It is often said that it is important for patients to possess hope that their treatment be successful. We agree, but many hopes are based on faith and if faith-based hope informs patient decisions to undergo medical procedures then important questions are raised about patient autonomy. Libertarians will want to permit patients to make decisions to undergo medical procedures on the basis of any considerations, including faith-based hopes, on the grounds that we should respect freedom of choice. And rational interventionists will want to restrict such choices on the grounds that they cannot be rational choices, and do not, therefore, express autonomy. We navigate a middle path between these two extremes and argue that patient decision making on the basis of faith-based hope should be regarded as acceptable in healthcare when it conforms to the norms of practical rationality. These are norms which, we argue, allow patients considerable room to make decisions to consent to undergo medical procedures informed by faith-based hope. We apply our approach to four cases of patient healthcare decisions informed by faith-based hope.