deception, and unrealistic optimism. But what, exactly, is the difference between hope and its more suspect cousins? One common way of drawing the distinction focuses on accuracy of belief about the desired outcome: Hope, though perhaps sometimes misplaced, does not involve inaccuracy in the way that these other states do. Because inaccurate beliefs are thought to compromise informed decision making, bioethicists have considered these states to be ones where intervention is needed either to correct the person’s mental state or to persuade the person to behave differently, or even to deny the person certain options. In this article, we argue that it is difficult to determine whether a patient is really in denial, self-deceived, or unrealistically optimistic. Moreover, even when we are confident that beliefs are unrealistic, they are not always as harmful as critics contend. As a result, we need to be more permissive in our approach to patients who we believe are unrealistically optimistic, in denial, or self-deceived—that is, unless patients significantly misunderstand their situation and thus make decisions that are clearly bad for them, we should not intervene by trying to change their mental states or persuade them to behave differently, or by paternalistically denying them certain options.



    Upload a copy of this work     Papers currently archived: 91,386

External links

Setup an account with your affiliations in order to access resources via your University's proxy server

Through your library

Similar books and articles

Unrealistic Fictions.Allan Hazlett & Christy Mag Uidhir - 2011 - American Philosophical Quarterly 48 (1):33--46.
Accommodating unconscious beliefs.Luis M. Augusto - 2010 - Princípios 17 (28):129-154.
False models as explanatory engines.Frank Hindriks - 2008 - Philosophy of the Social Sciences 38 (3):334-360.
Costs and Benefits of Realism and Optimism.Lisa Bortolotti & Magdalena Antrobus - 2015 - Current Opinion in Psychiatry 28 (2):194-198.
Unrealistic assumptions in rational choice theory.Aki Lehtinen & Jaakko Kuorikoski - 2007 - Philosophy of the Social Sciences 37 (2):115-138.
Contemplation on the Nature of Variability of Beliefs and Its Theoretical Foundations.Ruhollah Chavosh - 2014 - Journal of Philosophical Theological Research 15 (59):85-98.
Free Will, Foreknowledge, and Future‐Dependent Beliefs.Raphael van Riel - 2017 - Southern Journal of Philosophy 55 (4):500-520.


Added to PP

49 (#317,389)

6 months
15 (#157,754)

Historical graph of downloads
How can I increase my downloads?

Citations of this work

Self-Deception as a Moral Failure.Jordan MacKenzie - 2022 - The Philosophical Quarterly 72 (2):402-21.
Propositions and Pragmatics.Kevin P. Weinfurt - 2018 - American Journal of Bioethics 18 (9):18-20.
Hope, Denial, and Third-Party Effects.Dale Murray - 2018 - American Journal of Bioethics 18 (9):31-33.

View all 15 citations / Add more citations

References found in this work

Alief and Belief.Tamar Szabó Gendler - 2008 - Journal of Philosophy 105 (10):634-663.
On Bullshit.Harry G. Frankfurt - 1986 - Princeton, NJ: Princeton University Press.
Self-Deception Unmasked.Alfred R. Mele - 2001 - Princeton University Press.
On bullshit.Harry G. Frankfurt - 1986 - Princeton, NJ: Princeton University Press.
Radical hope: ethics in the face of cultural devastation.Jonathan Lear - 2006 - Cambridge, Mass.: Harvard University Press.

View all 26 references / Add more references