Should pilots have to go through tougher medical screenings?

Following a yearlong investigation into the fatal Germanwings crash caused by the flight's co-pilot Andreas Lubitz, French investigators have recommended more stringent medical screenings for pilots.

During the March 24, 2015, flight, Lubitz locked himself in the cockpit of the Germanwings Airbus A320-211 jet and adjusted the autopilot settings, causing the plane to descend rapidly until it collided with a mountain in the French Alps.

Lubitz had a history of depression and psychotic episodes leading up to the crash. A report released by the Bureau d'Enquêtes et d'Analyses pour la sécurité de l'aviation civile (BEA), a French aviation investigative agency, stated that Lubitz suffered a “severe depressive episode” in 2008 that included “suicidal ideation.” And in the weeks leading up to the jet crash, Lubitz was treated for psychosomatic and anxiety disorders, was referred to a psychiatric hospital for possible psychosis, and received prescriptions for various antidepressant and insomnia medications. Six days before the crash, Lubitz was placed on five-day sick leave by one of his physicians.

Lubitz’s doctors and relatives exercised their right of refusal to be interviewed by the BEA, but outside experts called on by the agency agreed that the pilot's medical history could point to a “psychotic depressive episode” lasting from late 2014 to the crash in March, 2015 as well as a possible personality disorder.

The BEA report concluded that the crash was solely caused by the “deliberate and planned action” of Lubitz and the failure of the medical evaluation process that could have prevented him from flying. Due to that failure, the BEA proposed that additional mental health training for aero-medical examiners be implemented and that, if a class 1 medical certificate – which Lubitz had renewed several times leading up to the crash – is issued to individuals with a history of psychological trouble, “conditions for the follow-up of his/her fitness to fly be defined.”

The BEA also found that data relating to mental health problems in pilots was hard to come by, because of aviation workers' reluctance to report possible issues and reporting restrictions due to medical confidentiality rules. The agency went on to discuss the conflict between such confidentiality and public safety, as the release or study of Lubitz’s medical information could have possibly prevented the crash.

The agency recommended the development of “clear rules to require health care providers to inform the appropriate authorities when a specific patient’s health is very likely to impact public safety” while still allowing for the principle of medical confidentiality.

“In Germany and in France, doctors are very attached to this notion of medical secrecy, but I hope there will be some moves there,” BEA director Remi Jouty told a news conference.

The BEA did not issue any suggestions for adopting a policy of having two people in the cockpit at all times or changing cockpit door specifications, two related issues that were considered to be factors in the crash.

Despite the recommendations, it remains to be seen if new policies will be put into place. And for relatives of the 144 passengers and 6 crew members aboard the Germanwings flight, the BEA report could seem like too little, too late.

“Some of the family members felt as if these BEA representatives were Lubitz's lawyers – making excuses as to why Germanwings didn't take action knowing what they knew,” said Robert Tansill Oliver, the father of one of the crash victims, to the Associated Press.

“How is it possible Germanwings would let a crazy guy fly a plane? He was mentally unbalanced, tremendously unbalanced,” he added.