ABSTRACT
In the normative arena of policy documents, media narratives and wider public discourse, ‘accountability’ – like ‘rights’ – has become a quintessential idiom through which democracy is envisaged. Practical experiences of accountability take many different forms, both formal and informal. Nurses and doctors manage and move between different modes of accountability. The patrimonial-style authority of doctors that was so characteristic of the colonial period remains significant, and can either operate alongside or in tension with bureaucratic modes of accountability. In a context in which accountability has become a key trope of institutional bureaucracy, nurses attempted to conform to the normative moral yardstick imposed by ideas of accountability, while also expressing a sense of moral uncertainty and discomfort with these. In the United Kingdom, Joanna Latimer argues that the tension between institutional management and patient care represents ‘two competing moral discourses: a utilitarian discourse, which demands that more people are treated, and a professional discourse of care for the individual’.
