On the taboo of triage

Some hard choices we don’t want to even think about

By David Salt

Former leader of the Liberal Party, John Hewson, made an astounding comment last week during an address to farmers and industry leaders. “Government ministers are not turning up at events if they have the word ‘climate’ in the title,” he claimed.

Hard to believe but everyone knows that political parties of different stripes avoid certain words that trouble the ideologies that underpin the core beliefs of that party. As George Orwell frequently noted (and dictators often put into practice), language is power.

And it’s not just things tagged ‘climate’. I was amazed to observe the word ‘biodiversity’ disappeared from almost all Government messaging after the Liberal Party (under Tony Abbott) took office in 2013. How is it possible that a term like biodiversity*, that emerged from the academic field of conservation science and surely carries no political baggage at all, is seen to be politically taboo?

Priorities

In a general sense I’d ascribe it to broad government priorities: first we fix the economy, then we look after the environment. It’s a common mantra of political leaders and particularly so for those at the conservative end of the spectrum. I won’t discuss here why I believe this prioritisation of economy first/environment later is wrong (on so many levels) because that’s a big and hairy discussion better left to another time. However, it’s closely related to another taboo: don’t question the primacy of economic growth – growth is good, ad infinitum.

Of course, the empirical evidence on climate change and biodiversity decline is incontestable in terms of evidence and the overwhelming scientific consensus. Which is not to say the evidence isn’t contested in the ideological arena of political power? Just consider the denialists’ most recent effort, a publication titled ‘There is no climate emergency’. It was reviewed and shown to be a text-book example of the denialist dark arts exhibiting bias, inaccuracy and cherry-picked information.

However, surely it’s easier to not mention something rather than expend considerable effort in constructing an ever more elaborate lie to deny the existence of that thing.

Which leads me to a taboo word so consequential that we must never breathe its name: triage.

Well, that’s not completely true. In medical settings like hospitals and treating wounded soldiers on battlefields, ‘triage’ is a common and accepted term. Indeed, the idea was born on the Napoleonic battlefield.

Triage comes from the French word ‘trier’, which means to separate, sort, sift or select. It’s all about setting priorities when the need is urgent and resources are limited. On the battlefield (or in a hospital’s emergency ward) doctors and nurses triage patients to ensure appropriate care is given as quickly as possible depending on available resources: “This soldier we can save, this soldier we can’t.” “This patient needs immediate care, that patient will have to wait.”

Triage this

Medical triage underpins some of the toughest decisions humans have to make but society accepts this process because these decisions are made by trusted experts working for the common good.

But when it comes to other forms of triage – namely conservation triage, landscape triage or enterprise triage – we’re entering dangerously taboo terrain.

Conservation triage refers to prioritising resources for threatened species (eg, “this species we can save, this species we can’t do much for so let’s stop wasting funds on it”); landscape triage refers to prioritising resources for different types of land use (eg, “we’ll support farmers working in this region but not those working over there”); and enterprise triage refers to prioritising resources for different business sectors (eg, “renewables is an emerging industry that should be supported but manufacturing is a mature sector that can’t be propped up”).

From a political perspective, these forms of triage are never to be mentioned because as soon as you do you draw a target on yourself. If you suggest that government should favour one thing while letting another fade away you’ll be accused of picking winners and giving up on losers.

Winners and losers

When triage is applied to threatened species the debate becomes particularly heated. If any politician even dares to suggest that resources might be better used if they were prioritised to where they might have the greatest impact, the media (and opportunistic politicians from the other side) immediately ask: “Which species are you giving up on?!”

It’s an effective attack because the broader community believes no species should go extinct, and the government is careful to avoid any discussion on whether this expectation is being met.

Of course, this expectation is not being met. Indeed, the reverse applies. The world is witnessing a biodiversity catastrophe and Australia leads the developed world in our rate of extinction.

The tragic irony of not undertaking robust conservation triage (which necessarily involves transparency and accountability) is that the pitifully inadequate resources available for threatened species conservation are poorly applied resulting in waste and ineffective conservation. Politicians pretend that all species will be saved while making ad hoc, reactive and opaque decisions to save whatever species is the flavour of the month. It’s not only inefficient, it’s quite immoral and represents a deep failure in leadership.

Whatever, don’t mention the word ‘triage’ as a tool of conservation. Not only is it a politically challenging process to prosecute, it also throws a light on our abject failure on threatened species conservation.

Don’t mention it

Similar arguments apply to other forms of triage, such as landscape and enterprise triage. Picking winners highlights the losers and throws a focus on the government’s failure in letting an unsustainable situation develop.

Attempting triage on land management, for example, would require the government to acknowledge that traditional farming is simply not appropriate in many Australian landscapes contexts, especially in light of predictions connected to climate change. Criticising farmers, of course, is another taboo.

It’s easier to simply not mention ‘climate’ (or ‘biodiversity’ or ‘triage’), and hope your pigeons don’t come home to roost until at least after the next election.

*On biodiversity: The word ‘biodiversity’ is a shortening of the term ‘biological diversity’ and broadly speaking refers to the variability of life on Earth. The word took on official usage in the 1980s (and its creation is attributed to the scientists Thomas Lovejoy and Walter Rosen). Truth to tell, while I attribute the demise of the term ‘biodiversity’ in political discourse to a plot by Abbott’s conservatives to avoid all science, a robust study of the decline of ‘biodiversity’ in conservation policy discourse in Australia has revealed that the downturn in usage began much earlier than Abbott’s rise to government in 2013. This study, led by Alex Kusmanoff at RMIT, suggests that from 2003 to 2014 the term ‘biodiversity’ was in steady decline while the term ‘ecosystem services’, an economic framing of the benefits of nature, was on the rise.

Image: Otis Historical Archives Nat’l Museum of Health & Medicine, Creative Commons Attribution 2.0

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