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After the A320 crash: Is relaxed patient confidentiality needed?

After the crash of a Germanwings flight in the French Alps, a debate has broken out over passenger safety in which the voices of employers are making themselves clearly heard. In the heated debate surrounding the co-pilot on the doomed plane, the German confederation of employers’ associations is demanding a relaxation of the rules on patient confidentiality. Are employers and management boards generally in favour of this position?

It is hard to say, as there has not been a serious survey conducted on this question. On the other hand, there are well-researched surveys backing up the widespread attitude of employees to the question of how to deal with mental health issues in the workplace: It is better not to tell your employer because doing so may risk endangering your career. Or because doing so has already harmed someone else’s. Or because you are afraid of losing friends.

These conclusions have not simply been pulled out of thin air as the results of a recent survey by the “Centre for Addiction and Mental Health” (CAMH) published in the International Journal of Occupational and Environmental Medicine shows. The research team headed by Carolyn Dewa found that four out of ten employees would choose not to inform their superior about mental health problems. Around 2,000 employees answered questionnaires for the study.

“Stigma is a barrier to people seeking help,” says Dr. Dewa. This is most likely an international problem – regardless of the employment regulations in force in the various countries. And, regardless of how the mental state of pilots in, for example, America or Europe, is assessed.

That is why it is so important to address the question of whether it would make sense to relax patient confidentiality in the manner proposed by Thomas Prinz, expert for employment rights with the Federal Confederation of Employer Federations, in the daily newspaper Der Tagesspiegel. Or whether it would have the opposite effect and prevent pilots with mental health problems from seeking the help they need.

Of course, safety has top priority. The provisional recommendation from the European Air Safety Agency (EASA) that two people should be in the cockpit at all times is a step in the right direction. Several European airlines have moved to introduce such a rule. We should also evaluate the effectiveness of such a rule in airlines where it has already been in force. Public debates on flight safety are both necessary and welcome after the deliberate downing of the Germanwings flight by the co-pilot. However, the debate should take all involved parties, studies and practical insights into account if false conclusions and knee-jerk reactions are to be avoided.

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Mental Health Problems

Passenger Safety

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Plane Crash