Study title

Interview data involving a set of anonymised transcriptions of face to face interviews by one ethnographer with palliative care staff about practices in palliative care (n=17), focussing on when and how decisions are made about not intervening. In these interviews, doctors and nurses discuss complex case decision making, multi-disciplinary teams, roles in palliative care, communication with patients, advance care planning, prioritising and managing dying processes, and differences between community and hospital care. An anonymised transcript of an online workshop with palliative care staff discussing changes to practice during the Covid-19 pandemic in 2020 with multiple ethnographers. A set of anonymised interview transcripts (n=10) with healthcare professionals conducted by a different ethnographer investigating the use of prescription in palliative care, discussing how complex decisions about medication are made and communicated with patients at the end of their lives.This project set out to conduct rich ethnographic fieldwork, and a follow-up period of stakeholder reflections, within a palliative care team based within a large NHS hospital and its surrounding neighbourhood. There is currently a great deal of interest in how the NHS as a whole is having to make treatment decisions at both the policy and individual level by taking into account diverse criteria and values. As part of this, a lot of debate has focused on so-called 'over-treatment' and high-profile cases of medical neglect. However, in practice, and between these two extremes, medical care regularly involves more modest practices of simply not intervening or of withdrawing treatment. For example, these 'non-interventions', as we currently call them, might include reducing or removing medications or other therapies (including fluid provision), withholding treatments before they have started, or simply waiting to observe how a patient's condition develops. The study consequently explored the many...