Primarily for general aviation discussion, but other aviation topics are also welcome.
#1593919
matthew_w100 wrote:
4535jacks wrote:Was this in reaction to a current diagnosis of migraines or a past history?

I was furious with myself, because I had another consultant's report also saying I was fine which made no mention of migraines (which were unrelated to the eye problem) which I could have used instead.

Which means I'm in the same boat as you; I'd like to do a CPL but can't.


:shock:

Anybody else as horrified about this as I am? I read this as "I can't fly commercially because I was careless and failed to let my AME continue to ignore a medical problem."

To quote an old boss of mine "Before taking any decision in aviation, always think of the subsequent Board of Inquiry".

In this case think of the discussion here where we were discussing the AAIB report saying "the pilot had a history of migraines that he had never declared" following, say, a loss of control in IMC.

Or even "the AME had been made verbally aware of this condition, but in contradiction of written instructions had not ensured that this was further investigated".

That, depending upon outcomes could be deaths, criminal prosecution, or a physician being struck off. Or Germanwings 9525 where an airline co-pilot and his doctors conspired to conceal a mental health problem from his airline and authorities.

G
#1593924
Genghis the Engineer wrote:Or Germanwings 9525 where an airline co-pilot and his doctors conspired to conceal a mental health problem from his airline and authorities.

G


I must have missed this in reading the French accident investigation report.

Could you point to the relevant bit where this was revealed?
#1593929
Flyin'Dutch' wrote:
Genghis the Engineer wrote:Or Germanwings 9525 where an airline co-pilot and his doctors conspired to conceal a mental health problem from his airline and authorities.

G


I must have missed this in reading the French accident investigation report.

Could you point to the relevant bit where this was revealed?

Just quoting Wikipedia...

The crash was caused deliberately by the co-pilot, Andreas Lubitz, who had previously been treated for suicidal tendencies and declared "unfit to work" by a doctor. Lubitz kept this information from his employer and instead reported for duty.


I don't know how medical ethics works so well as I do professional ethics for engineers, but my institution's ethics policy is very clear that public safety trumps client confidentiality every time. I can't see this any differently to my failing to notify an aircraft safety fault that I might be aware of.

And whilst I don't propose to give specifics here, I have done, albeit entirely openly - there's no benefit for doing such things behind anybody's backs.

G
#1593951
Ah, Wikipedia that bedrock of reliable information.

I am still not clear how a doctor 'conspired to conceal a medical condition' based on either the official information available or indeed Wikipedia.

Where is the evidence of that?
#1593968
Would you prefer "criminal incompetence"?

Physician and patient both knew that the patient presented a flight safety hazard; if the physician had spent significant time talking to his patient (inevitably under the circumstances I'd have thought) it must have presented itself as at least a risk that the patient would not notify his employer that he was unfit for work in a manner that could endanger the safety of the flight. By jointly failing to absolutely ensure that the pilot did not go to work - the two entered into a de-facto conspiracy. You don't need to huddle in a dark room and specifically agree something for it to be a conspiracy.

It cannot possibly be reasonable that a psychiatrist, knowing that somebody desperately wanted to keep his job, but was high-prob incapable of doing it safely, should be regarded as acting fully professionally in simply handing a "don't go to work" notice to the patient, with known suicidal tendencies.

And, lest we forget, 150 people died as a result.

Wikipedia is not, of course, an accurate source to the extent that the formal report was - but in this regard I think it is factually correct.

G
#1593996
Genghis the Engineer wrote:It cannot possibly be reasonable that a psychiatrist, knowing that somebody desperately wanted to keep his job, but was high-prob incapable of doing it safely, should be regarded as acting fully professionally in simply handing a "don't go to work" notice to the patient, with known suicidal tendencies.

G


Maybe you can give us the benefit of your wisdom and state what the doctor should have done, and the legal basis upon which whatever action you suggest, such action should have been taken.
#1594005
I have no legal knowledge on this whatsoever, and frankly the legalities are irrelevant.

150 people died, because a psychiatrist wasn't prepared after handing his patient a notice saying that because of his suicidal tendencies, driven partly by his concerns about losing his job as an airline pilot, wasn't prepared to also say "and, just to protect all concerned, I am going to notify LBA of this notice, given the nature of your job".

Let's think about the balance of that. Risk of disciplinary action for breaching patient confidentiality, versus risk of 150 people dying. That psychiatrist took the wrong call.

G
#1594011
In response to an earlier post yes I have just found out that they are on my childhood medcial record which are stored in a central archive somehere. I did not believe they were recorded as I my recollection of them is a bad headache with nausea so I have thought nothing more of them since childhood. However i requested copies to be sure and they recently arrived. For the past 17 years I have been using military medical centres hence why my notes are archived. My military medical record is clean with no mention of headaches or migraines because they stopped completely before joining up.
#1594013
4535jacks wrote:In response to an earlier post yes I have just found out that they are on my childhood medcial record which are stored in a central archive somehere. I did not believe they were recorded as I my recollection of them is a bad headache with nausea so I have thought nothing more of them since childhood. However i requested copies to be sure and they recently arrived. For the past 17 years I have been using military medical centres hence why my notes are archived. My military medical record is clean with no mention of headaches or migraines because they stopped completely before joining up.


I would therefore suggest if this is questioned during your class one medical then present your military medical record showing there has been no further history of such migraines, I am fairly certain the CAA would take a military medical record of 17 years as good evidence.
#1594015
Genghis the Engineer wrote:Anybody else as horrified about this as I am? I read this as "I can't fly commercially because I was careless and failed to let my AME continue to ignore a medical problem."

In this case think of the discussion here where we were discussing the AAIB report saying "the pilot had a history of migraines that he had never declared" following, say, a loss of control in IMC.

Or even "the AME had been made verbally aware of this condition, but in contradiction of written instructions had not ensured that this was further investigated".

G


Well those are interpretations, but they are not fair ones. We had discussed the matter, in detail, previously and in my AME's professional opinion my situation was quite acceptable. The CAA then changed the guidance - specifically mandating that visual disturbance be considered a "serious" migraine - with a concomitant requirement to follow a different path on the flowchart. My AME's professional judgement was unchanged but his discretion had been removed. At all stages we acted properly. The only issue is that i wouldn't have been aware that the guidance had changed and that the situation needed to be readdressed if i hadn't triggered re-consideration. We both remain convinced that I am not a danger and that the guidance is overly cautious. My AME is investigating the reasons for the change in guidance.

And don't be so sanctimonious about engineering ethics. All professionals use their professional judgement when making assessments. That's why you train to be a professional.

M_W100 C.Eng
#1594018
Genghis the Engineer wrote:I have no legal knowledge on this whatsoever, and frankly the legalities are irrelevant.

G


That you have no knowledge on the matter shows - and before spouting incorrect information and suggesting that someone was in cahoots with Lübitz, you should orientate yourself a bit or hold your tongue.

Legalities relating to who can share what with whom are very relevant.
#1594019
matthew_w100 wrote: I was furious with myself, because I had another consultant's report also saying I was fine which made no mention of migraines (which were unrelated to the eye problem) which I could have used instead.


Sorry, I misinterpreted that as you regretting not withholding relevant information from your AME. I was clearly mistaken.

G
Last edited by Genghis the Engineer on Tue Feb 27, 2018 6:59 pm, edited 3 times in total.
#1594024
Ethics are important to me too (also CEng IMechE) and as an Army Officer integrity is a value that I live by hence why I do not see withholding my medical history as an option.

I just want to know if a class 1 and commercial career is out of the question completely as it affects how I train now and what courses I choose to do. If getting a class 1 is possible but difficult then I will preemtpt this and see a CAA accredited neurologist) so I can fight my case during the medical.

I take some comfort that the CAA migraine flow chart says that pilots already holding a class 1 can regain an unrestricted class 1 once free of symptoms for 10 years because I can argue that the standard should be the same regardless of initial or renewal since the CAA has accepted the risk of reoccrance after 10 years is low enough to be acceptable. Interestingly I have found no research that proves that a history of childhood migraines increases the risk of migraines in adulthood.

I do hope that my military service will go in my favour as it shows that I can maintain good physical and mental health in very challenging environments. Most people I talk to seem think that if I am fit enough to serve then I should have no issues getting a class 1 but my experience of the CAA makes me question this!