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Examines the extent to which quality assurance can be conceived as a rational endeavour, particularly in ethical terms. Examines the Weberian distinction between rationality as values as an “end in themselves” and values conceived in terms of a“means‐ends” distinction. While the emergence and existence of quality assurance can be viewed from either of these two perspectives, both entail a number of problems. Suggests that quality assurance, while appearing rational, fails at a crucial point for two reasons. First, while rationality is a relational concept, quality within the health service does not appear to function in such a manner;and second that quality assurance often neglects to evaluate its own activities. Claims that in both instances quality assurance acts more in terms of its functional role than in terms of its rationality.

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