Ethical Duty to Report “Unfit to Fly” Diagnosis

If a commercial airline pilot is struggling with a medical or psychological issue that could severely impact their ability to perform their job, their doctor isn’t required to notify their employer. Thus, they’re allowed to continue flying at the potential peril of their passengers. Changing the rules would allow doctors to report a limited “unfit to fly” notice that may ultimately save lives.

It is common knowledge that health care providers are under an ethical duty, in the name of public safety, to report to an automobile licensing department that a patient is not fit to drive a car. The licensing agency automatically suspends that person’s driver’s license upon receipt of the notice. Public safety requires no less.

Strangely, there does not seem to be an awareness among medical doctors and those in the mental health field that a similar ethical duty must exist when an airman licensed to fly commercially is not fit to fly.

It is not suggested that merely because one becomes an airline pilot she or he entirely gives up the privacy rights to medical conditions and treatment. What is suggested is that all civilized systems must recognize that a pilot holds many lives other than his or her own in their hands and that public health and safety demand that a limited “unfit to fly” notice be required when a professional health care provider determines the necessity. The notice must be treated as strictly confidential by the airline and the provider. The notice should say no more but should bear the signature of the health care provider. In this way, health care privacy is maintained, but the public’s interest in safety is recognized.

An “Unfit to Fly” notice should result in the immediate grounding of the pilot, but not his or her suspension or termination. Until the pilot has had her or his right to contest the notice, the job must remain secure. Moreover, that such a notice has been received ought not to taint the pilot, as until the medical and psychological facts are fully explored, one health care provider’s opinion ought not to mark the pilot with a “scarlet letter.” Moreover, if, as and when the condition has been cleared, the pilot ought to have a right to full reinstatement.

If administered fairly, rules such as those suggested here might not be fought by pilots and their representatives, nearly all of whom agree, without reservation, that aviation safety is the highest priority of their profession.

Millions and millions of people are flying every year as commercial airline passengers. Strict notions of privacy must give way to public safety concerns where a pilot, often responsible for hundreds of lives on any given flight, is not fit to fly. Every pilot knows that mental, as well as physical health, is vital to their performance. It asks very little of them to require limited waivers of otherwise private matters when tragedy lurks in non-disclosure. Had these suggestions been in place prior to March 24, 2015, every person aboard Germanwings Flight 9525 would be alive today.