Germanwings: Privacy vs. Public Safety

We can argue about a lot in aviation, but one thing we rarely dispute is the unwritten rule that your AME and your doctor shouldn't be the same person. Unpack the logic of that and two things become implicit: We don't trust the government with our medical data (rightfully) and, if we're honest, we want to retain the option of a little duplicity. I might take the stink off that last word by calling it survival instinct instead, but by any other name, it's still sophistry.

I doubt if many of us get our moral pants snagged on this, nor should we. But then along comes the Germanwings suicide/murder-by-airplane incident and the morality becomes more ambiguous. The fact is, medical certification is supposed to assure the unwashed flying public that the pilots operating their flight are medically fit to do so. Implied is that "fit" means mentally fit, too. Obviously, the German system spectacularly failed in this because privacy laws clashed with the regulators' oversight efforts and privacy won. As a result, an Airbus A320 with 150 souls aboard was intentionally crashed into a mountain in France by Andreas Lubitz last March.

I originally thought that this would make for an interesting case demonstrating how lawmakers reset the balance between onerous government intrusion and the individual's right to privacy. I've reconsidered. European regulators won't have any choice but to devise a way that medical personnel can short circuit privacy laws when public safety is at stake. Depending on how carefully such a law is written, this may saddle docs with an onerous burden of their own. Any reasonable man would agree that a psychotic airline pilot should have his privacy breached in the name of protecting the public. And maybe a bus driver or a ferry captain. But how about a UPS driver, a postal clerk or a grocery produce manager? Them, too? Do they threaten the public if they run off the rails a little mentally? I don't envy the docs making these calls because as sure as one doc diagnoses a benign neurosis, another will find a wild-eyed lunatic.

And should the same standard apply to airline pilots, private and sport pilots? How can this question be reasonably answered? With only a few incidents of psychotic behavior resulting in aviation accidents amidst galaxies of routine, safe flights, is the depressed pilot as a public menace really a thing in need of fixing? The answer is self-evident once such an event crosses into the political realm. And here, there's a direct corollary to the Third Class medical we're trying to kill off. Just as no legislator would rise in the Bundestag to argue for the primacy of pilots' privacy rights, no FAA bureaucrat would put his name on a document attesting to the utter fallacy of medical certification as an argument to eliminate it. Germanwings provides, if nothing else, a convenient I-told-you-so counterpoint.

Whether any of this has any impact on medical certification in the U.S. is an unknown. To a large degree, our system is based on honest self reporting that, de facto, waives privacy rights. The 8500-8 medical form asks about medications and about doctor visits, meaning if you're guzzling Zoloft and getting weekly electroshock treatments, you're supposed to tell the FAA. The 8500-8 is considered a legal instrument and lying on it carries a $250,000 fine and/or five years in jail. Do people lie anyway? I suspect they do, which is why I mentioned the reason for keeping AME and family doc separate. And once in awhile, someone gets busted for fraud.

But whether they do or they don't lie or whether they get caught or not doesn't much matter. We have more than a half century of data that shows that medical certification has done little or nothing to improve system safety. The kicker on that cocktail is a decade worth of drivers' license certification for light sport flying that shows no correlation between accidents and medical incapacitation. But then you knew that and I've said it here several thousand times. For some reason, I can't resist saying it again and the Germanwings story provides the opportunity. And also some ambiguity. Andreas Lubitz clearly needed to be cut from the pilot herd. But you and I are just fine.