Accounting to the end of life. Scarcity, performance and death

This paper follows accounting to the end of life. We question how accounting can influence the way life ends to understand the conceptions of life, health and normality that inform accounting valuations of life itself. Specifically, we conducted an ethnographic study of a hospital's geriatrics and palliative care unit to analyse how accounting influences, and is informed by, conceptions of what makes a life worth living. The end of life problematises accounting and makes visible assumptions on what constitutes a good life. We draw on Agamben and Canguilhem to show that accounting builds on, and reproduces, several discursive positions – scarcity and the need for efficient resource allocation; separability and the possibility to isolate segments; commensuration and the possibility to relate each situation to standardised categories; valuation and the reduction of life to exchange values; normativity and the definition of normality through statistical regularities. We then discuss the kind of life that is included in accounting valuations of life itself and the dehumanising consequences accounting practices can have on the end of life. We conclude with opening questions on how to imagine forms of accounting that would acknowledge our vulnerability and allow for an art of living while dying.