I think the problem is, this responsibility is not clear cut. Such things can be implied, but disputed. Whatever is more convenient at the time.
That's right. The only reason a system of accountability works is that
everyone knows what they are responsible for and that it will cost them when they don't do their jobs.
You two make it sound like the intent is punishment or scapegoating. You can't punish someone for letting something fall apart if they never had personal responsibility in the first place. The point is not
always having someone to punish, it's everyone knowing that their asses are on the line so these things don't happen!
Sorry, I thought the intent was clearer than that. The reason for heavy, equitable punishment for crimes (including crimes of negligence) is not to make people feel better or to have a scapegoat; it's to deter people from committing those crimes. But no one was made responsible for anything here, which leaves us with two conclusions:
1. No one is personally responsible after the fact, because they were not made so before the fact. It would indeed be unfair to hold individuals responsible when it comes to punishment for this debacle.
2. No one was personally invested in doing things right because there were nil or negligible consequences for failure, even catastrophic failure. These people still have their jobs, assets, and health. People are not good, kind, or anything but self-serving on their own,
especially when they can avoid responsibility for their actions through anonymity or by any other method. They had no good enough reason to care properly, because they had nothing at stake.