Degree Granting Department
Eric Eisenberg, Ph.D.
Accountability, Autopoiesis, September 11 2001, Sensemaking, System failure, System resilience
The National Commission on Terrorist Attacks attributed the September 11 attacks on the U.S. homeland to the terrorists' exploitation of "deep institutional failings." These findings are similar to the conclusions of the Presidential Commission investigating the 1986 Challenger accident and the Columbia Accident Investigative Board (2003). Generally Commissions aim to provide the fullest possible account of events contributing to the catastrophe under investigation and to identify lessons learned, but avoid specifying responsibility and accountability. For this reason, various commission reports have been criticized for being abstract and shallow. These criticisms make a valid point. How commissions make sense of failures has real consequences in terms of preventing reoccurrences. If these accounts do not satisfactorily address the question, How did this happen?, clear prophylactic measures for the future also remain unspecified.
This dissertation calls into question the usefulness of current constructions of system failure that focus solely on the abstract role of the institution or system in creating the conditions for failure. For the purpose of acquiring insight into our current narratives of system failure and accountability, the 9/11 Public Hearing Transcripts are analyzed. This research is a qualitative textual analysis of excerpts from the Transcripts related to both pre-9/11 intelligence failures and accountability. Using Weick's view of sensemaking to gain a better understanding of our current constructions of system failure/resilience and accountability, this research identifies the dominant constructions of pre-9/11 intelligence failures and accountability that are documented in the 9/11 Public Hearing Transcripts and the sensemaking resources that reinforce and solidify these constructions. Verbatim excerpts from the 9/11 documents are included to support claims.
The theory of autopoiesis, a form of systems theory, is introduced as an alternative resource for constructing narratives on system-environment relationships and accountability. Leadership practices that foster system resilience and individual accountability for system-wide performance are presented.
Scholar Commons Citation
Cooper, Sandra M., "Making sense of complex system failure: The case of 9/11" (2007). Graduate Theses and Dissertations.