Doctor-Patient Privacy vs Public Safety

Airline staff including pilots have the highest rate of alcoholism out of all professions. It's not uncommon for pilots to drink and fly. Ask anyone who works in the insurance industry and they'll verify this.

People's preexisting conditions don't speak to their functionality. There are functional addicts and non functional ones, just like with depression, or any other illness.

You're not entitled to my personal medical info just because of the kind of job I perform. If people are driving planes into mountains on purpose we should be questioning the health of our society, not taking away more privacy rights.

Only doctors can determine functionality, not the armchair medical peanut gallery who watch Dr. Oz and think they know medicine. Piss off.

clownboy said:

To be fair, legal confidentiality has a few exceptions as well.

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I know. I'm an attorney.

A lawyer must disclose criminal activity if they are aware of it.

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Sometimes. It's more complicated than that.

As a lawyer you can ignore the feeling that your client is probably guilty, but if they present you with evidence of their guilt you cannot rely on the shield to protect you if you get caught calling them innocent and failing to disclose. Lawyers will tell you, "I don't want to hear that".

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No, you don't actually have to think that your client is innocent to defend them. Nor do you have to tattle on a client who is guilty of a crime. If you did, then clients would always hide information from their attorneys and sabotage their own defense, and attorneys would have to focus on protecting themselves while defending criminal defendants, rather than serving their clients.

It's the same for doctors. If a doctor wasn't prevented from disclosing the problems of their patients, a lot of patients would lie to them. It would undermine the integrity, and thus the usefulness, of the profession.

As far as I know, this is the first time something like this has happened. In nearly 100 years of commercial flights, we've had a single incident. How much privacy are you willing to sacrifice to stop one incident every 100 years? Personally, I'm not willing to sacrifice much at all. I don't expect to live in a crime-free world, and a type of crime that occurs once every 50 years, or indeed even 30 or 40 times that amount, is a crime not worth sacrificing much to end. Sure, the sacrifice may not seem like much since I'm not a pilot, but that can be said about any career I don't belong to. What if others made decisions limiting the rights of those in my career field? I wouldn't sacrifice anyone's privacy or confidentiality to address this incident, even if it were happening far more frequently than it is.

I think the current system is fine. The mental health community typically takes a "clear and present danger" approach. If you tell your mental health worker that you fantasize about mass murder, they will likely take no action. But if they discover that you have taken concrete steps such as: having an actual plan, purchasing the necessary weaponry, or choosing a specific date, you can expect to be involuntarily committed (which will naturally, get the legal system involved).

As a psychotherapist, I am bound by the client-counselor confidentiality rule. It is essential for the relationship and for treatment to be effective, considering that honesty and openness best fosters help. If I don't know what's going on, I cannot effectively treat the client. That being said, if I make the determination that either the client themselves, or other people are in imminent danger due to the client, I have a duty to warn either the potential victims, law enforcement, or of the danger is of self-harm, a family member to assist in creating safety for the client. These are the only reasons of which I can breach confidentiality. I have breached confidentiality on a few occasions for just these reasons.

CrabCake said:

As far as I know, this is the first time something like this has happened. In nearly 100 years of commercial flights, we've had a single incident. How much privacy are you willing to sacrifice to stop one incident every 100 years? Personally, I'm not willing to sacrifice much at all. I don't expect to live in a crime-free world, and a type of crime that occurs once every 50 years, or indeed even 30 or 40 times that amount, is a crime not worth sacrificing much to end.

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There have been a few other cases; however, I agree, not enough to give up our privacy.
A brief history of pilots deliberately crashing planes – Quartz

In a 2013 incident that resembled the Germanwings crash, a Mozambique Airlines flight was brought down deliberately by one of the pilots. The other pilot was locked out of the cockpit and pounded on the door, trying to gain entry. All 33 passengers aboard were killed.

In 1999, an EgyptAir flight from New York to Cairo crashed in the Atlantic Ocean—the prevailing theory is that the pilot intended to bring down the plane, killing 216 passengers in the process.

A 1997 Silk Air flight from Indonesia to Singapore crashed following a rapid descent, killing 104 people. Indonesian authorities never determined an official reason for the crash, but the US NTSB suggested it may have been the result of a pilot suicide.

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Why would we stop at pilots? anyone who could kill people because they were depressed could be impacted....taxi drivers, bus drivers, heck, even us private auto drivers. Or operators of construction equipment. Or ferry boat pilots...

I think, although it goes tragically wrong sometimes, our current system is a decent balance between privacy and risk

CaptainCourtesy said:

As a psychotherapist, I am bound by the client-counselor confidentiality rule. It is essential for the relationship and for treatment to be effective, considering that honesty and openness best fosters help. If I don't know what's going on, I cannot effectively treat the client. That being said, if I make the determination that either the client themselves, or other people are in imminent danger due to the client, I have a duty to warn either the potential victims, law enforcement, or of the danger is of self-harm, a family member to assist in creating safety for the client. These are the only reasons of which I can breach confidentiality. I have breached confidentiality on a few occasions for just these reasons.

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Hey CC, I am interested in your take on this case from the point of view that people seem to be equating Clinical Depression to Suicide to this act. In my opinion, Clinical Depression is an internalising illness and unlikely to result in a suicide where there is intent to also kill other people. I believe that it is media laziness leading to labelling this as Clinical Depression, I would value your thoughts on this.

William Rea said:

Hey CC, I am interested in your take on this case from the point of view that people seem to be equating Clinical Depression to Suicide to this act. In my opinion, Clinical Depression is an internalising illness and unlikely to result in a suicide where there is intent to also kill other people. I believe that it is media laziness leading to labelling this as Clinical Depression, I would value your thoughts on this.

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Clinical Depression CAN result in suicide, but this is not a given. Also, you are correct in that Clinical Depression in and of itself would be very, VERY unlikely to result in a suicide attempt that also harms others in the way that this person did. I would guess that there were other mitigating factors involved, probably some sort of personality disorder. Suicide attempts, true ones, tend to be very isolating. This was pretty dramatic. Depression this severe often causes one to collapse onto themselves, figuratively. It is more likely that they would choose a suicide method that would not physically involve someone else.