From what I just read after doing a Google search, "concern for the safety of other specific persons" is an exception to the doctor-patient confidentiality constraints.

You read German?

https://depts.washington.edu/bioethx/topics/confiden.html

http://doctor.ndtv.com/topicslider/ndtv/tid/323/pagenum/4/Confidentiality.html

Confidentiality information

"if a physician feels a pilot is unfit to fly, should he be mandated to notify the airline, and patient confidentiality be damned?"

Absolutely! Just heard a report (paraphrased and not verified ) that a former girlfriend of the co-pilot said that he told her that one day he will do something that will make people remember him. Red flags all over the place. The more that comes out I would hope that the confidentiality rules will be changed as quickly as the additional crew member in the cockpit scenario has been.

I agree that antidepressants are prescribed improperly like candy for *everything*! I also think that everyone is so worried about drug testing for the use of illegal drugs that they're missing the more obvious problem of people operating vehicles (and airplanes) while completely messed up on "legal" drugs!

The way it is now a doctor can stop you from driving a car (yes, patient confidentiality be damned in that case, so why shouldn't they be able to stop you from flying an airliner? "No-brainer"? In my book it is.

Your last thought is the one I've been curious about. More and more is coming out about this guy, now his girlfriend saying he told her, "Everyone will know my name", among others. I can't understand why no one notified anyone so that he was grounded and deemed unfit for piloting. He was clearly not stable.

I just don't know. Would it be better to have a depressed pilot not treated? I guess in a perfect world no medically documented pilot with a diagnosis of depression would be allowed to fly. But so many times depression is situational--the breakup of a marriage, children leaving the house (or not leaving), etc. etc. Even if a pilot has a yearly physical exam, they can become depressed in the month ensuing.

This guy had only 630 hours of flying time. That is paltry in the pilot world.

Now it comes out he was also being treated for vision problems.

I personally feel antidepressants are overused for situational depression. The examples you give, Sleeperblues, are things people have had to deal with for as long as humans have existed, and the idea of giving a pill to make people happy no matter what life throws them sounds like something out of a sci-fi novel to me.

Years ago I was in a difficult situation, and my doctor at the time prescribed Prozac. I took it for a short time, but stopped because my high spirits and energy, while certainly pleasant, felt ridiculous under the circumstances. For months afterward I experienced involuntary strong muscle twitches. I've read that some people, particularly women, can suffer permanent neurological damage from this kind of antidepressant. I'm glad that didn't happen to me.

I'm sure these drugs do wonderful things for people with cycling moods, chronic depression, crippling anxiety, and similar conditions. But should they be flying commercial airliners? I honestly don't know the answer to that question. But I have a hard time trusting the honor system presently in place. Nobody wants to lose their job, and this must be especially true of pilots.

This is such a tough question because anti-depressants have been known to help so many people.

This co-pilot seemed equally or more homicidal than suicidal.

I don't know whether he wanted to commit suicide by plane, or homicide.

I think he was much more than depressed as more comes out it seems he had a more serious mental health issue.

Any type of serious visual problems should have grounded him till resolved.

My husbands son is a pilot, he had developed a mild pressure in one eye and was being evaluated by an eye surgeon to determine the cause. He grounded himself, but would have been anyway by the rules of the company. And he didn't even fly human cargo. Just his crew. As it should be. Extraordinary jobs need extraordinary caution.

I have heard the doctor said he's unfit to work, not to fly. He may not have known his profession or the guy may have lied. Though you would think a doctor could look it up if he were really concerned if he knew his name. I guess we will find out soon - if it was an accident I doubt the doctor will ever forgive himself for not flagging it.

You'd think before the doctor could determine his fitness for work, the most basic question would be, "What kind of work do you do?" But as you say, Chi, his patient could have lied. Yes, serious repercussions for the doctor.

Considering they haven't even found the FDR (as of earlier today anyway) it's really stretching to think you know what went on and what happened based solely on publicity seeking "news" channels. I remember another flight that was also run amok with people chanting "pilot suicide" when it turned out it was a defective valve that caused the crash. That took years before the lawsuit was settled and the facts came out.

I choose to wait until there's some better evidence than wild speculation before vilifying people, their doctors and making their families suffer even more than they have already.

All of the proclamations that have been made above, and the "enlightening" Google searches that have been contributed, experiences described, etc., fail to consider the fact the Germany is NOT the 51st state of the US.

This is an episode involving a German national working for a German company. Yes, Germany has its own laws. Why would anyone think that what's the rule here, would be the rule there, or vice versa? It's mostly not the case. The general privacy laws there are MUCH more restrictive, as an example, and have been the cause of litigation and governmental action by several European countries against many American internet companies. It could be similarly the case for medical privacy too, that their rules are much more restrictive. Or maybe not, I don't know.

How many of you are familiar with German law? I suspect none of you, That was what my short earlier comment was intended to convey. Any speculation about what should have been done and who's culpable for what is just speculation. Blind guesses, nothing more.

For those who are interested, more details will surely be released in coming days and weeks.

You also have to remember that this pilot was flying under German regulations, not American.

I don't know how reputable this newspaper article is, but they're speculating that he might have downed the plane because he feared he'd lose his flying license. Of course one should never speculate...http://www.dailymail.co.uk/news/article-3013743/Germanwings-pilot-slipped-safety-net-devastating-consequences.html

Flamingo, I agree that we can speculate with the information we've got. I don't believe for a minute that we're vilifying this guy. Any sympathy I had for him ended when he decided to kill 149 innocent human beings.

I do,however, have a great deal of sympathy for his family. They will forever be cast in shadow because of what this maniac did.

Oh for Pete's sake. Our speculating is not going to affect anyone or anything in any country, therefore I shall speculate to my little heart's content.

Right on, FlamingO! I really don't think our questions and opinions are contributing to anyone's suffering.

The questions I posed originally about pilots taking antidepressants and doctor-patient confidentiality cross national boundaries and are not specific to the U.S., Germany, or anywhere else.

BTW, I saw on NBC News that several European countries are changing their protocol to adopt the U.S. practice of having a flight attendant step into the cockpit if one of the pilots has to step out.

"I really don't think our questions and opinions are contributing to anyone's suffering."

No, but nor are uninformed speculations leading to anyone's understanding.

No, but nor are uninformed speculations leading to anyone's understanding.

I believe it is. We are all in shock and we are trying to process something that's virtually impossible to understand.

It's normal. No one wants to think that we could be gone in the blink of an eye. No one wants to think that anyone could intentionally perpetrate such a heinous act. No one wants to think that it could happen to them.

It's normal to be afraid, and to discuss when we don't know all the facts.

We're discussing as such because we are all helping ourselves and each other.

I'm sorry if you can't see that.

I think he sees it just fine. Snidely just likes to come into a thread, find something he can disagree with and try to make someone feel stupid or inconsequential, mimipadv, it's his standard M.O. I guess it makes him feel good about himself.

Thanks, FlamingO. There's nothing being speculated here that hasn't been speculated on CNN by people making a lot of money doing it.

This discussion has been generally calm and helpful.

Snidely snickered, "All of the proclamations that have been made above, and the "enlightening" Google searches that have been contributed, experiences described, etc., fail to consider the fact the Germany is NOT the 51st state of the US.

"This is an episode involving a German national working for a German company. Yes, Germany has its own laws. Why would anyone think that what's the rule here, would be the rule there, or vice versa?"

Geez, Snidely, I think we're all intelligent enough to realize that German laws and regulations do not apply "here." Those of us here at the Table are mostly in the USA, the next-largest group is in Canada, and there are quite a few from Australia here, too. Since the majority of us (and that includes me) are in the USA, we are concerned with flying within the USA, or on a US airline flying from the USA to another country, or on a US airline flying from another country back to the USA. The laws in the United States would govern those flights and, therefore, our safety. We have every right to be concerned, and to wonder "what if" in a similar situation.

fail to consider the fact the Germany is NOT the 51st state of the US.

Duh! Now I don't have to google it.

I think I need to clarify that I was actually ending my post facetiously, with "Of course, one should never speculate..." because that is something we are often told. But I included a link full of speculation about why the Co-Pilot decided to take down a plane full of people, based on what is known about his background so far. I should have put a winking face after my last statement so sarcasm would be understood.

Snidely, like FlamingO, mimi, and Alisande, I too have always felt free to speculate about anything, because speculation is different than assumption. My dictionary says the definition of assumption is "to accept something to be true without question" and the definition of speculation is "Ideas or guessing about something that is not known." So speculation is all we have so far and might ever have, as for the precise reason the Co-Pilot felt compelled to do this.

Sigh... Really? Can we not have a conversation related to a current event without being accused of trying to pass new international laws? It is a discussion about IDEAS and OPINIONS. The question was "how do you feel about these things?" Not "What are you willing to testify to in court of law, right after we take over Germany?"

Bwahahahaha!

FlamingO wrote, "I think changing the rules about the cockpit will help a lot, except I'm not sure how a maniac pilot could be controlled by a flight attendant."

Some flight attendants are male, and they might stand a better chance against a manic pilot. Nevertheless, simply having another person in the cockpit would at least allow that person to allow the absent pilot (or co-pilot as the case may be) back into the cockpit.

Such a terrible tragedy, so much speculation. It looks like this guy did give out signs of being unstable. Yet when did Big Brother take over the rules for international flights? This did happen outside the US. When I was working,I occasionally went to work upset about something- a dead pet or an argument with my husband., etc. I wasn't responsible for people's lives but I did manage very large sums of money. I might come to work with tearstains and a scowl on my face. No one would question me. Of course, this isn't a good comparison. After my mother died (of old age and natural causes) my brother lived alone in her house. He was supposed to be fixing it up to sell it. We (other family members) knew he owned several guns (rifles and a pistol) was depressed and had big financial problems of his own, coupled with living alone. After he shot himself in the head, people asked , why didn't you suspect something? What was I supposed to do, call the county sherriff, tell them my brother is depressed and living alone and has guns? Then again, there are plenty of people walking around on medication for various ills. I really don't understand the stigma of mental vs. physical illnesses.

Vicsgirl, I'm sorry your brother and those who love him had to go through that. Sad all around.

Here's an article by a psychiatrist on the subject of the airline crash:

Don't Blame it on Depression