Emma Kirby

Families play important roles in transitions to end-of-life care, yet we know little about the social relations between doctors and families at the point of referral to specialist palliative care. In this study, we explore how medical specialists negotiated the transition to specialist palliative care with families. Drawing on data from 20 qualitative interviews, we examine data accounts about the roles of family members in discussions with clinical specialists about palliative care, and how families shape interpersonal dynamics. Our results indicate that families fulfil important ‘functions’ and ‘roles’in these delicate and emotionally laden conversations. Specialists’ accounts articulated referral processes as distinctly relational moments, with families viewed as potential ‘resources’ but also as ‘complications’, in attempts to encourage the ‘smooth’transition to end-of-life care. On the basis of these results, we argue that further attention should be paid to the centrality of families in key moments in care and how they may be utilised, managed and experienced by a range of health professionals.