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The increasing numbers of people at very old ages pose specific policy challenges for health and social care and highlight the need to rethink established models of service provision. The main objective of this paper is to introduce the concept of "avoidable displacement from home" (ADH). The study argues that ADH builds on and adds value to existing concepts, offering a holistic, person-centered framework for integrated health and social care provision for older people. It also demonstrates that this framework can be applied across different levels, ranging from macro policymaking to organizational and individual decision-making. The paper pays attention to the Brazilian context but argues that ADH is a universally applicable concept.

The objective of this study was to understand how physicians at the largest emergency department in a large Brazilian city orient care for critical patients with suspected brain death and who are potential organ donors. This ethnographic study was conducted in an emergency care hospital, a reference in traumatology in Latin America, located in downtown Belo Horizonte, Minas Gerais State. The institution took pioneering steps in Brazil with a specific sector where patients with suspected brain death are referred. The fieldwork was performed over the course of nine months, based on targeted observations and interviews with 43 on-duty staff physicians (25 men and 18 women), from 28 and 69 years of age. Data analysis followed the "signs, meanings, and actions" model. The ethnography revealed the process of medical care for patients with suspected brain death, including: intensive care, adherence to protocol, and communicating the patient's status to the family. In the latter case, the dialogue reveals the controversies in the concept of brain death, the sociocultural context, and the emergency care context. It became clear that this process of medical care extrapolates merely normative issues, entering into a complex web of elements, especially the professional's role as mediator of a myriad of interwoven elements and tensions. Between confirmation of the brain death and communicating the situation to the family, ambivalent perceptions emerge, both for the physicians and the family members. The study evidenced how the tenuous definition of what constitutes life and death touches on all of the medical act, with direct implications on care for patients/potential donors and their families.

: Ethnography is the principal research method in Anthropology. With a broad scope, it allows using different data collection techniques and incorporates elements observed and obtained in the field into the analysis. In Public Health, it can contribute to understanding the health/disease process and health professionals' and patients' values and attitudes in different healthcare settings. The aim of this article is to present and discuss the ethnographic method based on an empirical study of physicians' hospital work in the face of the limits between life and death. Data collection involved nine months of participant observation and interviews with 43 physicians (25 men and 18 women), 28 to 69 years of age, treating critical patients in different departments of a metropolitan emergency hospital. The various social and cultural aspects experienced by the researcher and obtained from the interlocutors in the field provide a dense description of this hospital ethnography.