This article was first published in
educational Horizons Winter 1999

The Ethics of Educational Triage
Is Special Education Moral?

©1999 Edward G. Rozycki

RETURN
edited 11/26/08
 

Effective and Efficient

To say that something is effective is to say that it produces a certain result . To say that something is efficient is to measure the cost of its producing a result. Nothing can be efficient if it is not effective. But something can be effective and not very efficient

This is how normal English speakers use the concepts. This is also how engineers use the concepts. Efficiency is Effectiveness measured against Cost. Educators, following the confusion introduced into organization theory by Chester Barnard*, foul this up. They not infrequently talk about schools being efficient but not effective. By this muddle they mean to indicate that certain results are produced at minimal cost, but that other, more desirable results, are not achieved at all. Perhaps this flip-flopping between the results under consideration -- the ones efficiently produced vs. the ones desired but not produced -- avoids revealing conflict that might occur should participants in the educational enterprise make it clear they were entertaining different goals.

This is important. Most teachers, administrators, and members of the interested public misapprehend the complexity (and cost) of the educational undertaking. The schools are charged with the conflicting burdens of equity and excellence. The effectiveness-efficiency confusion created by Barnard helps obscure this conflict.

Teaching to the Middle

Teachers, administrators, most people attempt to increase their work efficiency. They try to do what they are aiming for at the minimal cost to their own energies and resources. This is the point of rational activity. To expend time and energy pointlessly is thought to be inefficient, certainly no virtue.

Teachers -- though they dislike the simile -- are like battlefield surgeons. They have limited supplies, time, and energy, and demands greater than they can handle. Thus they divide their potential patients into three groups:

1) the Gifted: those they can neglect because they will get well (learn) anyway -- they don't need it, whereas others do;

2) the Subnormal: those they should neglect because all (or an unfair proportion) of their resources will not help anyway, the resources available are insufficient to help them and would be wasted;

3) the Normal: the group that will show maximum improvement (learning) for the resources used. Allotting resources to this group optimizes their effect.
 
 

This is called triage in medicine. In education it is called teaching to the middle. A common Principle of Equity, Fair Share, requires that no one receive more of a scarce resource than any other -- all things being equal. Thus, if educators are evaluated by the results they produce over a large, undifferentiated group of students for whom the equity principle applies, triage, teaching to the middle, is the reasonable approach to education. But triage requires some additional principles that override Fair Share. Scarcity, and the rational optimization of resource use, warrant their use.

Denying the Gifted

The commonsense principles appealed to in denying resources to the Gifted seem to be these.

a. Lack of Need Requires no Treatment -- none of the resources available are necessary to help the gifted achieve to the desired level;

b. Waste Not -- since resources are scarce, those given to the Gifted are superfluous and could be better used;

c. Attend to the More Needy -- All things being equal, those in greater need through no fault of their own should be given higher priority.
 

These override the Fair Share principle. Clearly, any argument that tries to show that the Gifted are deserving of scarce resources, must deal with these three new principles and show them to be not applicable.

Denying the Subnormal

The commonsense principles appealed to in denying resources to the Subnormal seem to be these:

a. Unanswerable Needs Dismiss all Treatments -- none of the resources available are sufficient to help the Subnormal achieve to the desired level; this is similar to the ancient principle that impossibilities impose no obligations;

b. Waste Not -- since resources are scarce, those given to the Subnormal are ineffective and could be better used.

These principles, too, override the Fair Share principle. Any argument that tries to show that the Subnormal are deserving of scarce resources must also deal with these principles and show them to be not applicable.

Special Education: New principles or no principles?

Special education contradicts the principles articulated about in both theory and in practice: it identifies both the Gifted and the Subnormal as Special Students, exempting them not only from the particular rules that support triage, but also from the Fair Share principle. On the one hand, no Subnormal child is to be left to "die" in a regular classroom; more resources are to be expended on their behalf. Nor, on the other hand, should Gifted students risk stultification through lack of attention. This is to be accomplished by diversion of resources from the "normal" students, so that optimum (group-wide) efficiency will not be achieved. Not infrequently, resources allotted to the Normal tend to be reduced beyond their Fair Share on a head-count basis. This undermining of efficiency is seldom, if ever, acknowledged. Basically Special Education denies the scarcity of resources and the ethics that reasonably govern such scarcity.

So it is that ends of classroom teaching multiply yet teachers are nonetheless expected to be both effective and efficient. But although ends multiply, it is not often that resources do. Educators are scolded that both teaching to the middle and homogeneous grouping are inequitable. Perhaps confusing effectiveness and efficiency in that great Barnardian tradition is the opiate that keeps us from feeling the horns of this dilemma.

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*Chester Barnard, The Functions of the Executive (Cambridge: Harvard University Press, 1938).

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