BS: A 'rights' issue?

Subject: BS: A 'rights' issue?
From: akenaton
Date: 14 Mar 16 - 02:58 PM

The inquiry into the plane crash in the French Alps which killed over a hundred people, has found that "doctors, who confirmed Lubitz had "shown symptoms suggesting a psychotic depressive episode" just weeks before the crash, refused to speak to investigators, citing patient confidentiality.
These doctors also refused to inform Mr Lubitz's employers of his condition even though they knew he was a pilot.

Another examples of bad "rights" legislation?

Whole story HERE

Subject: RE: BS: A 'rights' issue?
From: GUEST,Guest from Sanity
Date: 15 Mar 16 - 01:07 AM

Hey, you know that question has been floating around on that, and a few other issues, where that has come into question....so, here's my two cents.....'Liberals' love to cite rights, as their basis for a lot of their behaviors, so in the blur of political correctness, some things get obscured .... When your 'will' infringes on some one else's 'rights', somebody has crossed the line. In America the guideline used to be the Constitution to define those lines....I say 'used to be' because depending on one's subscribed political agenda, they seem to cherry pick the Constitution, when convenient, and wishing other parts would just go away...when in actuality, the different provisions(amendments) were considered to be integral to making the WHOLE thing work together....sorta like to keep us all in balance...including room for the people to take whatever action needed to fix or replace their government, in any way THEY saw fit.

Now, growing up in that, along with everyone else sets up a mindset, which may not be as dominant in your country, as ours, but you seemed to be quite 'in touch' with most of it...if not all......so, back to the question on hand, the above in mind....

In our Constitution, which, as I said, 'used to be' our prime law, we are supposed to be guaranteed, without government impediments, of which we are all collectively supposed to be, 'life, liberty, and the pursuit of happiness'...

..OK, that is supposed to be the law.

Now, where the source of the conflict lays, is at what point can a doctor, or business, make a concerned decision, AND on what basis, to release private information, and breach doctor/patient privilege...even if means possibly safeguarding the lives of others...and keeping in mind that hindsight is usually 20/20...and inaccurate speculation can pose 'inconvenient consequences'...even to the point of infringing others rights, over a 'false flag'(Read: The boy that cried wolf), to the point of irresponsibility.

So, it depends on the mindset of the holder of the information...
Examples: If you are a doctor, in their oath they took, as doctors, there is a phrase that implies that they do no harm(health wise), to their patients...in fact, anyone.
Example: If you're a business, such, as in the airline, your primary concern is to safely transport people, minimize expenditures, make as much profit as possible, and not get sued.
Example: If you are a family of a loved one that went down, you are devastated, it is if, a part of your own life went down with them.
Example: If you're a radical Islamic, they were all martyrs, who were killed by an infidel pilot.
...and believe it or not, that's what is going on, within the mindsets, and cultural societies that people are accustomed to..how they inter-act..so on and so forth.

IN our primary law, the Constitution, was written to address, the mindset, of white, Europeans, who fled Europe, to get away from a monarchy/religious system, and give the governing power to the people. This was able to be done, because Europe was basically working around a Judaeo/Christian point of reference, incorporated loosely into their social fabric...also, the forerunner of the Constitution was the Magna Carta, in regards to governing and rights....all that being said, to contrast, let's say, coming from an Islamic social fabric mindset. (NOTE: I am only using the Islamic social culture, to illustrate the fact that 'common sense' may differ from culture to culture, and therefore one culture may not understand that not only do they not see eye to eye, they may see each other as a threat, or even an enemy...and therefore a wariness, and distrust...OK, enough of that illustration.

Now all the different cultural mindsets are going to have different priorities...However, in the case of the pilot and doctor, IF the doctor was aware that Mr.Lubitz's psychological condition included suicidal thoughts, to some degree or another, and a medical examination was a part, or condition, of him possessing a commercial pilot's license, or international pilot's license pilot's license, as a prerequisite to pilot, then it would be the obligation of the doctor, to advise Mr.Lubitz, that he would notify the company, or even the issuer of such said license, that his activities should be suspended, until further evaluation and/or treatment determines his capabilities.

Now the reason I went into the various 'mindsets', is that one might argue that the doctor was either negligent, or misdiagnosed, or under-evaluated Mr.Lubitz....OR, the doctor may have felt restrained from violating Mr.Lubitz patient/doctor confidentiality privilege.

If you are considering the airline's point of view, they are going to do everything possible to shift blame onto the doctor...thereby avoiding as much liability as possible.

If you are just a concerned western citizen, puzzled, then you may think, depending on your cultural point of reference, that somebody should have said something to prevent this from happening, and see it as 'common sense' versus the 'right to privacy'.

To the family and friends, they will approach this from an emotional point of view, perhaps to the extent of being co-victims, and feelings of their rights being ignored.

And, of course, if you were approaching this from a radical Islamist's point of view, you'd be out to avenge the martyrs, and take revenge on the infidel....regardless of mitigating circumstances.

Soooo, all those factors would have to be considered(maybe except the last one, if it doesn't apply) before a 'legal opinion' could be reached.

Personally, if the doctor was aware that Mr.Lubitz posed a risk to himself, or others, and said nothing to the agency that qualifies pilots, based on abilities and medical evaluations, based on privacy concerns', and/or the company that employed Mr.Lubitz, then I would say not only was his sense of 'civil rights' out of balance, but so was his obligation to what he felt was a conflict of interest, and that guidelines to clarify his priorities, as to whom he is serving, made perfectly clear, before further action could be taken.

So, not enough is known, at this time.....which doesn't bring any comfort to the loved ones left behind.

Just my first thoughts on the matter....

GfS

Subject: RE: BS: A 'rights' issue?
From: michaelr
Date: 15 Mar 16 - 01:26 AM

OK, just to cut through the verbiage, the doctor had a responsibility to "do no harm". He may have violated that by keeping mum about the nut.

What is unclear is whether this doctor was in the employ of the airline Lubitz was flying for. I would expect that airlines retain physicians to check on the health of personnel. If the doctor was working for the airline, he should have reported his concerns. If he was not, he could claim confidentiality.

Subject: RE: BS: A 'rights' issue?
From: michaelr
Date: 15 Mar 16 - 01:29 AM

I meant to add that for the doctors to remain silent now smells fishy in the extreme. The patient is not only deceased, but also likely guilty of the deaths of dozens of innocent people.

Subject: RE: BS: A 'rights' issue?
From: Kampervan
Date: 15 Mar 16 - 01:30 AM

In the UK, if you apply for a shotgun certificate (licence) you have to tick a box giving the police permission to contact your doctor and ask if the doctor knows of any reason why you should not be given a licence. The idea of this is to reduce the chances of someone with mental health problems getting hold of a shotgun legally.

Why can't anyone whose job involves risk to the public, e.g. airline pilots, bus drivers etc, be obliged to give a health professional employed by the airline or civil aviation authority access to their medical records.
That way the persons doctor has no conflict of interest, or 'rights issue' because the patient has given their permission for their records to be accessed?

Subject: RE: BS: A 'rights' issue?
From: GUEST,Guest from Sanity
Date: 15 Mar 16 - 02:36 AM

michaelr: "What is unclear is whether this doctor was in the employ of the airline Lubitz was flying for. I would expect that airlines retain physicians to check on the health of personnel."

Yes, I said pretty much the same thing...BUT...was the doctor working with the airline, or privately, or for the issuer of the pilot's license...and all those may have different priorities, based on what 'mindsets' (which would be different from each other..as opposed to his conscience...AND, we may be dealing with international law, which may have a different set of guidelines to their priorities...That's why I went into all the 'examples'...cultural, versus legal, versus personal responsibilities, versus his doctors oath...and I know it was a lot of 'verbiage' (having to have typed it)...just to point out the possible conflicts of interests involved.

Of course you feel that way....as would a lot of us...based on your cultural background..as opposed to, let's say, a corporate background, and the legal guidelines to responsibility.

I tried to approach this, non-emotionally, NOT based on 'political persuasions'.

OK??

GfS

Subject: RE: BS: A 'rights' issue?
From: GUEST,Musket
Date: 15 Mar 16 - 03:14 AM

The whole issue of occupational health is mired in legislative contradictions in just about any country. Also, for pilots to have their licences recognised in countries other than their own, international agreements need to be in place. (Sure, your licence was issued in Khazakstan, but you want to land your plane in Italy...)

This has meant employers asking would be employees to consent to giving them knowledge of their health that not only satisfied their national legal rights but us st s level that suits other countries too.

A minefield for the employer and employee then. But with consent, fairly straightforward.

Then we come to the doctors. First and foremost, away from any interpretation of the Hippocratic oath, we have the contract. If a doctor feels a contract compromises professional integrity, they should not take it on. They should be comfortable with what is being asked of them.

But are we talking of a doctor carrying out an assessment on behalf of an employer or a patient seeking a consultation with his doctor?

Conclusions? The doctor in question may well be referred to his professional body to review why knowledge of a psychotic episode wasn't disclosed to his customer the airline if the former, but the crash investigators have no remit in Germany or most countries for that matter to force a doctor to disclose details of the patient consultation itself in either case.

A doctor the patient sees in the course of day to day health has a duty to advise the patient to inform his employer of any condition or disclosure pertinent to his work.

The confusion in all the stories over this event seem to confuse the reader between a doctor working on an occupational health contract and a doctor seeing a patient at the patient's instigation. If a patient tells a doctor he will not heed the advice, a doctor can, in both Germany and here in The UK make a decision to disclose in the public interest, but based on professional judgement. Examples here would include informing DVLA of fitness to drive.

A doctor working in occupational health can and should have disclosed such information to his client. However, an occupational health doctor should also have the latitude to be able to say "unfit for the role on medical grounds" without disclosing why. (Here in The UK, we call it "Caldicott" or "need to know" basis.)

There may be questions for a doctor to answer, but crash investigators have a different remit. For them it's "did the employer act appropriately on medical assessment?" or in the case of the employer seeing a doctor outside of work "did the employee fail to disclose?" If there are concerns that a doctor knew the patient wouldn't disclose, then an outcome from the investigation could be to refer a doctor to his professional body. But such a subjective question posed to a doctor wouldn't help the investigation. "Yes, I do expect patients to act on my diagnosis."

I have not read anywhere that an occupational health doctor failed to take anything into account or that a doctor elsewhere had concerns that a patient would fail to disclose. The consultation in question was shortly before the crash. This whole story is based on whether a doctor expected a pilot to carry out his professional obligation. There are protocols for dealing with such an event.

By the way, with regard to the OP, there were no "doctors" involved but there are doctors.

Subject: RE: BS: A 'rights' issue?
From: Spleen Cringe
Date: 15 Mar 16 - 03:14 AM

In the UK a psychiatrist will generally notify, for example the DVLA, if they think a patient's mental state is such that they pose a risk to themselves or others when driving. In fact, mental health professionalservices have a duty to breach confidentiality when the risk of harm significantly outweighs the alternative. I don't no enough about how things work in Germany to comment specifically on this case, but I would suspect the issue isn't one of 'rights'. Though I don't understand why the OP implies such a downer on rights generally - in principle, human and civil rights are a good thing, no?

Subject: RE: BS: A 'rights' issue?
From: Jim Carroll
Date: 15 Mar 16 - 03:23 AM

"bad "rights" legislation?"
I often wonder why people use tragedies like this to attack a sysytem that, as flawed as it is, guarantees us some few 'rights'.
That our doctors are sworn to confidentiality is fine by me - I don't want the press, the police, the government to have access to information on me that they might use against me, should they wish to - we are entitled to the protection that these rights have.
It is possible here that some degree of discretion might have been used, given the position that this sad individual held, but that has little to do with the general fact that were are entitled to protection from intrusion, from the state, from the media and from the general public.
This was a horrendous tragedy, for the passengers and for the pilot, who was obviously disturbed.
Please, let's not use it to undermine a basic freedom.
Jim Carroll

Subject: RE: BS: A 'rights' issue?
From: GUEST
Date: 15 Mar 16 - 03:55 AM

Working for an airline used to be a dream job, today is basically a modern form of
slavery 

Subject: RE: BS: A 'rights' issue?
From: akenaton
Date: 15 Mar 16 - 04:16 AM

The general concensus is that the doctors did not inform the employers on the grounds that they may have been sued.

In my opinion these people should have to answer in court for their lack of action.

Much of our "rights" legislation is beneficial ....a large part of it is dangerous and counter productive.

One size does not fit all.

Subject: RE: BS: A 'rights' issue?
From: akenaton
Date: 15 Mar 16 - 04:22 AM

I also don't see how it could possibly be in the interests of the airline to knowingly employ someone with Mr Lubitz's mental problems.

Subject: RE: BS: A 'rights' issue?
From: Spleen Cringe
Date: 15 Mar 16 - 04:24 AM

It''s not a rights issue. It's a risk management issue and a medical ethics issue.

Subject: RE: BS: A 'rights' issue?
From: Jim Carroll
Date: 15 Mar 16 - 04:59 AM

"a large part of it is dangerous and counter productive."
No it isn't - only when it's abused or ignored.
Nobody gives us or anybody rights that aren't necessary, and quite often they are hard fought for.
Stop using an anomaly of a tragedy to attack a very necessary human right please.
Perhaps you might clairify your argument by listing those rights you believe to be "dangerous and counter productive." so we know what we are argguing about - I wait with bated breath!
Jim Carroll

Subject: RE: BS: A 'rights' issue?
From: GUEST
Date: 15 Mar 16 - 04:59 AM

It's not a rights issue. It's a risk management issue and a medical ethics issue. If someone could get sued it's a legal issue as well, and there seem to be a lot of things related to "duty of care" that have not been tested in the courts in the UK.

However, in the UK, Musket's example of a doctor the informing the DVLA of unfitness to drive suggests there is a way of sorting these things out. What happens if a doctor who signs an application for or renewal of a firearms licence sometime later thinks that the person is no longer fit?

Subject: RE: BS: A 'rights' issue?
From: MGM·Lion
Date: 15 Mar 16 - 05:36 AM

I wait with bated breath!


Like the cat that swallowed the Camembert and stood exhaling beside the mousehole, eh Jim?

≈M≈

Subject: RE: BS: A 'rights' issue?
From: Jim Carroll
Date: 15 Mar 16 - 06:15 AM

"Camembert" - sighhhhhh - can't get decent Camembert over here
Jim Carroll

Subject: RE: BS: A 'rights' issue?
From: GUEST,Raggytash
Date: 15 Mar 16 - 06:24 AM

Try the English Market in Cork Jim. I've had some good stuff from there.

Subject: RE: BS: A 'rights' issue?
From: GUEST,Dave
Date: 15 Mar 16 - 06:54 AM

Jim, surely you can getCooleeney cheeses.
Liverpool Cheese Company stock them sometimes, and there is a soft mushroomy one which is better than any Camembert you get round here.

Subject: RE: BS: A 'rights' issue?
From: GUEST,Dave
Date: 15 Mar 16 - 07:02 AM

As far as the OP goes, this case will be dealt with under German law, with, as Musket says, regard to any international agreements Germany will have in place regarding the licencing of pilots. So any talk of the US constitution, or Magna Carta, simply is not relevant. Does anyone here know anything about German law? I don't. Musket's post implies he might.

Subject: RE: BS: A 'rights' issue?
From: GUEST,Musket
Date: 15 Mar 16 - 08:08 AM

German law isn't my strong point, but EU concordats with respect to regulatory bodies means harmonisation of aspects of professional ethics, conduct and obligations.

I am a doctor, I am on the specialist register with The General Medical Council and could in theory practice under German law, as local registration is a quick process within EU states where you are already registered.

With regard to mental health, an example was given above of psychiatrists informing DVLA. Where a psychiatrist is involved in care, the patient would come under either The Mental Health Act 1983 where decisions are made for the patient by others or The Mental Capacity Act 2005 where the decision to disclose to DVLA was made in the best interest of the patient, as the patient lacked the capacity to be trusted to inform. In any case, and not just mental health but any aspect of health, a health care professional has the duty to disclose in the public interest where they have advised a patient of the patient's obligation to disclose and have grounds for concern that this would not happen, coupled with public safety risks if nothing is done. This is dealt with under The Health Act 2006 and a regulatory clause under The Health and Social Care Act 2008 regarding taking national guidelines into account when assessing and delivering care.

Again, having read a number of articles over this case, and it is of huge interest to our profession, should precedents follow, I am still not clear regarding detail. What is clear however is the wish of the OP to use this tragic episode for a sick crusade against human rights.

Subject: RE: BS: A 'rights' issue?
From: MGM·Lion
Date: 15 Mar 16 - 08:44 AM

That should have been the most valuable post, if the form-carrying poster had not degenerated into the fatuity of the final paragraph.

Am I ever glad you are not my doctor who hides behind the Popgun pseudonym [& note the pertinence of the first syllable of that word], if your diagnoses are as reliable as your Mudcat posts. There is not a hint of exploitation of this 'tragic episode' as a 'sick crusade against human rights' in the OP, except in the twisted thinking of one whose mind is made up about the poster so would prefer not to be confused with facts.

So just be off with you, whichever of the Muski·boobies you may happen to be -- and take the rest of them with you, please. The whole pack of you are a burden and a liability to this forum.

Subject: RE: BS: A 'rights' issue?
From: GUEST,Musket
Date: 15 Mar 16 - 09:09 AM

No? Try reading it then or have nurse read it to you. Three others had pointed it out prior to me. But as ever, wait for someone who you enjoy trying to put down before nursing a semi whilst you type. Your defence of Akenaton, whether it be this or any other subject of his mind is at best ill placed and at worst revealing.

You have form Michael and suffering fools gladly isn't my strong point. The other Muskets may enjoy a joke with you but your posts dismay me.

The op suggested the rights of doctors and their patients are questioned by this incident and he put the word doctors as "doctors." He uses a similar tactic when describing marriage of normal people, my husband and I included.

Leave the forum yourself if decency offends you.

Subject: RE: BS: A 'rights' issue?
From: MGM·Lion
Date: 15 Mar 16 - 09:12 AM

☞〠☜

Subject: RE: BS: A 'rights' issue?
From: Donuel
Date: 15 Mar 16 - 09:41 AM

Here comes the closing thread solution.

the world along with mudcat has lost its finesse.

Subject: RE: BS: A 'rights' issue?
From: Spleen Cringe
Date: 15 Mar 16 - 10:48 AM

Musket is right on this one. The OP is clearly using this tragedy to put over his 'anti-rights' agenda.

Subject: RE: BS: A 'rights' issue?
From: akenaton
Date: 15 Mar 16 - 11:40 AM

Rubbish, I don't have an anti rights agenda.....much of it is necessary and beneficial to society.
Some of it does no good at all...there should be no such thing as patient confidentiality in cases like this where the public are put in harms way.

The inverted commas were of course a typo on this occasion.
Doctors are doctors.....they come in all shapes and sizes and have myriad psychological hangups.....just like the rest of society.
However suicidal tendencies are not appropriate in an airline pilot.

Subject: RE: BS: A 'rights' issue?
From: Jim Carroll
Date: 15 Mar 16 - 12:15 PM

"Musket is right on this one."
I'm afraid that's the impression I was left with and that will remain the case until the poster specifies the "large part of it (our personal rights)" he is referring to - obviously not just the right to patient confidentiality which he has already made clear.   
"there should be no such thing as patient confidentiality in cases like this"
Of course there shouldn't but it is prejudging this particular case to suggest that it is the right to patient confidentiality at fault here, rather than a error on the part of some individual somewhere along the line.
Now - perhaps we might now learn what the rest of these rights are we need to have taken away from us
Jim Carroll

Subject: RE: BS: A 'rights' issue?
From: akenaton
Date: 15 Mar 16 - 12:39 PM

The doctors have refused to co-operate with the inquiry so good luck with any attempt to get at the truth.......I smell a rat.

Subject: RE: BS: A 'rights' issue?
From: MGM·Lion
Date: 15 Mar 16 - 12:43 PM

"Try reading it then or have nurse read it to you," predictably trot out the silly old Musket-mob at me again, as if this was a hilarious witticism, instead of [what might just have been] a joke when first aimed at me about 7 or so years ago, but which I suspect most Catters must be as bored out of their ☠☠ with as I am.

≈M≈

Subject: RE: BS: A 'rights' issue?
From: akenaton
Date: 15 Mar 16 - 12:47 PM

If I were a "liberal" I would condemn it as Bigoted Ageism.

Even as a social conservative I find the reference disgusting, witless and demeaning.

Subject: RE: BS: A 'rights' issue?
From: GUEST,Musket
Date: 15 Mar 16 - 02:22 PM

Fucking priceless.... Anyone would think nobody had ever read a worm post before. Mind you, a typo at one end of a word is one thing but both ends? Possibly thinks everyone is on his intellectual level, coming out with that one.

Regarding the thread.. This afternoon, I was doing some teaching and a registrar we have on the course from Cuba did his house jobs in Germany so over coffee I asked about disclosure. It seems the law is, as I thought, mirroring ours in just about every aspect.

Doctors have an obligation to act in the public interest where public safety could be compromised and report to appropriate authorities where risks could in their judgement exist or where criminal actions are suspected, (presenting with gunshot wounds etc.) In areas such as occupational health, a doctor can, with the patient's consent give pertinent detail or if the patient doesn't consent, say that they are fit or unfit for the duties described but not give details. Under employment law there, same as here, an applicant should not be discriminated against for opting for a yes or no only.

So, if in this case a doctor is refusing to disclose, the doctor is either a) of the opinion disclosure has already been adequately dealt with or b) may be being defensive in which case the airline has the right to ask the medical regulator to investigate fitness to practice.

Or in other words, no laws need changing based on what is in the public domain about this case and safeguards are in place so not seem to be failing if what we read reflects the facts. A court may force disclosure if pertinent to proceedings in the opinion of defence or prosecution but the remit of airline and police investigators is limited to their role.

If Musket is reading, he might clarify some of the above as he was involved in health regulation for many years.

Two other things here..

1. The patient's rights are not an issue as you lose most of them when deceased.

2. The incident was not on German soil.

Subject: RE: BS: A 'rights' issue?
From: Jim Carroll
Date: 15 Mar 16 - 02:26 PM

"I smell a rat."
And I smell somebody who has made a sweeping statement about our rights and is now refusing to qualify it.
Jim Carroll

Subject: RE: BS: A 'rights' issue?
From: akenaton
Date: 15 Mar 16 - 02:32 PM

The patient was not deceased when examined by the doctors and found to have severe depression.
The doctors decided not to inform the airline at the time and subsequently refused to explain their conduct to the inquiry "citing patient confidentiality."

Never mind the jargon!

Subject: RE: BS: A 'rights' issue?
From: GUEST,Musket
Date: 15 Mar 16 - 02:35 PM

Kindly read what I put and get someone to explain it to you. I'd do so myself but I have had two showers today as it is...

Subject: RE: BS: A 'rights' issue?
From: Jim Carroll
Date: 15 Mar 16 - 02:51 PM

"Never mind the jargon!"
What "jargon" - patient confidentiality is a hard won right.
If the doctor has attempted to cover up a dangerous condition, that has SFA to do with patient confidentiality; it's the doctor not having carried out his duties.
We're a funny old country - we usually wait until the facts are examined and a conclusion has been reached before we throw the rope over tye branch and string someone up - but that's a different matter altogether.
You have suggested that patient confidentiality is not only to blame for this tragedy, but it is grounds for undermining that basic right (and others - as yet unnamed)
You have linked this tragedy to a basic right we all have - please qualify that link
Jim Carroll

Subject: RE: BS: A 'rights' issue?
From: akenaton
Date: 15 Mar 16 - 03:43 PM

It is definitely "to blame for this tragedy", if the airline had been informed of the pilots state of mind, he would certainly not have been in control of the aircraft.....of course it is grounds for amending the right of patient confidentiality, when it endangers public safety

As I said earlier the one size fits all ideology just does not work in practice.   Circumstances alter cases.

Any doctor with an inch of gut would have informed the airline immediately regardless of the possibility of legal action.
Sloppy legislation!

Subject: RE: BS: A 'rights' issue?
From: GUEST,Musket
Date: 15 Mar 16 - 05:42 PM

If yo don't understand how grown ups work, don't embarrass yourself.

Your post, from the first, has been ill informed, trying to undermine the system and based on ignorance, all with an aim to question professional standards and human rights.

There is no evidence that the doctor didn't discharge his duty correctly. There is no remit for accident investigators to demand information outside of (to use the UK term) Caldicott principles. If the medical examination was as part of his job and was occupational health, the doctor will have filed a report to the employer stating whether the pilot was fit for duties. If the patient saw a doctor outside of his work, the patient as a professional himself with professional obligations was obliged to inform his employer of the outcome of the consultation if the doctor advised accordingly.

Usimg words such as ideology and jargon instead of seeking to learn just serves to make your embarrassment compound. "Any doctor with an inch of gut" would go jogging in the morning till it disappeared. You read sensationalist shit and because it suits your dim take on the world, leap to conclusions. Doctors are people, include saints and sinners but nobody, neither you nor I know whether this doctor discharged his professional duty or not. If there is a question, he or she will be answerable under the present legal system in Germany. Crash investigators are not the competent body.

As Jim said, you are confusing basic human rights with a story to which the facts are not yet ascertained and in your opening post are linking it to your wish for a fascist society where rights take second place to your particular form of hatred. Patient confidentiality is already secondary to public safety risk and protocols are in place, as I explained in the thread for such eventualities.

You are a disturbed specimen. It is impossible to reason with you, as you are incapable of the niceties of debate.

Subject: RE: BS: A 'rights' issue?
From: GUEST,Guest from Sanity
Date: 16 Mar 16 - 01:19 AM

Was that really necessary??

It's a matter of jurisdiction....and who set up the 'rules'.

And BTW, the reason I brought up 'mindsets', using our own Constitution, as an EXAMPLE, is the PERCEPTION of 'rights' can vary, as well as enforcement, from culture to culture. We might think it does violate 'rights'...but on whose basis.

That being said, Musket, I thought had a well thought out explanation...assuming that another system, might bear the same concerns.. Others may not.

GfS

Subject: RE: BS: A 'rights' issue?
From: GUEST,Musket
Date: 16 Mar 16 - 02:25 AM

Fair comment Goofus. However, if I were to pick two professional standards regimes with the most international harmonisation, it'd be doctors and pilots.

Subject: RE: BS: A 'rights' issue?
From: akenaton
Date: 16 Mar 16 - 02:52 AM

"you are confusing basic human rights with a story to which the facts are not yet ascertained "


What do you not understand about "The doctors have refused to give evidence to the inquiry citing patient confidentiality"?
The patient is now dead along with one hundred and fifty people who were being piloted by someone who was known by the doctors to be severely depressed with suicidal tendencies.

Bad legislation producing gutless professionals.

Subject: RE: BS: A 'rights' issue?
From: Jim Carroll
Date: 16 Mar 16 - 03:08 AM

"It is definitely "to blame for this tragedy""
I really don't know why people bother holding enquiries into these incidents - all they need to do is get in touch with you for the solution - job done
Won't bother asking how you know who is to blame for this particular tragedy - divine inspiration? a Ouija board maybe?
I suppose it must remain as much your little secret as all those "many other" rights you would have abolished.
You have dismissed the right we all have to patient confidentiality as "jargon" which says it all really - it is a questionable right, as are all these "many" other rights you apparently disapprove of yet refuse to disclose.
It is a right we all have and should not be breached unless we, as individuals agree that it should.
In the case of people whose jobs involve the safety of others, rights like these should be dealt with, not by removing them, but by covering them with regular medical checks instigated and paid for by the employers - an M.O.T.-type check, if you like, built into the contract of employment.
You have used this tragedy to undermine all our rights by suggesting it an unnecessary "rights issue" - isn't that always the case with 'right-wingers' - (pun intended).
The last few decades have seen a number of our rights, and employees, as tenants - disappear up the Swanee at the behest of the State.
Here in Ireland we have just seen the wholesale eviction of over 100 Dublin families from their rented homes because their landlords have sold the property to Goldman Sachs - security of tenure has become as much a thing of the past as has security of employment            
People like you would add patient confidentiality to that steadily growing list.
It really is somewhat ghoulish to make an "ideological" issue of the deaths of so many people.
Jim Carroll

Subject: RE: BS: A 'rights' issue?
From: akenaton
Date: 16 Mar 16 - 03:34 AM

One hundred and fifty dead people(and their relatives ) say I am right.

When the doctors come forward and explain themselves, you may have a case.

Subject: RE: BS: A 'rights' issue?
From: Joe Offer
Date: 16 Mar 16 - 03:37 AM

I know from family experience that it does seem in the United States, that even minor psychological issues can be an impediment to getting a job as a pilot. As a government personnel investigator, I encountered extreme prejudices against psychological issues in most fields of employment, particularly in "sensitive" positions.

But counseling professionals may tend to discount such prejudices, and probably do put priority emphasis on the employment of their clients. In this particular case, the counseling professional failed to predict that the client would go off the deep end.

Could the counselor have predicted the disaster? I don't think so. I'm not sure that this is reason to find fault with anyone.

-Joe-

Subject: RE: BS: A 'rights' issue?
From: akenaton
Date: 16 Mar 16 - 03:54 AM

Joe, would you travel on a plane or let any friends or family do so, if you knew the piolot was a "severe depressive" with "Suicidal tendencies"?
That was the decision the doctors had to make.

Subject: RE: BS: A 'rights' issue?
From: Jim Carroll
Date: 16 Mar 16 - 04:05 AM

"oe, would you travel on a plane or let any friends or family do so,"
None of this answers your attack on patient confidentiality - nor does it answer Joe's question.
Jim Carroll

Subject: RE: BS: A 'rights' issue?
From: Joe Offer
Date: 16 Mar 16 - 04:24 AM

Ake, in many (probably most) situations, "severe" depression can be controlled by medication. If that's the case, should the prejudice against mental health problems persist. For that matter, should there be prejudice against any medical or psychological problem that experts believe to be under control?
In this case, there was failure to predict that the pilot would go out of control. But is that enough to support an overall prohibition against people with a past history of psychiatric issues?


-Joe-

Subject: RE: BS: A 'rights' issue?
From: GUEST,Musket
Date: 16 Mar 16 - 06:26 AM

And again... Can anyone who seems to think there is s problem tell us whether the doctor was doing occupational health work on behalf of the airline or personal healthcare for the pilot?

In the former, the investigation has the report as submitted by the airline to the inquiry. If the latter, the doctor has to ask his patient to consider the impact of the consultation concerns on his work and if the doctor knows he is a pilot, to require the patient to disclose that he has a medical concern that is covered by the terms of his pilot licence and employment therein. Only if a doctor has concerns that the patient will not act on the advice should a doctor preempt that. Out of interest, neither UK or German law requires details of employer on personal medical records, just type of employment to aid diagnosis as appropriate. Some do ask and many people supply details but you cannot preempt that to be the case.

So... Was this a GP? Psychiatrist? Other? The former can diagnose mild depression but would refer for suspected acute depression. You see, just saying "doctor" doesn't even begin to address responsibility or role.

Fed up of repeating here but a doctor is obliged to preempt disclosure in the public health and safety interest only if there are grounds for concern (we are all trained in trying to distinguish such grounds) that a patient would not do it themselves, a communicable disease has been suspected / diagnosed or a doctor suspects a criminal act, (gunshot wounds etc.)

The inquiry is required to work on the basis the requirements have been met or if they suspect otherwise, refer it to a competent authority. The inquiry isn't a medical one so cannot pass comment on clinical judgement. 20/20 hindsight tends to be the main focus, based on inquiries I have been involved with.

If the ludicrous position Akenaton is putting forward were the case, then the local chemist shop is culpable if a person takes pain killers "that may cause drowsiness, do not drive or operate machinery" and does so. If I buy a bottle of Night Nurse, should Boots take my car keys off me?

Subject: RE: BS: A 'rights' issue?
From: akenaton
Date: 16 Mar 16 - 08:13 AM

Joe.....where the lives of the travelling public are concerned "Severe depression or suicidal tendencies" are inappropriate ......I am not talking about "a history of psychiatric issues"...that could mean anything.

I repeat the question, would you or wouldn't you.

Subject: RE: BS: A 'rights' issue?
From: Stilly River Sage
Date: 16 Mar 16 - 08:38 AM

Hindsight is always 20/20. You're asking a ridiculous question, Ake, because Joe would be in no position to know. We all calculate that the odds are good we'll survive a trip out our front door every morning.