Noblesse Oblige: how systems for accountability affect trust among professionals

Abstract

Whereas professionals were once regarded as trustworthy agents whose actions stemmed from their ‘calling’ and social responsibility for the community, nowadays, numerous public scandals seem to have eroded the public’s trust. Institutions are continuously being challenged to account for their actions and trust in professionals seems to be replaced by various accountability systems – both calculative and narrative. Calculative accountability as the dominant means for building trust with outsiders seems to have reached its limits, and the question arises how accountability affects trust among professionals. Based on a qualitative case study using a structurational discourse analysis, we revealed how accountability affects several layers of trust among professionals. Calculative accountability served to showcase good practices for restoring trust outside the profession and retain autonomy. Narrative accountability, however, was perceived as essential for interprofessional trust and to genuinely discuss the real ethical matters. As distrust among professionals erupted about the issue of a quality control system, this threatened the trust necessary to benefit from narrative accountability. The proposed solution in the literature to implement both calculative and narrative accountability simultaneously, thus seems to run into a Catch-22 situation in practice.