Unpacking ethical aspects in serious illness conversations.

Serious illness conversations help patients who are at a high risk of mortality to discuss future care. The present empirical ethical study aims to explore health care professionals' views on the ethical dimension of serious illness conversations. The first theme identified was providing and sharing prognoses in serious illness conversations, which was analyzed with the concepts of chronos, kairos and the hermeneutics of time. We discuss the ethical tensions that emerge when prognosis is reduced to a measurement of time, as this risks diminishing hope. An alternative approach-informed by kairos-can support meaning-making and the broader exploration of hope. Furthermore, we present an analysis of the theme autonomy and its relational aspects in serious illness conversations and claim that an individualistic conception fails to convey the significance of relationships in the exercise of autonomy, as patients' goals and decisions are shaped within their relational context.