President’s Corner, 4Q15, “Fitness for Duty and the Pilots’ Bill of Rights 2”

Fitness For Duty and the Pilots’ Bill of Rights 2

The FAA Administrator is due to release the recommendations of the FAA’s Pilot Fitness Aviation Rulemaking Committee (PF ARC) on the 22nd of December, after receiving inputs from a variety of aviation professionals and safety experts. The PF ARC focused primarily on pilot mental health issues, triggered in part by the Germanwings tragedy and other events in recent history. Recognizing that encouraging professional pilots to seek help voluntarily for medical and psychological issues with the support of their airline employers, the PFARC sought to optimize pilot health and enhance the safety of the flying public.

The Aerospace Medical Association (AsMA) recently released its updated recommendations on Pilot mental health that were endorsed by the European Society of Aerospace Medicine, the European Cockpit Association and the European Association of Aviation Psychology. The FAAPF ARC recommendations are likely to be similar to AsMA’s position paper.

The Pilots’ Bill of Rights 2 passed last week at the Senate Transportation; if passed by the House and signed by the President, it will give more pilots the opportunity to fly without the requirement to have a current medical certificate or interaction with an Aviation Medical Examiner with certain limitations. Its proponents claim that safety will not be compromised. The PBOR2 has included provisions that will help all pilots, including recommendations (but not funding) to streamline the special issuance process and expand the Conditions AME’s Can Issue (CACI) list of diagnoses. Perhaps the aspect most beneficial for safety and pilot health is the requirement to complete a free online educational course every two years related to aeromedical factors and medications that can affect flying abilities. This is consistent with two of the NTSB’s Most Wanted Items for 2015, Insure Pilot Fitness and Eliminate Impairing Substances in Aviation.

My major concern regarding the PBOR2 is that pilots may not recognize potentially impairing conditions or medications, nor will they seek prompt, thorough evaluations for medical concerns since in lieu of an AME examination, they must document visits to their physicians every four years.

My experience in the last 4 years with evaluating dozens of non-airline professional business jet pilots causes me concern. These pilots have been identified by their contemporaries or management as having substandard performance in the cockpit with the overwhelming majority of these pilots not recognizing the deterioration in their skills. Many deny their worrisome flying even when pointed out by fellow pilots who may have tried to compensate for these weaknesses in the cockpit until the deterioration was too egregious. If professionals in a two-pilot cockpit fail to recognize their own deficiencies, how can we expect a non-professional single pilot to evaluate their personal fitness to fly independent of outside medical or professional feedback?

Interestingly, most of the conditions discovered in my fitness for duty evaluations are not recognizable by the pilots by the nature of the disease. Approximately one third of the pilots have a previously unidentified medical condition as the cause of their flying deterioration, while one third have a psychological condition and one third have cognitive decline as the precipitating factor. Some have overlapping provocateurs. The good news is that the majority of these conditions can be identified and treated with the pilots safely returned to the cockpit and medically certified by the FAA. The bad news is that even with this group of highly trained professionals, they failed to recognize the deterioration in their flying abilities because of the condition or were simply in denial. Approximately 20% of the pilots elected to retire when a medical condition was identified or chose not to pursue an evaluation once identified as substandard performers by their fellow pilots.

The medical component of the PBOR2 is targeted to help those pilots who may have medical conditions that would preclude certification continue to fly without aeromedical oversight. My concern is that this is the population that may need the most oversight to keep them safely flying, even if they would be legal to fly. The PBOR2 may be amended by the House. Regardless of the final form, aviation insurers may be the ultimate arbiters of who is deemed safe to fly without aeromedical oversight.

Pilots are ultimately responsible for the safe operation of their aircraft. I believe aeromedical expertise is a critical component of a full complement of Aeronautical Decision Making tools. Even those pilots who may not be required to hold a medical certificate in the future should avail themselves to this expertise for their own health and safety and that of the flying public.

Happy Holidays and best wishes for a safe and productive 2016!

Stay safe and fly safely!

Quay Snyder