Did Medical Confidentiality Cause The Germanwings Crash?

The tragic crash of Germanwings Flight 9525 last Tuesday has raised debate on whether the medical records of airplane pilots should be made available to their employers, and perhaps even to the public.

Andreas Lubitz, who put a plane full of 150 passengers into a deadly descent into the French alps last week, had been told not to go to work by his doctors. The 27-year-old Germanwings co-pilot had sought treatment at a Düsseldorf Hospital on March 10, a fact he concealed from Lufthansa, the parent-company of Germanwings. Moreover, prior to obtaining his pilot’s license, Lubitz was in a period of psychotherapeutic treatment for symptoms that included suicidal tendencies. After the fatal tragedy, German police who visited Lubitz’s home found anti-depressants and prescription drugs to treat what has been termed a “psychosomatic illness.”

If there been more transparency with medical records, the public could have known that Mr Lubitz was unfit to fly. As things currently stand, not even the airline company that employed Lubitz had access to his medical records. As Newsmax reported,

“Lufthansa has also made clear that Lubitz’s medical records were subject to doctor-patient confidentiality and that the airline therefore had no knowledge of what they contained. Under German law, employers do not have access to employees’ medical records…”

Thus, despite Lubitz’s extensive medical history that should have precluded him from being put in charge of a plane, Lufthansa declared Lubitz “100% fit to fly.”

The United States system is hampered by similar limitations, relying mainly on airplane pilot’s self-reporting.

Should Medical Records Be Made Public?

Last week’s disaster is likely to add fuel to the ongoing debate on whether there are health benefits to making people’s medical records public. Larry Page, co-founder of Google, jump-started this debate last year when he suggested that making all health data public could have huge benefits.

A more specific question is whether the medical records of airline pilots, and others who work in high-stakes jobs, should have their medical records made available for public scrutiny. Currently, medical records in the United States are regulated by laws that stringently protect an individual’s right to confidentiality. There is thus a great deal of uncertainty among health professionals about what they are allowed to disclose if their patient happens to be a pilot who is unfit to fly.

Unforeseen Consequences?

In light of the 150 deaths last week, it is hard not to have sympathy with calls for greater transparency. But renegotiating a pilot’s relationship to the public could have unforeseen consequences in other areas, undermining the public’s trust in the screening processes already in place by the airlines to insure the competency of their pilots.

Handing over pilot’s medical records to the tribunal of popular opinion might also fuel a sense of hysteria in which those who are depressed and mentally ill may begin to be stigmatized as being dangerous (a tendency that The Atlantic has already warned against in their article ‘Depressed Doesn’t Mean Dangerous.’).

Many competent pilots in America suffer from depression, and in 2010 the FAA even relaxed rules that prohibited pilots on antidepressant drugs from flying. Would these depressed but capable pilots be branded as “unsafe” if the public had access to pilot’s medical records?

Where does Personal Privacy End and Public Safety Begin?

With the recent death of 150 innocent passengers still fresh in our minds, many may feel that these and other drawbacks would  be worth the cost in order to save lives. Certainly the question of how to balance personal rights with public safety is a difficult issue that surfaces in many other areas of public debate.

At TSM we’d like to hear from you about your views on these challenging questions. We will be using our Facebook page as a public forum to discuss the issue.

Further Resources

 

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