DYING OF AWARENESS - THE THEORY OF AWARENESS CONTEXTS REVISITED

In this paper, I employ a grounded theory approach to extend an existing theory. My starting point is the theory of awareness contexts, first formulated in 1965 by Strauss and Glaser. Using introspective ethnography, I illustrate that the way patients and relatives emotionally cope with terminal information defines the kind of awareness context. I therefore suggest that the open awareness context should be split into three different contexts. In the suspended open awareness context, the patient or kin ignores or disbelieves the message communicated by the physician. In the uncertain open awareness context, the patient or family member dismisses the bad parts of the message and hopes for the best outcome. In the active open awareness context, the patient or relative accepts the impending death and prepares for it. This revision reclaims the emotional power of terminal illness from the viewpoint of patients and relatives and adapts the theory to changed structural conditions.