Seeking medical cert help!!

[PeterNSteinmetz]

Avoiding being subject to a regulation does not make that regulation non-coercive. It just means that it doesn't apply to you.

...
In essence, my argument is that there is no such thing as a non-coercive regulation, and therefore the repeated characterization of a particular body of regulations as "coercive" seems like a red herring.

Ok, if it is in your view a red herring, then do you really want to continue the discussion on that point presently? I don’t think it matters a bit to the meaning of the actual arguments with respect to the efficacy of aeromedical regulations.

I suspect there is some point where we are not understanding each other about this, but it is not important to the main subject here. If you like, perhaps we can discuss further in a separate thread at a later time.

 

[Stan Cooper]

Proposing "experiments" especially with medical criteria is an interesting and perhaps wonderful mental exercise that will never happen. But let the games continue!

Jon, offhand I can think of at least two proposed experiments involving medical criteria that have been codified and have proven successful so far:
1) sport pilot certificate using a valid driver license in lieu of an FAA medical certificate, and
2) BasicMed as an alternative to a third class medical certificate

 

[mryan75]

The results of the review showed that sport pilot accidents were caused by medical incapacitation 3.7% of the time, while private pilots with Class 3 medicals had accidents that cited medical incapacitation 2.5% of the time. Medical incapacitation represents either a probable cause or contributing factor in aviation accidents less than 5% of the time. The author concluded that although there is a slightly higher rate where the NTSB cited incapacitation among pilots not receiving regular aeromedical evaluations, the difference was not statistically significant.

I'm no statistician, but I'd consider a 50% higher rate of incidence to be statistically significant. Furthermore, I'd love to see the per 100,000-hours flown rate for both. I'll eat my sneakers if it doesn't show an extraordinarily higher per rate for sport pilots, given the above.

 

[mryan75]

I'm not buying this so-called distinction. I was under the impression that ALL agreements were backed by contract law. Furthermore, just like you voluntarily agree to purchase a house, you voluntarily decide to become a pilot. However, under that logic, ALL regulation of pilots would be "non-coercive."

Sounds like you can't actually show me an example of a real-life "non-coercive" government regulation as you use the term.

I'm glad someone else took this up. The short answer is that "libertarians" find all laws they disagree with coercive and offensive to their existence, and laws they agree with are perfectly fine, even if they strongly burden others. It's a philosophy of convenience.

 

[Kenny Phillips]

I'm glad someone else took this up. The short answer is that "libertarians" find all laws they disagree with coercive and offensive to their existence, and laws they agree with are perfectly fine, even if they strongly burden others. It's a philosophy of convenience.

Oh, please. If that's the case, then the holder of those beliefs certainly isn't libertarian.

 

[mryan75]

Oh, please. If that's the case, then the holder of those beliefs certainly isn't libertarian.

I agree entirely. Most people who call themselves libertarians wouldn't know a libertarian if one kicked them in the jewels.

 

[mryan75]

Ok, but what standard of evidence should be applied to determine whether enforcement of the regulation is justified ? Or necessary?

Here's what gets me: why do you assume no such evidence exists? Because clearly you don't believe it does. Either that or you have done absolutely zero research on the matter (which is, of course, entirely possible). I just took a half hour and with two google searches learned about the history of aeromedical research and certification in the United States dating to 1912. We have had aeromedical research centers conducting research on human and medical factors in aviation since 1926. Much of the early research centered on military aviation. The idea that this is all just voodoo and has no impact on safety is just preposterous. The earliest research was done on hypoxia and he effects of altitude, which resulted in regulations on oxygen use. Guess what made them look into that?

It's actually quite a fascinating history. And it's astounding to me that someone who claims this is all pointless and irrelevant apparently doesn't know anything about it.

 

[PeterNSteinmetz]

Either that or you have done absolutely zero research on the matter (which is, of course, entirely possible).
...
It's actually quite a fascinating history. And it's astounding to me that someone who claims this is all pointless and irrelevant apparently doesn't know anything about it.

Firstly, please don't start making assumptions about what I do and do not know. Particularly apparently without having checked my CV, which is available online. These really are a form of personal attack because they are raising characteristics of the speaker. I do believe you when you say that you are astounded based on your current knowledge, so I will let the attack aspect of it go this time. I will attempt to explain some of the reasons that what you have cited there does not address my arguments in this thread in a following post.

I agree these are interesting questions and there is a lot of fascinating history. I'm glad you have enjoyed looking into some of it.

 

[PeterNSteinmetz]

I just took a half hour and with two google searches learned about the history of aeromedical research and certification in the United States dating to 1912. We have had aeromedical research centers conducting research on human and medical factors in aviation since 1926. Much of the early research centered on military aviation. The idea that this is all just voodoo and has no impact on safety is just preposterous. The earliest research was done on hypoxia and he effects of altitude, which resulted in regulations on oxygen use.

I don't believe I ever tried to argue that "this is all just voodoo" -- so the straw man fallacy there. Indeed, the regulations regarding the use of oxygen appear to be based on good science in the aeromedical and other fields of high altitude research.

My argument has been that there is no good data or research to show that the regulations of aeromedical certification of pilots have an overall positive effect on the safety of the traveling public. The only data which has been adduced so far in favor that it does is the study which @Stan Cooper kindly posted a reference to. It does show a small effect in absolute terms which failed to reach statistical significance. (Statistical significance is determined by the size of the samples, the deviation amongst the observations, and the magnitude of the effects, not by someone just considering it to be because of the size of the effect.) There are various possible problems with that study -- that it just looked at the rate of medical certification in fatal accidents rather than estimating actual overall rates; that it did not apparently account for age differences, which almost certainly impact the rate of medical incapacitation, etc. Those weaken further, beyond the lack of statistical significance, the ability to use that to conclude that medical certification, per se, improves the safety of the traveling public.

So the lack of statistical significance in the one small and somewhat poor study is one (not entirely technically correct) argument that there is no positive effect on traveler's safety of such regulations. The others are more general as I have noted at length in posts above which I believe you read previously.

The question thus comes down to how much evidence should there be in order to justify the use of government regulation? -- to make people do things they might otherwise not want to do through the threat or use of physical force? In cases where the evidence is mixed, the answer to that will determine how one views policy. That is why I asked @Palmpilot what his standard was. He has not responded. What is the standard of evidence you think should apply? Is a hunch good enough? Some weak data that means it may possibly be true? The preponderance of evidence? Clear and convincing evidence? Proof beyond a reasonable doubt?

Depending on the answer to that question about the standard of evidence, in the presence of weak data, reasonable people will disagree. The more interesting discussion from a policy perspective is then which standard of evidence to use.

 

[PeterNSteinmetz]

I'm no statistician, but I'd consider a 50% higher rate of incidence to be statistically significant. Furthermore, I'd love to see the per 100,000-hours flown rate for both. I'll eat my sneakers if it doesn't show an extraordinarily higher per rate for sport pilots, given the above.

Agreed the rates would be a much better piece of evidence, though can be hard to estimate because the denominator is difficult to obtain.

Given the existing data, I personally wouldn't offer to eat my sneakers, they probably taste pretty bad.

What could be done here is to go back and try to expand the dataset to get the ages of the pilots in those incidents to do an age adjustment and see if the difference continues to exist under those circumstances. If you are seriously interested in that, I am willing to help, but will ask that you do a fair amount of the work in the data gathering aspects.

 

[Palmpilot]

This is why I ask about the standards of evidence required for enforcing such regulations. Thus casting my query in the other light, how much evidence do you think should be required to enforce an aeromedical regulation? Is a good hunch sufficient? Some suggestive data? A preponderance of evidence they will reduce clear and present danger? Clear and convincing data that it will reduce a clear and present danger? Proof beyond a reasonable doubt?

That is why I asked @Palmpilot what his standard was. He has not responded. What is the standard of evidence you think should apply? Is a hunch good enough? Some weak data that means it may possibly be true? The preponderance of evidence? Clear and convincing evidence? Proof beyond a reasonable doubt?

The reason I didn't respond is that I don't have an opinion on that, and formulating one would would require more time than I am willing to devote to the subject.

 

[PeterNSteinmetz]

The reason I didn't respond is that I don't have an opinion on that, and formulating one would would require more time than I am willing to devote to the subject.

Fair enough and an honest response. It just means that it is hard to debate the policy implications of the available weak evidence. My invitation stands. I am willing to try and help improve the evidence if people want to pitch on the data gathering side.

 

[denverpilot]

In essence, my argument is that there is no such thing as a non-coercive regulation, and therefore the repeated characterization of a particular body of regulations as "coercive" seems like a red herring.

This is waaaaay off-topic for the thread, but one could make a distinction of HOW coercive a regulation is.

A regulation that allows a tax-break for a desired public behavior is coercive, but not as much as something you'll be fined for, or arrested for, or just plain shot legally for by law enforcement or the military ... for example.

Coercion is a spectrum. Everything from a suggestion to threatening or taking a life. Government uses the entire spectrum, depending on how many people agree and what it thinks it can get away with.

If you want to say it's not a "regulation" that allows the tax-break, mmm-kay, but I would disagree.

Just a thought - not hanging out in this thread. But we could also discuss laws intended to entrap folks who do other bad things, but are never otherwise enforced -- the threat of enforcement has to be real, or the words are meaningless.

 

[Palmpilot]

Fair enough and an honest response....

Why would anyone care enough to lie about their opinions on a message board?

 

[PeterNSteinmetz]

Why would anyone care enough to lie about their opinions on a message board?

Don't know either. I suspect there are a lot of people that rather than admitting they don't have the time presently to think carefully about something and come to a reasoned opinion, would just spout off whatever. I imagine we could both find some examples of that.

 

[Palmpilot]

...admitting they don't have the time presently to think carefully about something and come to a reasoned opinion....

That would only represent an 'admission' in a person's mind if they considered spending time on a particular subject to be some kind of moral obligation. It isn't.

 

[PeterNSteinmetz]

That would only represent an 'admission' in a person's mind if they considered spending time on a particular subject to be some kind of moral obligation. It isn't.

I guess some might interpret it that way, which might account for some people's reluctance. Though certainly that was not how I intended the meaning. Here's a definition - "ad·mis·sion noun 1. a statement acknowledging the truth of something." So doesn't always mean something like admitting guilt or a moral failure. Clearly I agree that there is no obligation of any kind for someone to spend time on a subject. OTOH, I guess I would argue that just spouting off nonsense is not a good thing to do, though a fault easily dealt with by ignoring such people.

 

[Palmpilot]

...Clearly I agree that there is no obligation of any kind for someone to spend time on a subject....

I'm glad to see you admit that.

 

[vman]

Several evidentiary issues here. In general, the burden of proof is on the party asserting existence. Is there any evidence that the FAA’s aeromedical regulations improve the safety of flight? None has been presented so far. As noted, it is very difficult to prove a negative (that is - has no such effect), which is why such a general burden of proof exists.

OTOH, there is a presumption for the status quo, especially when proposing making changes. I think in this case that would suggest careful studies (which so as we can tell, have never been performed) and proceeding carefully.

The fact that we have in the US the safest commercial air travel certainly suggests something works well in terms of safety. But that in and of itself does not mean the FAA or government regulations are responsible. There are myriad possible causative factors. Indeed, it appears that a primary factor has been improved procedures and training. A government bureaucracy attempting to ensure medical safety may have little or nothing to do it.

A good reason to consider this more carefully is that there is a large body of work on the inability of coercive regulations to achieve their intended effects generally. This is often due to unintended consequence of the coercive regulations.

In terms of aeromedical regulations, this would be the many pilots who may avoid receiving medical care because they don’t want to jeopardize their medical certification. Since the number of such pilots may vastly exceed the number of pilots such as the GermanWings pilot, the negative consequences of the former’s behavior may exceed those of the latter group. In that case, the regulations, while well intended, would actually _decrease_ safety overall.

These can be treated as empirical questions, but have not been due to strong emotional reactions to high profile disasters.

In general I would certainly agree that passengers on commercial airliners deserve not to have pilots having psychotic reactions in the cockpit. I just am not convinced a coercive regulatory regime is the best way to achieve that. It may be better to have a greater role for market forces.

As to “my opinion is iron-clad”, please correct me if I am mistaken, but that would seem to suggest your views are fixed and not amenable to facts or reason. Is that correct? If so, I don’t imagine this or further discussion will be of interest. Apologies then, but hopefully my thoughts may have been of interest to other readers.

i doubt i'm the only one

 

[vman]

Also, the goal here can’t be perfection. Yes, some people will be blocked from chasing their dreams. And yes, some people who shouldn’t be flying will sneak through the cracks. But neither is a reason to change a system that on whole has worked extremely well. We haven’t had a major aviation accident in this country in what, 12 years? Works for me.

major?

i wouldn't call this one minor
https://en.wikipedia.org/wiki/Asiana_Airlines_Flight_214

 

[vman]

The fact that we have in the US the safest commercial air travel certainly suggests something works well in terms of safety. But that in and of itself does not mean the FAA or government regulations are responsible. There are myriad possible causative factors. Indeed, it appears that a primary factor has been improved procedures and training. A government bureaucracy attempting to ensure medical safety may have little or nothing to do it.

the faa is ultimately responsible for the current max 737 fiasco

 

[Greg Bockelman]

Yeah but that was a foreign carrier operating under their rules and as far as I know, it had nothing to do with medical issues. Apples and oranges.

 

[vman]

that one also touched on the faa & their decision making
https://en.wikipedia.org/wiki/Asiana_Airlines_Flight_214

The NTSB reached the following final conclusion:
Contributing to the accident were (1) the complexities of the autothrottle and autopilot flight director systems that were inadequately described in Boeing's documentation and Asiana's pilot training, which increased the likelihood of mode error;

 

[jonvcaples]

Also, the bottom line is our feelings, judgement, and interpretation really do not count. However, those of the FAA, NTSB, etc. do count and all that matter. So ultimately we are subject to their decisions and actions.

Medical issues are almost irrelevant in terms of safety of flight. The drivers are equipment, maintenance, training, and operating rules. Part 91 is so loose (compared to 121) that it actually sets pilots up by giving us so much rope a few of us hang ourselves every year. As an example, can you depart under part 91 if the weather is below minimums for the departure field? Yes and you do not have to have an alternate. Under part 121 you must be able to shoot an approach at the departure field or have an alternate.

91 is pretty loose goosey, not documented and virtually never examined.

121 is extremely well defined and documented. The documentation will show that you should have been able to complete a flight with adequate safety margins. And, said documentation is frequently reviewed on an ongoing basis. Even though the flight went off without a hitch a minor error in the paperwork can trigger a violation.

Hope this provides some useful info.

Be legal, smart, and safe!

 

[mryan75]

Firstly, please don't start making assumptions about what I do and do not know. Particularly apparently without having checked my CV, which is available online. These really are a form of personal attack because they are raising characteristics of the speaker. I do believe you when you say that you are astounded based on your current knowledge, so I will let the attack aspect of it go this time. I will attempt to explain some of the reasons that what you have cited there does not address my arguments in this thread in a following post.

I agree these are interesting questions and there is a lot of fascinating history. I'm glad you have enjoyed looking into some of it.

Yes, this conversation is just oh so important to me that looked up your CV online before posting, your eminence.

 

[mryan75]

What is the standard of evidence you think should apply? Is a hunch good enough? Some weak data that means it may possibly be true? The preponderance of evidence? Clear and convincing evidence? Proof beyond a reasonable doubt?

First of all, you're the one making the allegation. Prove it. Upon what do you base your allegation that this is based on "weak data" and "hunches"? Stop asking everyone else to do your work for you. It's cheap rhetoric. It's like arguing with a lazy student. You make the statement, you back it up.

It's actually you that is making an unfounded, baseless argument here, not anyone else. You're playing rhetorical and semantic games, trying to twist the burden of proof to others. Why is that? Back up what you claim. It's not my, nor anyone else's job to refute a claim you refuse to support.

 

[PeterNSteinmetz]

Upon what do you base your allegation that this is based on "weak data" and "hunches"?

Please see post #89, which lays that out in detail, including how one might interpret a result like this which failed to reach statistical signficance. If you want to discuss that study from a scientific perspective, please lay out a case how it supports the proposition that FAA aeromedical certification improves the safety of flight, or adduce other actual data to support that proposition.

And as previously noted, saying "I think the effect size is large so it must be significant" is not a valid statistical or scientific argument. Saying "there are a whole bunch of studies about oxygen requirements" or some other unrelated aeromedical issue also is not a valid argument for the proposition above.

The way this whole discussion started was that I asked "Is there evidence that FAA medical certification improves the safety of flight, perhaps for commercial pilots?". The only actual data which has been adduced here is the study which failed to failed to reach significance. I would say that in answer to my question that is either no data (the more technically precise interpretation of such a failure to obtain a statistically significant result) or rather weak data if one wants to simply try and estimate the means. Is there some other data that can be adduced here -- we haven't seen it posted despite much discussion and a fair amount of searching by several of the participants.

Please also note that I never said that dataset was just a hunch. Rather I asked a question about the interpretation of such data in terms of policy. Near the end of post #89 I asked a general question about what you thought about policy and what sort of evidence is needed to justify a government regulation. Without an answer to that general question, it really is not possible to meaningfully interpret this evidence in terms of its policy implications. So if you don't wish to answer that, that is fine, but I don't see any point in our having a further discussion about the policy implications.

 

[jonvcaples]

To some degree this whole area is akin to arguing about how many angels can stand on the head of a pin. Once a regulation is enacted it exists and must be recognized. Admittedly, there are some stupid rules and regulations that should be stricken and, until they are, ignored. The city where I grew up had (probably still does...south GA turn your clock back a few decades) a city ordinance requiring horseless carriage drivers before starting the engine to have someone stand in the street behind the vehicle in order to look for and warn people on horseback.

Kind of amusing but the point is obey the law or be prepared to suffer. Last point, the IRS says paying income tax is voluntary. But see what happens if you do not comply. Like, don't like it neither matters. To quote Viper, "Lt Mitchell, the rules of Top Gun exist form the safety of you and your team. Obey them or you are history." Remember, Al Capone went to jail for tax evasion.

 

[PeterNSteinmetz]

To some degree this whole area is akin to arguing about how many angels can stand on the head of a pin. Once a regulation is enacted it exists and must be recognized.

The point regarding what we have to practically comply with is a good one. Nonetheless, I think it can be fruitful to consider how things might be improved -- that is how the world gets better.

I don't agree with the argument about angels. Those are imaginary beings so any such discussion is inherently not going to be based on reality. I think we can at least ask that what the government is doing be based on actual facts and be well grounded. Particularly since what the government does with regulation inherently is forcing some people to do something they might otherwise not want to do.

I would agree that unfortunately much of our current regulatory structure is not well based on facts or good policy. I would also agree that it is very difficult to change. But some of us like to keep trying for rationality, despite that fact.

 

[jonvcaples]

Peter,

Some of us do believe in angels and many other things that cannot be explained, contained, or measured. You are totally on target about working to improve things. Right there with you 100%! We should all push for better.

Unfortunately, we have too many idiots like Bo (parked a Bonanza in Half Moon Bay, CA) who stupidly disregard everything but their own short sighted self serving agenda. To borrow a phrase the emperor is naked.

 

[PeterNSteinmetz]

Finally, I will once again reiterate my offer. If participants are interested in better understanding this issue, versus just spouting opinions, I am willing to help with a re-analysis of an expanded version of this dataset, including controlling for some possible confounds. Might actually be publishable. I contacted the author but he says the prior dataset may not be available electronically, so it would be some work to regather the information from the NTSB reports. I am not going to do that myself as I already have other side projects. But if others want to help with the data gathering aspects, I am happy to do a share of the work.

 

[mryan75]

The way this whole discussion started was that I asked "Is there evidence that FAA medical certification improves the safety of flight, perhaps for commercial pilots?". The only actual data which has been adduced here is the study which failed to failed to reach significance. I would say that in answer to my question that is either no data (the more technically precise interpretation of such a failure to obtain a statistically significant result) or rather weak data if one wants to simply try and estimate the means.

Okay, fine. The answer to your question is "yes":

Findings from this study indicate that pilots without an FAA medical certificate who were fatally injured in accidents were more likely than pilots with at least a third-class medical certificate to have toxicological evidence of recent use of drugs, potentially impairing drugs, drugs that indicate a potentially impairing condition, controlled substances, and illicit drugs. The study findings further indicate that accident pilots conducting 14 CFR Part 121 and Part 135 operations subject to DOT mandatory drug and alcohol testing requirements for safety-sensitive aviation personnel were less likely than those conducting general aviation operations to have toxicological evidence of recent use of drugs, potentially impairing drugs, drugs that indicate a potentially impairing condition, controlled substances, and illicit drugs. Therefore, the NTSB concludes that FAA medical certification requirements and DOT mandatory drug and alcohol testing requirements for safety-sensitive aviation personnel have been associated with fewer toxicological findings of impairing drugs and conditions among accident pilots subject to those requirements. Conversely, these results suggest that allowing pilots to fly without a medical certificate could contribute to an increased risk of pilot impairment while flying because study pilots without an FAA medical certificate were more likely to have toxicological evidence of impairing drugs and conditions.

https://www.ntsb.gov/safety/safety-studies/Documents/SS1401.pdf

And of course I have no doubt that there is plenty more such evidence - plenty more.

This took me ten mines to find. Which again brings me back to the question: how can someone who is truly interested in this question not be aware of a pretty definitive answer which took someone who is not interested in this question (only because the answer is patently obvious and I don't like wasting my time) ten minutes to find? My guess is that you haven't looked for an answer to the question because you would much rather keep believing your own opinion rather than finding out you were wrong. Which of course presupposes that you knew you were wrong, which I can only imagine is the case. Because however uninformed, you don't seem dumb.

 

[mryan75]

Here's an even more fascinating study:

Results: Eighty percent (5,872) of the 7,317 AMEs had zero fatalities, and 876 of the AMEs (12%) had only 1 fatality in 10 years. One AME had 25 fatal pilots involved in aviation accidents during this 10 year study.

https://www.google.com/url?sa=t&rct.../AM16-07.pdf&usg=AOvVaw0l77qtCcrMHc26q99Xf_hL

So 92% of the AMEs surveyed had 1 or 0 fatalities over a 10-year period, and one guy had 25. He either had some seriously bad luck, was someone who dealt with extremely tricky cases (and should promptly be removed from such duties), or he was the AME that all the pilots with otherwise disqualifying conditions could go to and get a medical with a wink and a nod.

I know which one I would put my money on...

 

[Kenny Phillips]

Here's an even more fascinating study:



https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=13&cad=rja&uact=8&ved=2ahUKEwiz5evqxLrkAhUrT98KHSvIAo4QFjAMegQIBBAC&url=https://libraryonline.erau.edu/online-full-text/faa-aviation-medicine-reports/AM16-07.pdf&usg=AOvVaw0l77qtCcrMHc26q99Xf_hL

So 92% of the AMEs surveyed had 1 or 0 fatalities over a 10-year period, and one guy had 25. He either had some seriously bad luck, was someone who dealt with extremely tricky cases (and should promptly be removed from such duties), or he was the AME that all the pilots with otherwise disqualifying conditions could go to and get a medical with a wink and a nod.

I know which one I would put my money on...

Fairly recently an AME was, um, removed from the roles, and I believe that everyone he had examined was told to get a new medical. (I think that he was associated with a large airpark in the south eastern US that may have a large, affluent, and aging pilot community.)

 

[PeterNSteinmetz]

Okay, fine. The answer to your question is "yes":
https://www.ntsb.gov/safety/safety-studies/Documents/SS1401.pdf

However, the end of the very paragraph quoted states "It is NOT currently possible to compare the safety of medically certificated pilots with those flying under the Sport Pilot and Light Sport Aircraft Rule because there is limited information about the number and flight activity of pilots without medical certificates." (emphasis added)

That would seem to indicate that the authors themselves do not think that study goes directly to the proposition being discussed here, i.e. that FAA aeromedical certification improves the safety of flight, and that they do not believe it is "a pretty definitive answer". I can see why they included that caution in the original report because the implications of people flying without a medical being more likely to have been using drugs when involved in a fatal than people with a medical are not immediately clear to me in terms of the proposition.

It is selective quotation when a portion of a document contradicting the assertion of the speaker is omitted, particularly when it is right there.

 

[PeterNSteinmetz]

Here's an even more fascinating study:
...
So 92% of the AMEs surveyed had 1 or 0 fatalities over a 10-year period, and one guy had 25. He either had some seriously bad luck, was someone who dealt with extremely tricky cases (and should promptly be removed from such duties), or he was the AME that all the pilots with otherwise disqualifying conditions could go to and get a medical with a wink and a nod.

Interesting study yes. But fairly peripheral to the proposition being discussed. Have a look at figure 2 in that report. It shows there is a distribution of fatality crash rates amongst AMEs with outliers on both high and low crash rates. There is always going to be some AME who is the most outlying. But there is a distribution there so this is not just a single datapoint on the more fatalities side.

What the data in this paper showed is that there is such a distribution in the likelihood of fatalities by AME. I would not find that result surprising. People differ in the care and detail with which they apply a set of rules. Pulling out the single datapoint at the tail on one side and contrasting it with the middle range only, omitting the relatively continuous nature of this distribution is a form of fairly selective citation to the data.

Quite a speculative leap to assert that this means both that pilots with disqualifying medical conditions are going to a specific subset of AMEs with looser criteria AND that those disqualifying conditions then resulted in the fatalities.

I truly do applaud taking the time to do the searches and find some of the data which may bear on this questions. Many kudos. Thanks for pulling them out.

Interpreting such data with some level of scientific objectivity often takes a fair amount of time and an attempt to consider all the data and all of the paper in their appropriate balance. I think these deserve more scrutiny and thought. Based on a brief review, I certainly would not conclude they demonstrate that FAA medical certification improves the safety of flight.

The authors themselves appear to share some of this reservation. While the discussion in this paper is fairly long and sort of mushes around on both sides of the issue, it does state "However, further study is needed to determine what role, if any, the medical certification process played. The procedure used in this study was able to identify a small group of AMEs with atypical high fatality rate per exam; however, the significance is yet to be determined." This strongly suggests the authors themselves do not think that ""the answer is patently obvious".

If you want to continue the discussion of objective interpretation of these papers, I am happy to do so and explore how they bear on the proposition being debated here. However, I will ask that the personal attacks and assumptions of some sort of malicious motive come to an end. May I suggest another way of looking at it? That when people with different perspectives look at data it can lead to honest differences of opinion about the meaning of that data. The best and most useful way for such people to have a discussion is to focus on the data and the arguments themselves, leaving aside any differences in personal characteristics. I appreciate the effort to bring up these other datasets and interpretations. I hope they can continue in a civil manner.

 

[jonvcaples]

Peter thou rocketh!!

 

[jonvcaples]

Just to be clear we are talking about AMEs who administered FAA physical exams to pilots who then were involved in accidents or incidents?

 

[PeterNSteinmetz]

Yes, the Canfield et al 2016 study examined the rate of fatalities per FAA physical exam broken down by AMEs. There was a distribution of this rate. There are a number of other interesting items in that paper in terms of the proposition being discussed which I am reviewing in a bit more detail.

 

[ProjectInfinity1]

And that is the beauty of government. Their concern is singular: safety. I’m glad that can be said. What you consider a problem, I consider a positive.

The road to hell is paved with good intentions. I am medically disqualified. I believe you’ve seen my thread Ryan that stirred up a lot of trouble.
I’m one of these people those strict regulations block, I’ve never asked to even fly commercial as I just wanted my PPL. Everyone has a right to be safe, however not at the expense of other people’s civil rights. I’m not referring to aviation, but more firearms.

If we as a country want to layer ourselves in bubble wrap for “safety” than that’s fine. But we can’t have it both ways. You, I,all non felon US citizens have a right to arms. Dare I ask what the death rate for non passengers is for crashes?

No one, wants someone who is having a break with reality driving a car, much less flying a plane, however I believe context should be considered, op was a solider returning from combat. Veterans give more than you and I ever could in service to this country. Perhaps consideration should be given to flying commercial cargo.

It’s fascinating the logic, based on a blanket ban, in my personal case, ADHD, and depression with Autism Spectrum. So a someone who is has depression, wants to fly, is told he can’t because of his depression, how does that not feed into of “insert depression thought here.” ADHD yet hyper focused about aviation, ect. Needless to say, our current system sucks.