The role of design and materials in the enactment and experience of healthcare has gained increasing attention across the fields of evidence-based design, architecture, anthropology, sociology and cultural geography. Evidence-based design, specifically, seeks to understand the ways in which the built environment can support the healing process. In the context of palliative care, however, the very measure of healing differs vastly. Physicians Mount and Kearney suggest that ‘it is possible to die healed’, and that such healing can be facilitated through the provision of ‘a secure environment grounded in a sense of connectedness’ (2003: 657). Acknowledging this critical difference raises important questions around the various ways through which the built environment might support healing, but also about the potential of architecture to impart care. This paper reports on 15 interviews with architects, experienced in the design of palliative care settings, from the UK, USA and Australia, to provide a deeper understanding of the questions being asked within the briefing processes for these facilities, the intentions embedded in the ways that architects respond, and the kinds of compromises deemed allowable (by various stakeholders) within the procurement process. Our findings suggest that palliative care architects often respond to two briefs, one explicit and the other unspoken. Design responses in relation to the first include: formally expressing a differentiation in the philosophy of care (signalling difference), attention to quality, extending comfort and providing ‘moments’. The second relates to the unburdening of palliative care facilities from their associative baggage and responding to the tension between the physical and imaginative inhabitation of space. In revealing the presence of this hidden brief, and the relationship between the two, this paper invites a broader discussion regarding the capacity of architecture to support palliative care patients, their families and staff.
- palliative care
- cancer care
- medical humanities
Data availability statement
Owing to ethical constraints we are unable to make this data set available. N/A.
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Contributors RM was responsible for the conception, design and implementation of this research. RM and BG completed the data analysis and drafting of the paper. Both authors have reviewed and approved the final version for publication. RM and BG are both guarantors for the work.
Funding This research was funded under an Australian Research Council Australian Discovery Early Career Award (DE190100730) funded by the Australian Government.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; externally peer reviewed.