This paper explores two of the most important challenges facing contemporary scholars who seek to assign blame for deviance in organizational contexts. The first concerns the selection of an appropriate level of analysis. The second focuses on the social meaning of intent, or willfulness, also called mens rea in criminal trials. We suggest that scholarly worldviews play a central role in determining how these issues are discussed in the literature, thereby impacting the assignment of blame. Throughout, we use the case of the Tuskegee syphilis study to illustrate key issues.