ABSTRACT
This chapter explores how accountability can be achieved both in circumstances where a coherent narrative may be drawn and where, despite concerted efforts at alignment, the disunity of the patient's body persists. It discusses the role of routines and norms of a clinical setting, and how these come to signify accountable practice. The chapter also explores how incoherences are addressed in situations where an organizing script a routine is missing, so that a course of action must be pieced together and clinicians must work overtly to make each step, action or intervention accountable. It highlights the tensions between understanding practice as something fluid, unstable and multiple and the expectations of certainty inherent in healthcare practices and the need to act sometimes in the absence of such certainty. Certainty in knowing and doing is highly valued in healthcare settings.
