Performance measurement: the new accountability

Over the years, "accountability" in the human services has focused upon issues such as the legal framework, organizational management, financial responsibility, political concerns, and client inputs and expectations. Within the past decade, the meaning of "accountability" has been extended to the more dynamic organizational functions of "efficiency" and " effectiveness." Efficiency and effectiveness increasingly must be put to the tests of performance measurement and outcome evaluation. Forces outside the social work profession, including, among others, federal expectations and initiatives and the increased implementation of the concept of managed care, will ensure that efficiency and effectiveness will be central and highlighted concerns far into the future. This "new accountability" is demanded by the stakeholders in the nonprofit sector and by federal requirements built into the planning, funding, and implementation processes for nonprofits and for-profits alike.     

The microphysics of accountability

How is it possible to deploy the law to create and perform accountability? To answer this question, I address the argumentative function of the law in order to legitimize genetic medicine. Using interview data, I will in particular elaborate on how medical experts strive to convince interviewing social scientists that their own professional action is above all ethical reproach. For this purpose, medical experts capitalize on the law in specific ways. It is the aim of this article to expound exactly how this happens during qualitative research interviews. The analysis of the interview data is informed by the works of Sheila Jasanoff and Michel Foucault. The former provides an instructive conceptual background for demonstrating how the law serves as an important element of accountability practices. The latter is known for his plea not to understand the law in repressive terms. Accordingly, the law does not prohibit specific medical practices, but in a specific sense it rather makes medical practice socially robust. Based on qualitative analysis of interview data, I conclude that referring to the law allows experts of genetic medicine to evade engaging with ethical and social aspects of their work. The law was rhetorically utilized to bring a discussion on such issues to a communicative closure. For that purpose, the existence of the law was presented as proof that undesirable practices would not be possible and consequently further discussions of the matter would be unnecessary. The law allows medical experts to transfer ethical problems to other places and actors and also to promote their professional interests.     

Dissemination to research subjects: operationalizing investigator accountability

Recent articles have argued from principles of bioethics for the right of research subjects to receive the results of the studies in which they have participated. We argue that accountability is a powerful tool of meso-level analysis appropriate to reasoning about answerability in research ethics, and that it captures the responsibility of researchers to disseminate study results to research subjects. We offer the following features of the research situation as relevant to the manner of dissemination to study subject, in addition to factors already proposed in the literature (risk and impact on health outcome): (a) features of the research subject in relation to identity, personal investment, disease, and community; (b) characteristics of the research study and field of inquiry in relation to certainty and significance; and (c) relationships among the research subjects and the healthcare workers involved in their care and in the research.     

The board of directors and agency accountability

The demand for greater accountability in the social service arena has forced those responsible for funding and operating programs to look for more efficient ways to evaluate them. The board of directors of the nonprofit organization, as legally constituted, is the most appropriate body to exercise the accountability function.     

Suppressing research data: Methods,context, accountability,and responses

Research data can be suppressed in various ways, including organizational secrecy, defamation law and refusal to reply to queries. In a broader sense, methods of suppression include pressures not to do research in the first place and attacks on scientists who produce unwelcome data. The context of this sort of suppression includes individual self‐interest, vested interests, and paradigms. Suppressing research data can be either compatible with or contrary to accountability, depending on the constituencies involved. Ways to challenge suppression of research data include individual requests, exposés, refusal to suppress, publicity, creating new data, and social movements.     

Reining in excessive risk-taking by executives: the effect of accountability

Performance-contingent compensation by means of stock options may induce risk-taking in agents that is excessive from the point of view of the company or the shareholders. We test whether increasing shareholder control may be an effective checking mechanism to rein in such excessive risk-taking. We thus tell one group of experimental CEOs that they may have to justify their decision-making processes in front of their shareholders. This indeed reduces risk-taking and increases the performance of the companies they manage. Implications are discussed.     

The role of litigation in human research accountability

This essay examines and analyzes the recent and dramatic series of personal injury lawsuits instituted against those individuals and institutions that conduct and monitor human research. It discusses the social engineering functions of tort litigation, outlines the legal elements and viability of lawsuits against those who conduct and monitor human research, and evaluates and predicts what role tort litigation will play in fulfilling the goals of accountability in the context of human research and human research regulation. In general, tort law engenders two forms of accountability: retrospective and prospective. Retrospective accountability is backward looking, focusing on harms that have already occurred, their culprits, and the reimbursement of individuals for their injuries. Prospective accountability is forward looking in that it encourages actors and institutions to fulfill responsibilities toward individuals in order that harm does not occur, or at least that the risk of harm is decreased. This article argues that research litigation is not, and will probably never become, an effective means of ensuring retrospective accountability in regard to research injuries and ethical violations. Paradoxically though, the current wave of research litigation may serve an important and even key role in encouraging and ensuring prospective accountability.     

Editorial: Loss and renewal

The authors review the literature that calls for the incorporation of relational theory into social work practice. Two strands of relational theory are important to developing a relational social work perspective: the psychoanalytic and the feminist. Based on a feminist understanding of relationality, Dorothy Smith has provided an alternative sociological perspective that can inform social work practice on the macro level, which she has termed institutional ethnography. In looking at ways that relational theory can inform macro practice in social work we can begin to formulate a more general relational perspective—beyond the clinical—in social work.