Robert Klitzman Considers Airline Pilots as Medical Patients

Professor of clinical psychiatry Rober Klitzman wrote an essay for CNN on March 31 reflecting on the issues of reporting and confidentiality involving patients such as airline pilots. This piece, "What If My Patient is a Pilot?", reflected issues raised by the recent deliberate crash of a Germanwings jet by its co-pilot. Klitzman wrote,

The FAA requires that pilots self-report any diagnoses. But health care professionals have no obligation to notify anyone. They may know that a pilot has a medical problem that is poorly or not treated and may endanger passengers, but these providers have no obligation to do anything about it.

These issues are crucial, given that Andreas Lubitz deliberately crashed the Germanwings Flight 9525, killing 150 passengers. We still don't know why he committed suicide-murder, but the latest reports indicate he was treated for suicidal tendencies before getting his pilot license.

The Germanwings disaster has demonstrated that current standards of medical and psychiatric evaluation are inadequate. The FAA requires only that pilots fill out a psychological questionnaire, asking whether they have had psychological symptoms. But pilots are not assessed in person by a psychiatrist. Such face-to-face assessments can provide crucial information that self-report forms might miss, partly because pilots might answer inaccurately.