In this paper, the author employs a grounded theory approach to extend an existing
theory. His starting point is the theory of awareness contexts, first formulated
in 1965 by Strauss and Glaser. Using introspective ethnography, he illustrates that
the way patients and relatives emotionally cope with terminal information defines
the kind of awareness context. He therefore suggests 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.