This discretion can also be enhanced through the limiting of accountability that physicians have both in interactions with patients and with regard to top-down regulation.
Appignanesi's study highlights sweeping changes in social, legal and medical definitions of mental illness, as courts struggled to decide the limits of personal accountability.
However one views the nation state – and I am no great fan – it has proved to be the upper limit of democratic accountability.
Kimberly Young, a psychologist and founder of the Center for Online and Internet Addiction (netaddiction.com), said it would be unfortunate if the religious tenor of a service limited the appeal of accountability partners.
The latter would make it possible for them to develop standards and regulations for their profession and define the limits of authority, responsibility and accountability of each member of the profession.
It entrenches large existing systems, eliminates patient choice, promotes consolidation, limits competition, and perpetuates the lack of accountability for outcomes.
We're being included in everything [regarding emergency preparedness]." Limits are also shaped by the lines of accountability and procedures within businesses and governments.
As the politicians cast around frantically for a new "middle tier" to sit between schools and these monoliths of national accountability, the limits of the monster they have created become clearer.
But Amnesty said there had been limited progress in addressing police impunity, lack of accountability and policing methods that fall far short of international standards.
UNICEF and other cluster lead agencies need to have a joint dialogue with IASC to clarify for agencies the responsibilities, accountabilities and limits of the 'provider of last resort' principle.
The NHS should have the confidence to allow Manchester to probe the boundaries of structures and accountability, testing the limits of how the power and authority of the secretary of state can be balanced with local democratic control.
