{"id":3795,"date":"2015-06-11T07:00:32","date_gmt":"2015-06-11T07:00:32","guid":{"rendered":"http:\/\/www.lifeandnews.com\/articles\/?p=3795"},"modified":"2016-08-30T23:27:32","modified_gmt":"2016-08-30T23:27:32","slug":"should-airline-pilots-have-less-medical-privacy","status":"publish","type":"post","link":"https:\/\/www.lifeandnews.com\/articles\/should-airline-pilots-have-less-medical-privacy\/","title":{"rendered":"Should airline pilots have less medical privacy?"},"content":{"rendered":"<p><a href=\"http:\/\/theconversation.com\/profiles\/carissa-veliz-161745\">Carissa V\u00e9liz<\/a><em>, <a href=\"http:\/\/theconversation.com\/institutions\/university-of-oxford\">University of Oxford<\/a><\/em><\/p>\n<p>Since it was revealed that Andreas Lubitz \u2013 the co-pilot who purposefully crashed Germanwings Flight 9525, killing 150 people \u2013 had been treated for psychiatric illness, a debate has ensued over whether privacy laws regarding medical records should be less strict when it comes to professions that carry special responsibilities.<\/p>\n<p>It has been widely argued that Germany\u2019s privacy laws were to blame for the tragedy. The Times, for example, <a href=\"http:\/\/www.thetimes.co.uk\/tto\/news\/world\/europe\/article4397392.ece\">headlined an article<\/a>: \u201cGerman obsession with privacy let killer pilot fly.\u201d Similarly, another article <a href=\"http:\/\/time.com\/3761895\/germanwings-privacy-law\/\">published in TIME<\/a> said: \u201cGerman privacy laws let pilot \u2018hide\u2019 his illness from employers.\u201d<\/p>\n<figure class=\"align-center\"><img src=\"https:\/\/62e528761d0685343e1c-f3d1b99a743ffa4142d9d7f1978d9686.ssl.cf2.rackcdn.com\/files\/77919\/width668\/image-20150414-24654-q4syup.jpg\" alt=\"\" \/><figcaption><span class=\"caption\">Medical records.<\/span><br \/>\n<span class=\"attribution\"><span class=\"source\">Record by Shutterstock<\/span><\/span><\/figcaption><\/figure>\n<p>While Dirk Fischer, German lawmaker and the transport spokesman for the Christian Democratic Union (CDU), <a href=\"http:\/\/www.nbcnews.com\/storyline\/german-plane-crash\/germanwings-crash-should-pilots-surrender-medical-records-n333776\">called for<\/a> airlines to have mandatory access to pilots\u2019 medical records, Frank Ulrich Montgomery, president of the German Medical Association (B\u00c4K), disagreed. Montgomery <a href=\"http:\/\/www.theguardian.com\/world\/2015\/mar\/31\/germanwings-plane-crash-insurers-compensation-costs-200m\">believes<\/a> that current laws are appropriate, since aviation doctors are already relieved of their duties of confidentiality if they think a pilot could put other people\u2019s lives at risk. If Lubitz\u2019s doctor did not alert Germanwings, it must have been because Lubitz did not seem like a threat.<\/p>\n<h2>Confidentiality and trust<\/h2>\n<p>There are two arguments for why Lubitz\u2019s doctor did the right thing by not disclosing Lubitz\u2019s depression to his employer. First, functional doctor-patient relationships depend on trust. If confidentiality between patients and doctors is breached, patients will no longer trust their doctors. And a lack of trust will lead (at least some) patients to hide some of their symptoms or refrain from seeking medical attention altogether for fear of bad consequences, such as stigmatisation and work-related penalties.<\/p>\n<p>More dangerous than a pilot with a mental illness \u2013 or any number of other professions that carry the responsibility of a great many lives \u2013 is that one with a mental illness who will not seek treatment because he does not trust his doctor.<\/p>\n<p>For these reasons, philosopher Kenneth Kipnis goes even further. <a href=\"http:\/\/www.tandfonline.com\/doi\/full\/10.1080\/15265160500506308#abstract\">He argues<\/a> that confidentiality should be \u201cfar closer to an absolute obligation that it has generally taken to be\u201d and that doctors should honour confidentiality even in cases where the patient might harm a third party. If patients come to doctors for help, doctors have a chance at avoiding a possible catastrophe. If patients lose trust on doctors and do not ask for help, nothing will be gained \u2013 patients will remain afflicted by their illnesses and people who might be put at risk by patients will remain at risk.<\/p>\n<p>In the days before the crash, Lubitz <a href=\"http:\/\/www.theguardian.com\/world\/2015\/apr\/02\/germanwings-crash-second-black-box-found\">searched<\/a> online both for medical treatments and for ways to commit suicide, which suggests he was undecided as to what to do. So another way of thinking about his scenario is that perhaps if he had trusted his doctor even more \u2013 and shared with him or her the way in which he was thinking of committing suicide \u2013 his doctor could have done more to help him and to protect the passengers of the aircraft he piloted.<\/p>\n<h2>What is relevant to reveal?<\/h2>\n<p>Lubitz\u2019s doctor also did the right thing by not revealing his depression to Germanwings because his depression was far from obviously related to his crime. Simon Wessely, the president of the Royal College of Psychiatrists and an adviser to the British army, <a href=\"http:\/\/www.theguardian.com\/world\/2015\/mar\/28\/germanwings-plane-crash-alps-depression-doctor\">said<\/a> that \u201cthere isn\u2019t a link between depression and aggressive suicide\u201d. J\u00fcrgen Margraf, psychologist and professor at Bochum University, likewise <a href=\"http:\/\/www.nbcnews.com\/storyline\/german-plane-crash\/germanwings-crash-should-pilots-surrender-medical-records-n333776\">told<\/a> NBC News that, given the sheer weight of numbers involved, you are far less likely to be harmed by a person with depression than by a person without depression: \u201cThe chances of killing others are higher for non-depressed than for depressed people,\u201d he said.<\/p>\n<p>Furthermore, given the lack of relationship between depression and the pilot\u2019s crime, it was not obviously in the public\u2019s interest to know about Lubitz\u2019s depression and morally questionable that his medical history of depression has been exposed so freely. In Germany, medical confidentiality is supposed <a href=\"http:\/\/www.wsj.com\/articles\/after-germanwings-crash-some-call-for-measured-response-to-medical-confidentiality-rules-1427818552\">to be valid after death<\/a>. Publicly disclosing Lubitz\u2019s ailment harms the public trust in doctor-patient confidentiality after death \u2013 and it may stigmatise people who are suffering from depression but who would never hurt anyone (but themselves).<\/p>\n<p>The avoidable deaths of 150 people is a calamity and it makes sense to have a public debate about how to prevent future similar events from happening. Luckily, breaching confidentiality and endangering relationships between patients and doctors is not the only answer.<\/p>\n<p>Along with the crucially important rule of having two people in the cockpit at all times (which violates nobody\u2019s privacy), one medical measure to avoid future catastrophes is to notify employers of stay-home orders from doctors for employees who have high-responsibility jobs without mentioning the cause of the incapacitation. Lubitz reportedly had a sick note for the day he flew but never told the airline. If they had been aware of the sick note things might have been different.<\/p>\n<p><img loading=\"lazy\" src=\"https:\/\/counter.theconversation.edu.au\/content\/39895\/count.gif\" alt=\"The Conversation\" width=\"1\" height=\"1\" \/><\/p>\n<p><a href=\"http:\/\/theconversation.com\/profiles\/carissa-veliz-161745\">Carissa V\u00e9liz<\/a> is DPhil Student in Philosophy at <a href=\"http:\/\/theconversation.com\/institutions\/university-of-oxford\">University of Oxford<\/a>.<\/p>\n<p>This article was originally published on <a href=\"http:\/\/theconversation.com\">The Conversation<\/a>.<br \/>\nRead the <a href=\"http:\/\/theconversation.com\/should-airline-pilots-have-less-medical-privacy-39895\">original article<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Carissa V\u00e9liz, University of Oxford Since it was revealed that Andreas Lubitz \u2013 the co-pilot who purposefully crashed Germanwings Flight 9525, killing 150 people \u2013 had been treated for psychiatric illness, a debate has ensued over whether privacy laws regarding medical records should be less strict when it comes to professions that carry special responsibilities. [&hellip;]<\/p>\n","protected":false},"author":40,"featured_media":7546,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[42],"tags":[],"_links":{"self":[{"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/posts\/3795"}],"collection":[{"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/users\/40"}],"replies":[{"embeddable":true,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/comments?post=3795"}],"version-history":[{"count":2,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/posts\/3795\/revisions"}],"predecessor-version":[{"id":7547,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/posts\/3795\/revisions\/7547"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/media\/7546"}],"wp:attachment":[{"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/media?parent=3795"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/categories?post=3795"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/tags?post=3795"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}