Accountability refers to the implicit or explicit expectation that one may be called on to justify one's beliefs, feelings, and actions to others. Although most theories of decision making have conveniently assumed that decision makers act as isolated individuals, decision makers, including those in the field of medicine, seldom think and act free from social influences.

Decision making in the field of medicine is fraught with complex, conflicting pressures from various parties, including patients, physicians, hospitals, health policy makers, and insurers, that promote distinct and often competing objectives, such as maximizing life expectancy versus optimizing quality of life, or weighing quality of treatment against economic constraints. Therefore, to best structure accountability relationships and ultimately to improve the quality of decisions in the medical setting, careful analysis ...

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