The Germanwings disaster in which the pilot deliberately crashed a plane carrying 150 people into a mountainside was shocking. The results of the just-released investigative report are shocking as well.
What has now emerged is that Germanwings co-pilot Andreas Lubitz had a long history of serious personal problems, and that only two weeks before the crash a doctor had recommended that he be treated in a psychiatric hospital.
Yet, neither the unidentified private physician, nor any of the numerous others he had consulted before that, informed aviation authorities or his airline about his illness. The report said that he had been suffering from a “psychotic depressive episode” that started in December 2014. When he entered the cockpit on the day of the crash, March 24, 2015, he was either still under the influence of that episode, or was in the grip of another.
European aviation authorities are now en route to a relaxation of the privacy rules which kept such vital information about a suicidal pilot from the airlines. France’s BEA air accident investigation agency, which authored the report, has recommended to the World Health Organization and European Commission a revision of the rules in order that doctors will inform authorities when a patient’s illness could endanger public safety; if necessary, without the patient’s consent.
We might expect that all the parties involved in ensuring safe air travel would hasten to agree to such changes, in order to lessen the chances of another disaster like this occurring as a result of trying to protect the privacy of a single individual.
Think again. The biggest pilots’ union in France is not ready to support a more balanced system in which privacy would be weighed against public safety.
“If medical confidentiality becomes too flexible, if a pilot can lose his job and see his medical secrets become public, some pilots won’t seek treatment,” Yves Deshayes, the union vice-president said. Instead, the union suggests better follow-up on pilots’ health and a system that would let pilots with psychological issues disclose their conditions to colleagues first, Deshayes said.
This is a pragmatic position, and it is likely that union opposition would be withdrawn if adequate compensation is provided for pilots who are disqualified from flying due to psychological issues. That, and sufficient public pressure.
But the existing system, which enshrines doctor-patient confidentiality, and the reluctance in Europe to change it, is also rooted in history. In Germany in particular, the extreme measures for safeguarding privacy derive at least in part from a reaction to the pervasive government surveillance under Communism in East Germany and during the Nazi era. As a result, official probing into private matters is generally avoided.
Ironically, the insistence on privacy at almost any cost, even, as in this case, at the cost of human life, is itself an example of a desire for freedom crossing the line back over to fanaticism. The privacy rules which enable a single patient to consult freely with a doctor for the sake of healing — justifiable and vitally important in itself — becomes an insurmountable barrier to divulging information which imperils the lives of many.
A delicate and careful balance must be found, one that will ensure that patients will feel comfortable to confide in doctors, but also doing everything possible to protect the lives of the innocent.
The release of the BEA report has reignited the grief and outrage of relatives of people killed in the crash. They charge that Lufthansa, the parent airline of Germanwings, did not live up to its responsibility to do everything possible to protect the safety of its passengers.
Furthermore, they are angry that doctors who knew of Lubitz’s potentially dangerous depressions refused to speak to investigators, again citing patient confidentiality.
We can only speculate as to why the doctors continue to insist on silence in the matter. Is it because they consider that, even in light of the tragic consequences of their confidentiality, some information remains privileged? Or is it because they are so ashamed of their failure to grasp the fact that disclosing the patient’s mental state was a matter of life and death that they will not discuss it with anyone?
We hope it is the latter. And that the air authorities and the pilots in Europe will also be stricken with sufficient remorse that it will lead them not only to a revision of the privacy rules, but a revision of their understanding of morality.