by Mark I Levy MD
Medical Director fpamed
Assistant Clinical Professor, Psychiatry, UCSF School of Medicine
Two articles in the March 31, 2015 New York Times revealed that Andreas Lubitz, the presumed suicidal co-pilot who appears to have intentionally crashed a Germanwings aircraft into the French Alps last week, murdering all 149 passengers and crew aboard in addition himself, had been treated for “deep depression” in the past. German medical confidentiality laws precluded his treating physicians from warning to the parent company, Lufthansa, although the airline acknowledged yesterday that it knew this information.
William Hurt Sledge, MD, a Yale Professor of Psychiatry who has consulted to the U.S. Federal Aviation Administration (FAA) and the Airline Pilots Association and major carriers explained that the stigma of mental illness keeps most pilots from bringing any mental health problems to the attention of their employers or their unions. “The stigma is enormous,” said Dr. Sledge. “And of course none of them wants that to be known, nor do they want to confess it or believe that they have it.” The article stated that “Pilots’ fears about the consequences of being honest about their mental health was one reason the Federal Aviation Administration in 2010 loosened its policy, allowing them to take certain antidepressants and still fly if the illness was mild.” Nevertheless, if for example, a pilot’s marriage is disintegrating causing him or her to be distracted while working, a “macho” cockpit culture discourages the pilot from making his supervisors aware of his emotional stress or often even obtaining professional treatment for his symptoms albeit secretly.
What is most remarkable is that although physicians in the United States have an affirmative duty to protect the public by reporting to most State Departments of Motor Vehicles if a patient has a grand mal seizure or is suffering from dementia, or to report possible child abuse or elder abuse, and to inform the police of a potential third party victim if a patient voices credible threats to harm another individual, no such legal duty overrides the physician’s duty to protect an airline pilot’s confidentiality even if he is depressed and possibly suicidal. Even if a commercial pilot takes bereavement leave from his job following the death of a loved one, it is up to the pilot him or herself to decide when they are fit to return to flying. There are no FAA policies or procedures requiring that a pilot who has taken bereavement leave first undergo a psychiatric fitness for duty evaluation before returning to the cockpit. This is an extraordinary omission in the regulations governing airline pilots who are charged with protecting the lives of tens of thousands of passengers and fellow crew members every day. Imagine if it were up to a pilot with chest pain or a cardiac arrhythmia to decide himself whether or not he was fit to fly the aircraft!
It is high time for the FAA with the assistance of pilots’ unions and major carriers to review these regulations and supplement them with required regular mental health screening of all commercial pilot, comparable to their required periodic medical physical examinations conducted at regular intervals.
Download New York Times articles here:
Lufthansa Says Germanwin…epression – NYTimes.com