Care-full negotiation of hospital discharge and end-of-life care in an Indonesian palliative care unit.

How do palliative care professionals negotiate end-of-life care with family members when prognosis and dying are not openly discussed? Based on ethnographic fieldwork in an Indonesian palliative care unit, I argue that palliative care professionals employ implicit, ambiguous and culturally sensitive communication to carefully negotiate hospital discharge and discuss end-of-life care. I focus on listening to what is said and what remains unspoken in the embodied communicative practices about end-of-life care in family meetings to discuss hospital discharge. I show how palliative care professionals carefully navigate tensions between the hospital's need to discharge patients, family expectations of a cure, and the palliative care value of supporting patients and families. They do so by keeping the possibility of receiving treatment open while simultaneously using implicit language to suggest that end of life may be near.