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Jewish World Review May 25, 2004 / 5 Sivan, 5764

Walter Williams

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Managing a disaster | Imagine you're a head physician faced with a large-scale disaster such as the Sept. 11 attack on the World Trade Center, the Oklahoma City bombing or battlefield casualties. The first thing that must be acknowledged is that you have limited resources. That means treatment priorities must be set. This is the foundation for triage, a word from the French verb "trier," which means "to sort."

Some disaster victims are critically injured and require immediate treatment if they are to survive. Other victims are already dead, and others, though alive, are so severely injured that no degree of medical help will enable them to survive. Then, there are others who are injured and require medical attention, but they will not die if care is delayed.

It's a waste of resources to give medical attention to a victim who's going to die no matter what is done or to give medical attention to a victim who, though injured and requiring medical attention, won't die if care is delayed when to do so takes medical attention from a victim who will survive only if he's given immediate treatment. For efficient, not to mention humane, resource allocation, medical resources should first be spent on victims who will die if unattended but will survive if attended. Next, treat victims who will get better (or at least survive until more resources are available), and last, treat and give comfort to those who will die, even if attended.

Any doctor who'd say, "In the interest of fairness, I'm going to treat all victims equally or on a first-come, first-served basis or those who're nearest death" shouldn't be seen as compassionate and caring.

The triage principle is applicable to any disaster. When the average black high school graduate has an academic achievement level on par with that of a white seventh- or eighth-grader, and the achievement levels of white seventh- and eighth-graders are nothing to write home about, I think we can reasonably say black education is a disaster. As such, we might benefit from what could be called educational triage.

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There's no question that black youngsters from female-headed and/or low- and moderate-income households can excel academically. Partial evidence is the achievement levels of black youngsters who attend private schools such as Marcus Garvey (Los Angeles), Marva Collins Preparatory (Cincinnati) and Ivy Leaf (Philadelphia) and public schools such as Frederick Douglass (New York). At these schools, nearly all students are at grade level and often several years above.

Educational triage would acknowledge that there are black youngsters who cannot benefit academically no matter how many educational resources are spent on them. They have little or no family support. Their very presence in school, through disruptive and criminal behavior, makes education impossible for others. Spending resources on these youngsters is the educational equivalent of medical practitioners spending resources on disaster victims who'll die even if treated. These youngsters should be removed and not allowed to take resources from and make education impossible for those who do have a chance for academic achievement.

Some might suggest that the idea of educational triage represents a callous lack of concern for students most in need. But would that same argument make sense when there's a terrorist or battlefield disaster? In other words, would it also be seen as callous for doctors not to treat victims most in need — those who're going to die anyway? Efficiency criterion dictates that resources be allotted to those who can best use the resources as opposed to those who best need it.

By the way, there's another triage category that doctors won't own up to, and that's disaster victims who will survive only if they don't receive medical treatment. The educational equivalent of this category, where education victims are made worse off, is found in programs such as bilingual education and fuzzy math.

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