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User Name Thread Name Subject Posted
GUEST,Musket BS: A 'rights' issue? (82* d) RE: BS: A 'rights' issue? 15 Mar 16

The whole issue of occupational health is mired in legislative contradictions in just about any country. Also, for pilots to have their licences recognised in countries other than their own, international agreements need to be in place. (Sure, your licence was issued in Khazakstan, but you want to land your plane in Italy...)

This has meant employers asking would be employees to consent to giving them knowledge of their health that not only satisfied their national legal rights but us st s level that suits other countries too.

A minefield for the employer and employee then. But with consent, fairly straightforward.

Then we come to the doctors. First and foremost, away from any interpretation of the Hippocratic oath, we have the contract. If a doctor feels a contract compromises professional integrity, they should not take it on. They should be comfortable with what is being asked of them.

But are we talking of a doctor carrying out an assessment on behalf of an employer or a patient seeking a consultation with his doctor?

Conclusions? The doctor in question may well be referred to his professional body to review why knowledge of a psychotic episode wasn't disclosed to his customer the airline if the former, but the crash investigators have no remit in Germany or most countries for that matter to force a doctor to disclose details of the patient consultation itself in either case.

A doctor the patient sees in the course of day to day health has a duty to advise the patient to inform his employer of any condition or disclosure pertinent to his work.

The confusion in all the stories over this event seem to confuse the reader between a doctor working on an occupational health contract and a doctor seeing a patient at the patient's instigation. If a patient tells a doctor he will not heed the advice, a doctor can, in both Germany and here in The UK make a decision to disclose in the public interest, but based on professional judgement. Examples here would include informing DVLA of fitness to drive.

A doctor working in occupational health can and should have disclosed such information to his client. However, an occupational health doctor should also have the latitude to be able to say "unfit for the role on medical grounds" without disclosing why. (Here in The UK, we call it "Caldicott" or "need to know" basis.)

There may be questions for a doctor to answer, but crash investigators have a different remit. For them it's "did the employer act appropriately on medical assessment?" or in the case of the employer seeing a doctor outside of work "did the employee fail to disclose?" If there are concerns that a doctor knew the patient wouldn't disclose, then an outcome from the investigation could be to refer a doctor to his professional body. But such a subjective question posed to a doctor wouldn't help the investigation. "Yes, I do expect patients to act on my diagnosis."

I have not read anywhere that an occupational health doctor failed to take anything into account or that a doctor elsewhere had concerns that a patient would fail to disclose. The consultation in question was shortly before the crash. This whole story is based on whether a doctor expected a pilot to carry out his professional obligation. There are protocols for dealing with such an event.

By the way, with regard to the OP, there were no "doctors" involved but there are doctors.

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