Not intervening as a form of care: Negotiating medical practices at the end-of-life

Abstract

Biomedicine is organized around interventions. Despite growing concern about overtreatment in healthcare systems, not intervening can still raise questions about potential negligence and the quality of care. Based on ethnographic fieldwork with palliative care teams in England, we explore the work palliative care specialists do to reduce and sometimes halt interventions for patients at the end-of-life, in a general medical environment that is largely interventionist. We describe how judgments about what is an action or not aren't based on obvious or agreed criteria, but ultimately according to what different actors feel constitutes the best form of care. In other words, the underlying values that shape ideas of care determine how action and inaction are nominated, and not the other way around.