AIN Blog: Bye-bye Medical Privacy

 - March 27, 2015, 2:12 PM

If there’s one thing we’ve learned from aviation accident history, it’s that new regulations almost always follow when an unusual accident or string of events occurs. The tragic Germanwings accident, where one of the pilots apparently locked the other out of the cockpit then flew into the ground, will lead to new regulations, and not just having to do with requiring two crewmembers in the cockpit at all times. The new regulations will lead to eliminating privacy of medical records.

News coverage from the Germanwings accident–albeit some of which has not being officially confirmed–suggests that the co-pilot Andreas Lubitz had a medical problem that he may not have fully disclosed to his employer. Allegedly, the medical issue was serious enough as to cast doubt on whether he should have been allowed to continue flying commercially.

The problem here is that it appears that there was no adequate mechanism for that medical information to be shared with the airline or German medical examination and certification authorities. In the U.S., it is against FAA regulations not to reveal any disqualifying medical issue. But if a pilot is diagnosed with a serious medical problem by a doctor who isn’t the certifying Aviation Medical Examiner (AME), and if the pilot essentially lies and doesn’t disclose that information, then that pilot could get away with flying in a medically unsafe condition. The system relies a great deal on trust that the pilot will not lie on the application for the medical certificate. There is just one case where it would be difficult for the pilot to conceal information, and that is a record of driving violations, which the FAA is allowed to check. But for medical conditions that the pilot chooses not to disclose, there is no mechanism for sharing that information with the FAA.

At least, not yet.

Here’s where things get sticky.

Medical technology is advancing rapidly and there is a great push for the medical community to switch to electronic medical records (EMR) systems. These systems supposedly will improve efficiency for doctors, nurses, hospitals, patients and insurance providers. In a perfect world, EMR could prevent dispensing the wrong medicine or operating on the wrong body part. Someday, patients will not have to fill out lengthy forms for every doctor that they visit because that information will be available electronically.

We have seen from past accidents that either regulators or legislators push for new regulations to prevent future similar issues from causing the same accident. The February 2009 Colgan Air accident near Buffalo, N.Y., is an example. Following that accident, families of the victims pushed legislators to force the FAA to require airlines to employ only pilots with airline transport pilot (ATP) certificates. We know that these new rules would not have prevented that accident because the pilots were not below the new rule’s thresholds. In any case, there is a clear precedent for legislators to take action when they perceive that the FAA isn’t doing what they feel is necessary.

I’m going to step out on a limb here and predict that someone—either the FAA or legislators—is going to push for new regulations allowing the FAA to tap pilots’ EMR data to see whether pilots are being honest on their medical certificate applications. I’m willing to bet that this is happening now, but we just haven’t been privy to these discussions.

Whether this is a good idea or not will not affect the push to make this happen. The fact that it would be a gross invasion of privacy will not affect those who think this is a good idea. We know from accident history that even full disclosure within the current system doesn’t always weed out the occasional pilot who collapses and sometimes even dies while in flight, but that will not stop efforts to tie EMR to aviation medical certification.

Technology is a boon to mankind, but it also contains the seeds of destruction of privacy. We’ve given up privacy in our use of social media and computers in general, but are we willing to allow the government to dig into our medical records as a means of potential accident prevention?

Don’t be surprised when this happens. It’s just a matter of time.