Jade Ealy frames hope as a moral commitment—not rooted in a feeling, but in how we choose to show up in the world and how we care for one another.

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In January 2025, following his electoral victory, President Trump withdrew the United States from the World Health Organization, created the Department of Government Efficiency, and dismantled Diversity, Equity, and Inclusion initiatives—all within his first month in office. The ripple effects have been devastating: hospitals are cutting staff, universities have imposed hiring freezes, and promising Alzheimer’s and cancer trials have been put on hold. When research dries up, we lose more than data—we betray the ethical duties of care: to heal, to do no harm, to act justly, and to remain faithful to our patients. In doing so, we erode the trust that underpins every clinical encounter. Clinicians, researchers, and public health workers, still reeling from the pandemic’s toll, are left questioning whether their work can ever make a difference. This is moral distress in plain sight—a test of our collective resolve.

On a chilly Tuesday evening in March, my friend and I squeezed into a small church across from Harvard Yard to hear Roxane Gay discuss The Portable Feminist Reader. There, hope revealed itself as more than just a warm feeling. Listening to Dr. Gay unpack feminist theory, American politics, and the power of collective resistance, hope became tangible. Hope was made real by every person leaning in, bearing witness. This was care in action—the very ethics of care we honor in clinical practice, where bearing witness is a moral act.

Photo Credit: Peter Alfred Hess/flickr. Image Description: The First Parish Church in Cambridge, Massachusetts.

That sense of possibility first took root long before that night. When I was 17, a car accident left me with a traumatic brain injury—a single moment that fractured my life. Most of the doctors’ words about “permanent brain damage” have since blurred together, but one moment remains vivid. One night in the hospital, an East Asian physician entered my room. As a fellow East Asian woman, her presence felt like a lifeline. Sensing my restlessness, she took my hands to steady me. Leaning close, she whispered, almost as if sharing a secret, “This heartbreak is not for you.” In that act of pure, intentional care, I felt a flicker of hope. It reminded me that in our darkest moments, the way we care for each other makes all the difference.

Still, whenever I’m tempted toward despair, I find my conviction renewed in community. Hope is often misunderstood as a passive feeling, a quiet wish for a specific outcome. We might hope for a sunny day or a job offer after an interview. In these moments, hope feels like longing—something we quietly wait for life to deliver. But hope, at its core, is a moral commitment to act—a refusal to disengage, even when despair feels justified. It is the ethical insistence that we keep caring, keep working, keep believing that change is possible, even if we never see it ourselves. Hope calls something out of us: not simply to wish, but to respond.

Philosopher Lars Svendsen defines hope with three key elements: real possibility, uncertainty, and care. To hope for something impossible is simply wishful thinking. To hope for something certain is not hope, but knowledge. Hope is rooted in the possibility of an uncertain outcome, and it requires genuine care for what that outcome might be. We do not hope for something we are indifferent about. To hope is to actively pursue what we care about—to take deliberate steps toward making it a reality.

Hope takes many forms. Sometimes, we hope for specific outcomes, like a patient responding well to treatment. This is the hope with a clear goal. But there is also a deeper, more fundamental hope, which is not tied to any particular result. This kind of hope is not about wishing for immediate change; it’s about holding on to the belief that, even when things feel uncertain or bleak, something will arise that is worth hoping for again. It is hope in hope itself.

Like any other virtue, hope must be actively cultivated. We don’t wait to feel it; we practice it. Just as honesty calls us to speak the truth even when it’s uncomfortable, and courage asks us to act in the face of fear, hope urges us to act with intention—especially when optimism is in short supply. It is a discipline, nurtured through our choices. We may not always feel hopeful, but we can commit to acting in ways that sustain it.

In uncertainty, hope can understandably waver. But it’s also the spark that drives us—fueling every policy reform, every restored grant, every small act of compassion. If we ever decide our system is irreparable, we will abandon the work that could fix it.

Hope doesn’t always roar from a podium—sometimes it whispers between us in quiet togetherness, in the steady pulse we share: a colleague covering your shift without complaint, a neighbour dropping off soup unannounced, a friend simply sitting beside you through the silence. In those moments, we feel solidarity’s heartbeat—proof that, even if systems falter, our community endures. Together, hand in hand, we plant hope and discover the strength to rebuild anew. Guided by an ethics of care, clinicians, researchers, and public health workers must recommit ourselves to crafting policies that honour human dignity and equality, restoring the funding streams that sustain progress, sharing our expertise where it’s needed most, and above all tending to one another with unwavering compassion.

That physician steadied my hands when I was most vulnerable; today, we steady one another as proof that hope is both a moral commitment and a living promise. In every quiet act of care, we forge hope into our strongest force, binding us together and driving us forward.

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Jade Ealy is a Program Coordinator in the Recovery Services Bureau at the Boston Public Health Commission and a Teaching Affiliate with the Center for Bioethics at Harvard Medical School.