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Citation |
Kenedi CA, Appel JM, Friedman SH. J. Am. Acad. Psychiatry Law 2019; 47(2): 224-232. |
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Affiliation |
Dr. Kenedi is Assistant Professor, Departments of Medicine and Psychiatry, Duke University, Durham, North Carolina, and University of Auckland, New Zealand. Dr. Appel is Assistant Professor of Psychiatry and Medical Education, and Director of Ethics Education in Psychiatry, Mount Sinai School of Medicine, New York, New York. Dr. Friedman is The Phillip Resnick Professor of Forensic Psychiatry, Case Western Reserve University, Cleveland, Ohio, and Associate Professor of Psychological Medicine, University of Auckland, New Zealand. sjh8@case.edu. |
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Copyright |
(Copyright © 2019, American Academy of Psychiatry and the Law, Publisher American Academy of Psychiatry and the Law) |
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DOI |
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PMID |
31000576 |
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Abstract |
Confidentiality, considered a fundamental principle of medical ethics, is potentially at odds with public safety when an airplane pilot is experiencing symptoms of mental illness. Reporting requirements for pilots vary across the world, and pilots can be subject to multiple national regulatory authorities for international flights. Stigma exists about getting treated for depression. If one's livelihood and core sense of identity is placed at risk by seeking treatment, people will naturally avoid assessments and engagement with mental health clinicians, the very treatment that could mitigate risk. Suicide and homicide by aircraft are rare events and are difficult to predict, but the impact can be catastrophic. Variables other than mental illness, such as personality structure, occupational and relationship stressors, and coping mechanisms are also critical in conceptualizing risk in this population. Requirements for those employed in other methods of transportation are contrasted with those for pilots. Finally, legal and ethics concerns regarding reporting requirements for pilots are discussed and suggestions made. Language: en |