The Bureau d’Enquetes et d’Analyses (BEA), the French institution comparable to the US’ NTSB, has issued a Preliminary Report on the tragic Germanwings crash. It is 29 pages long and in its last paragraph labeled Ongoing Safety Investigation reads as follows:
The investigation will also study the systemic failings that may have led to this accident or to similar events, with two main investigative orientations:
- “Medical aspects: the investigation will seek to understand the current balance between medical confidentiality and flight safety. It will specifically aim to explain how and why pilots can be in a cockpit with the intention of causing the loss of the aircraft and its occupants, despite the existence of:
- regulations setting mandatory medical criteria for flight crews, especially in the areas of psychiatry, psychology and behavioural problems;
- recruitment policies, as well as the initial and recurrent training processes within airlines.
- Cockpit security: the investigation will seek to understand the compromises that were made between the requirements of security, specifically those that followed the attacks on 11 September 2001, and the requirements of flight safety. In this context, the investigation will include a focus on cockpit door locking systems and cockpit access and exit procedures.”
The BEA’s statement of the issue was crafted with a surgeon’s scalpel, narrowly the interstice between safety and privacy (a bigger issue within Europe than the US). Its focus is on governmental actions (regulations and recruitment standards). Those are momentary slices in the life of the cabin crew. Mental health is a moving phenomenon which may vary with seasons, personal disturbances, body chemistry, stress and a large number of factors.
The way points of hiring and regulatory checks may be useful, but they are still pictures of a pilot’s psychological balance which is a moving picture. Awareness of all of the symptoms and intervention strategies to deal with this nebulous problem needs a reliable and systematic education. For example, a local NBS television station has broadcast a series of informative information briefs on this subject. Such an approach is needed for all who are involved in the airline (even more broadly aviation) industry.
It is most encouraging to read that the association of Dutch pilots (the VNV union) has endorsed peer-operated self-help groups to help pilots suffering from depression or battling with addiction. Their proposal is in response to the BEA’s posing of the possibility of a rule requiring doctors to disclose dangerous mental conditions. The union states that it has had “good experiences in helping members suffering from alcoholism and drug addiction through self-help groups operated by their peers. In most cases they overcame their addiction.” This broader approach clearly sets both a more comprehensive (24/7/365) and a more holistic tone than a purely regulatory regime.
BEA, EASA, FAA and other CAAs would be well advised to study the efficacy of the VNV peer process. It might be worthwhile to assess whether the circle of involvement can be extended beyond the cockpit to the cabin (these safety professionals usually travel with the pilots) and management. Pilots, somewhat like the psychiatric professionals, may be occasionally conflicted; they know that interceding with a brother/sister could result in jeopardizing her/his career. At the same time, failing to take that action may have dire consequences in the future.
It will be fascinating to see how the issue of the disclosure by the doctors versus public safety is resolved. The BEA report notes that none of the health care professionals reported the Germanwings pilots problems even though the record includes the following:
- “..on 1 September 2008, he started his basic training at the ‘‘Lufthansa Flight Training Pilot School’’ in Bremen (Germany);
- on 5 November 2008 he suspended his training for medical reasons;
- on 26 August 2009 he restarted his training;
- on 13 October 2010, he passed his ATPL written exam;
- On 9 April 2008, he obtained a class 1 medical certificate without restrictions and valid until 9 April 2009, issued by the Lufthansa aeromedical centre.
- On 9 April 2009, his class 1 medical certificate was not revalidated by the Lufthansa aeromedical centre due to depression and the taking of medication to treat it.
- On 14 July 2009, his request for renewal of his class 1 medical certificate was refused by the Lufthansa aeromedical centre.
- The latter informed the LBA of this. On 28 July 2009, he obtained a new class 1 medical certificate valid until 9 April 2010, endorsed with the note ‘‘Note the special conditions/restrictions of the waiver FRA 091/09 -REV-’’. His pilot’s licence then included the limitation ‘‘***SIC**incl. PPL***’’, which means ‘‘Specific regular medical examinations – contact the licence issuing authority’’. This limitation requires that the aeromedical examiner (AME) contact the licence issuing authority before proceeding with a medical evaluation relating to any extension or renewal of the medical certificate. It may relate to the medical history that the AME must be informed of before undertaking an assessment.
- From July 2009, he obtained each year a class 1 medical certificate valid for one year that was endorsed with the note ‘‘Note the special conditions/restrictions of the waiver FRA 091/09 –REV -’’.
- The last valid class 1 medical certificate had been issued on 28 July 2014 and was valid until 14 August 2015.”
The NYT article quotes the BAE’s investigator on the difficulty of the medical/privacy v. aviation safety conundrum:
“Rémi Jouty, the director of the Bureau of Investigations, expressed hope that the findings would lead to a broader discussion among medical and aviation regulators worldwide about the need to find the proper balance between privacy and public safety.
Mr. Jouty acknowledged that attitudes about individual privacy varied widely among cultures, making it difficult to prescribe solutions that could be accepted universally. While countries like Germany have strict patient privacy laws that doctors can be prosecuted for violating, others, including Canada, Israel and Norway, require doctors to alert regulators about a pilot who may pose a safety risk, he said.”
Some sort of external requirement seems to involve considerable discussion before any implementation, regulatory and likely statutory. While some governmental involvement seems inevitable, if not advisable, regulators should expedite the global implementation of the VNV peer approach.