[bonyt]

> Each issue is reasonable by itself...

The problem of many hands - when responsibilities in a group that collectively does harm are divided between many people, who can be held accountable when each person individually acted reasonably?

I think organizations are, more and more, siloing roles in this way intentionally (or at least emergently), such that blame can only ever be collective if they do harm. Since it's so much harder to redress collective blame, this can be effective in avoiding consequence entirely.

[jerf]

I think it's mostly emergent. I can even point to a plausible mechanism, which is that if you think of an organization as a network of people and how they are connected together, you can think of "responsibility" as something that arcs through an organization like electricity and burns out whatever it courses through, prompting the creation of alternatives to avoid getting zapped the same way in the future.

It isn't completely inevitable, I think it's possible for relatively strong leadership to understand that the processing of responsibility through an organization is a necessary feature and people handling it without external forces conspiring to make it even more like that it will "burn out" a part of the org is a necessity and a good thing. But it's really easy for an organization to just default to burning out the path and evolving ways to avoid it in the future, and it is very motivated to make it happen.

[testaccount28]

the correct answer here is that they are all accountable. there is not some fixed quantity of blame to divvy up: each malfunctioning leg is responsible for the outcome.

[close04]

They all contribute but they can’t all have the same degree of accountability.

[ajb]

I think the GP's point is that accountability/responsibility isn't a substance, it doesn't have to be conserved like energy or momentum. I agree with them.

It would be perfectly valid for the law to be that individuals don't need to unpick the corporate web of relationships, but hold any of those who contributed (above some size threshold) culpable for the whole injury, and leave the corporates to arm wrestle about how culpability is assigned between them.

[s1artibartfast]

Liability laws incentives play a big part. Good faith effort and patient care increase the surface are for attack.

[FireBeyond]

Potentially. However, depending on the nature of the interaction, abandonment is equally a concern for a provider. If I'm treating or begin care of a hypoglycemic patient (and I'm not saying that in this case, such a thing has happened), then legally, I can be found guilty of abandonment if I don't transfer care to a higher level provider or conclude the course of treatment or intervention planned. I can't just say "I can't do anything for you, you're on your own."

[s1artibartfast]

I think we are saying the same thing. There is a line that triggers obligation and liability. If the location is abigious or the liability is extremely high, then there is incentive to error on the side of avoidance.

This might mean not taking a patient or class of patients into care.

[FireBeyond]

THat's fair.

One other point to note, in general) is that depending on your provider type, avoidance may not be an option. On duty EMS cannot "avoid" a patient encounter, likewise with emergency medicine (though I'm honestly not sure whether immediate/urgent care is considered there, too).

[cucumber3732842]

>The problem of many hands - when responsibilities in a group that collectively does harm are divided between many people, who can be held accountable when each person individually acted reasonably?

"You can't justify hanging us all from the overpass" is the magic of the system.

And not just the medical system.