Our concept of risk/benefit analyses needs to change
Instead of trying to determine frequency and severity of uncertain situations, we should choose pre-determined courses of action and then engage in serious and continuous self-critique
Much of the research into humans' risk-avoidance machinery shows that it is antiquated and unfit for the modern world; it is made to counter repeatable attacks and learn from specifics. If someone narrowly escapes being eaten by a tiger in a certain cave, then he learns to avoid that cave.
"Learning to Expect the Unexpected," The New York Times (2004-04-08}
In the first article of this two-part series, we took a look at the risk/benefit analysis and problematized the application of risk (used as a noun) in fireground contexts. The next question is, "what are 'benefits'?"
First of all, I find the common framework, "risk a lot to save a lot" functionally meaningless. It begs the question, "What is a lot?" I know my definition of what was "a lot" changed after I got married and then changed some more after I had my first child.
What is a lot? And if I am risking a lot (though I cannot effectively define what risk is), to what end am I risking it? In other words, what are the benefits? And in order to assign a benefit, we must also know value.
Would you risk as much for an occupied apartment house as you would for a shed? No you would not, because on the fireground you make value judgments on the relative worth of things.
Beyond the obvious imperative of racing into a house to save a known victim, are there other benefits? Do we count family saved photos as benefits and if they are, is a family photo saved worth a firefighter's broken hand or burned ear?
Do we not have a moral obligation to accept exposure to danger as part of the oath we swore to society? When we accept the job, do we not also accept that despite our best efforts we might break our thumb in the process of saving someone's dog from a house fire?
I doubt there would be an outcry because a firefighter broke his hand saving a house from total destruction, but we might hear some rumblings if a firefighter died trying to save a woman trapped in a burning basement.
If we start to make rash decisions about risk and benefits, do we not place ourselves in the precarious position on reneging on our voluntary obligation to society? People expect firefighters to do things that they cannot do, i.e. race into the burning home and save people.
If we relegate ourselves, via obscure notions of risk, especially when it involves civilian life, to squirting water from the curb, how do we separate ourselves from the average civilian? What makes us different from the average citizen if not our willingness to accept higher than normal levels of danger?
Benefits are tougher to define than risk.
I constantly hear the refrain, "We need to do better risk/benefit analyses." That statement has to be true, but what continues to concern me is that while we encourage our people to conduct "better" risk/benefit analyses we don't ever tell them how. There is a gap between what we require and what we teach.
If I cannot define either the risks or the benefits, how can I make a good decision on the fireground?
Our concept of risk/benefit analyses has to change. The real question we are asking of a new unit officer when we ask her to conduct a risk/benefit analysis it to decide whether or not the person or things in that house are worth dying for and that has nothing to do with probability. About 100 firefighters die each year; 50 percent of those deaths are the result of health issues and another sizable portion is the result of vehicular crashes. In the end, the ratio of firefighter death to number of interior attacks performed is very low. Mathematically, the risk of a firefighter dying in a fire is really low.
However, the amount of attention that we pay to those few deaths as compared to the statistical likelihood of those deaths is sufficient proof that there is something more than numbers involved. In other words, we are encouraged to use mathematics in the form of probabilistic risk analysis to decide how to act, but we refuse those mathematics when we consider death as a result of those actions.
"[traditional risk/benefits methods used]…in contexts having severe consequences with low probability, puts emphasis on the tails of probability distributions over different kind of values at risk in the case of a catastrophic scenario, still not discarding the unconditional probability of an extreme event actually occurring but treating both the conditional and unconditional expected value as decision objectives." 1
In order to figure out what needs to change, if anything, the fire service is going to have to do some soul searching. It is "possible" that you pull up to a house with fire showing from all the windows and there is a living, breathing civilian inside. It is a small chance but a chance all the same.
If we, as the fire department, do not at least try to do a search, what are we really saying? I think we are saying that, "I am unwilling to put my life in danger in an effort to assist you even though your life is in danger." I also believe that that thought process is a gross violation of the social contract we have, or should have, with the people we claim to serve.
Take away the notion of whether or not we assume that people are in a house, or whether the occupant reports that everyone is out. Don't we owe the public, within reason, the best of all possible shots at saving their lives? I think we do.
Now, mind you, if someone can provide me with some proof that I can be just as effective in protecting life and property from the curb, I will buy that. However, I cannot accept a risk/benefit analysis that essentially assumes that the life of a firefighter is more important than the life of a civilian.
When I pull up on a house fire, what I am most aware of is what I do not know. If I do not know something, i.e. the interior flow paths, the location of the fire, the structural status of the building, then I cannot assign a valid "risk" profile because I cannot know the "risk" because I cannot know the frequency or the severity of uncertain combinations of events.
I also cannot assign benefits really because I don't know if that lady still trapped in the house is dead or alive. I don't know if she died of CO exposure faster than expected because of an underlying cardiac issue or if despite the volume of fire she was in an isolated compartment and uninjured.
I cannot assign either risk or benefit without all the information, just like I could never assign an accurate probability of a coin landing on heads if I don't know that both sides of the coin were heads.
Instead of using probabilistic approaches, we should use possibilistic approaches. Instead of trying to determine frequency and severity of uncertain situations, we should choose pre-determined courses of action and then engage in serious and continuous self-critique using any number of techniques while preparing for the worst.
In other words, when I enter a room to search and I am so hot in my gear that I am uncomfortable, I can assume that no one is alive in that room and move on to the next one.
I can enter while thinking about how I would get out if I had to. I can continually question, "…is this thing that I am doing the best thing to be doing based on what has happened, is happening and could possibly happen."
Finally, we should consider the quote that opened this discussion and translate it into fire speak: "If someone narrowly escapes a flashover and makes a save, the only thing he/she learned what that in that house, on that night, at that time, with that weather, and those crew resources I had on hand, I escaped flashover and made a save."
Beyond that, you are none the wiser for your effort. This is a tough thing to accept but I believe it is the beginning point for a true understanding of how to actually approach firefighting choices in the face of uncertainty.
1 Larsson, Aron; Ekenberg, Love; and Danielson, Mats (2010) "Decision Evaluation of Response Strategies in Emergency Management Using Imprecise Assessments," Journal of Homeland Security and Emergency Management: Vol. 7 : Iss. 1, Article 53.