Over many years I have treated in the ER, patients from (obviously) many walks of life. It's been my privilege to have treated a not-insignificant number of ill and injured airline pilots coming through a metropolitan ER in that time. Professional pilots, especially those over 35, have always impressed me as people who understand their limitations and in the vast majority - 99.99+% - of cases will not operate if they don't feel they can do their job properly.
Rather like younger doctors, it's more often the younger pilots (and I appreciate this is completely a generalization; but sometimes the plural of anecdote is indeed data…) tend to want to push the envelope and operate even when by the appropriately strict FAA medical guidelines, they should not. It's been my direct professional experience that for a lot of reasons which seem convincing to them, they think their specific situation is different. Again, something we see in many of our younger medical colleagues. Something which I well remember doing myself when I was in my 20s.
It is in this context that the very prolonged medical apprenticeship which follows after being trained during medical school, which lasts into your early 30s before you become a consultant, while extremely frustrating at the time does stop many younger doctors again including myself, from doing things we simply shouldn't have because we didn't think the consequences through and we lacked the experience that comes with situational seniority. And so as someone who is absolutely nowhere near being a professional pilot (only a hang-glider pilot and low-time PPL), I wonder why someone with such low hours relatively speaking, can be left in sole charge of an aircraft with so many souls on board?
I think there are two other differences in the medical profession from the pilot profession which bear keeping in mind. Although this is not universally applicable, i.e. depends on the medical jurisdiction by country, doctors are obliged to both self-report and report colleagues who are putting patients in hazard, because of the doctor's own medical problems (medical obviously including psychiatric problems). Secondly, unless you are Harold Shipman, doctors can't kill a couple of hundred patients at a time even when we go rogue. Even Harold Shipman could only kill one patient at a time… Every profession has their bad eggs. (Actually, bad eggs is insufficient. Evil people is more appropriate).
So I do wonder why there is so much resistance to cockpit video recording and real-time GPS monitoring. Video recording will not stop an event like this, but will very quickly allow everybody to know exactly what happened. Also, I'm sufficiently prehistoric that I well remember when it was first proposed that there would be real time event monitoring with paper printouts during operations so the anaesthetist's actions and reactions could be judged minute by minute; similarly, for the surgeons, over the shoulder video monitoring of particular procedures. At the time a lot of people (waaaay older people, in other words, older than I was then… and probably the age I am now…) said ‘no way no how’ / 'over my dead body' and so forth. Guess what. These days it is common. The patients expect it, our professional organisations expect it, our insurers expect it, our employers expect it and we comply. It's a condition of the privilege to practice medicine. Similarly, being video-monitored during flight operations may become a condition of the privilege to be an passenger airline pilot.