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CASA Avmed – In my opinion, a biased, intellectually dishonest regulator

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CASA Avmed – In my opinion, a biased, intellectually dishonest regulator

Old 19th Dec 2018, 05:35
  #101 (permalink)  
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Post his event they made him fly privately with QFI only as a mitigation as out of 100 Jims much more than 1% will suffer an incident, not going to be a fun day for the QFI though as Jim's 10 through 38 keel over and not appropriate to have it occur in a commercial context i.e. multicrew as a mitigation (although it could be feasible in a younger, less comorbid individual as their culminative hazard would be less but that's a different story).
Sophistry.

Out of 100 Jims much more than 1% would have suffered an incident in their 75th year. Yet CASA issued him with a Class 1 medical certificate. That, as I understand it, is FE’s point.

And post event nobody “made” Jim do anything. He was free to fly as a passenger in any aircraft he liked and CASA couldn’t do anything about it.

Of course, there’s always the possibility that Jim’s scenario is a complete fabrication.
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Old 19th Dec 2018, 06:00
  #102 (permalink)  
 
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Nowluke... I think your post at 13:11 is quite revealing. Firstly, I made no assumptions, except ones which are inarguably obvious. Obvious, like, I don't need to see a double blind peer-reviewed study with controls to know, say, that parachutes save lives.
Secondly - and not that it matters in the context of this discussion - I am not (and never have been) a pilot, and have very little to do with aviation other than as a regular passenger on typical commercial airlines. "My" response is an objective analysis of comparative data and CASA's decisions based on that data. Whatever assertion you make about "me" in regard to the effects CASA actions will have on whether actual pilots reveal medical information is (like some of your qualitative maths) way off the mark. If the regulator appears to punish honesty and (more importantly) obstinately defends/protects its own decisions from new information and independent review, then the end result will be increased dishonesty = reduced safety. Whether you or I like it is irrelevant - unless you are a person with responsibility in the field. If you are, I counsel against denial.
"My" magical "Jim" is described in CASA's own published case study. I cannot post links (yet), otherwise I would have saved you 5 secs of search.
I suggest you read its details very, very carefully and understand fully the facts it reveals, and then try again to credibly defend your carefully crafted claptrap - after recovering from your surprise. It's clear you did not read the Case Study, when you theorise about all those mitigating restrictions which were not placed on Jim's flying. Similarly, disingenuously quoting failure rates of 15% to 40% in engineered parts as if these are the numbers that equate to Clinton's incapacitation risk was the icing on the cake.
I will repeat for you, but I know your opinion is set (perhaps you should apply for a job at CASA - or better still, don't): despite the comparative stats and data/studies available, CASA's application of stats for safety risk assessment between Clinton's case and "Jim's" case is inconsistent.
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Old 19th Dec 2018, 06:36
  #103 (permalink)  
 
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See above? or as copied Retrospectively his condition may have been present for a number of years prior and wasn't/couldn't be detected. If all of the required/indicated investigations were negative and then guidelines stratified him into lower risk cohorts of diabetic, hypertensive elderly men he may not be (in the narrative he obviously isn't') above the level where his Class 1 is revoked.

That said, it's a narrative story with none of the references to the decision makers reasoning or guidelines/evidence applied to underpin the decision. His changing licence restrictions aren't annotated as he aged into the 60+ zone nor are the frequency and types of tests he most definitely would have needed prior to then to support the decision i.e. ATPL loss, CPL loss or restrictions etc. In the absence of these, and a point where you are correct, is that his baseline risk, without investigation would have likely precluded his renewal.

It's a repetition of previous, "here's a "safe" apple!!!!!" "now apply it to my orange". "Here's a single related story, and I say CASA got it wrong!!!!" therefore "everything must be wrong!!!"

The percentages were not linked to anything, just that they were in a range where it is not negligible and it's not above odds- I don't think Clinton in this case (and I'm not spending a couple of hours trawling through neuro/radiology journals) has a clearly evidenced prospective risk percentage (for or against a renewal), hence the waiting period/non consideration (as I understand it) for 12 months. I don't think the CASA decision reasoning has ever been fully placed on here, only Clinton's interpretation/recall of it and my perspective on what the reasoning possibly was.
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Old 19th Dec 2018, 06:47
  #104 (permalink)  
 
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Originally Posted by Nowluke View Post
vis Jim, it all appears pretty reasonable, he probably would have met the threshold in some guidelines for some more invasive cardiac screening (CCT/Angio) years before his stroke if you take him as a Class 1 who does single pilot air show work and some instructing. Retrospectively his condition may have been present for a number of years prior and wasn't/couldn't be detected. If all of the required/indicated investigations were negative and then guidelines stratified him into lower risk cohorts of diabetic, hypertensive elderly men he may not be (in the narrative he obviously isn't') above the level where his Class 1 is revoked. What's the exact issue? There is a conflict though at around that age, where as it was raised, it doesn't really matter how many negative tests you have, it's getting close to closing time percentage wise- this conflict I understand is based on age discrimination issues, you can't blanketly revoke licences on that basis and there aren't sensitive enough tests to demonstrate prospectively what pathology Jim has.
And yet, despite all that extensive, invasive screening, investigations, long history and stratification into lower risk cohorts (presumably by individual experts) among the large statistical population of Type 2 diabetics, Jim then went on to have a "surprise" stroke before the year was out. Perhaps if CASA had used this case study to then document and publish some revised, substantially more cautious approach to dealing with the patently obvious high risk Jim posed, then that might justify CASA's inconsistent statistical approach in these two cases. That's the exact issue. You, and CASA, have used the fewer (but still sufficient for statistical analysis) data points associated with "nominally cured" DAVFs as a blanket excuse to bend the incapacitation risk to a level the data/maths does not support.
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Old 19th Dec 2018, 12:05
  #105 (permalink)  
 
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you are way out of your depth Nowluke, and you know it. You don’t get to “localise” data (Your post 96) meaning cherry pick the ICAO standards, methodology and procedures, especially as they refer to humans, unless you wish to make the racist claim that australian pilots are subhumans. The Australian regulations are a cancerous concoction that is worse than the sum of its parts
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Old 19th Dec 2018, 21:29
  #106 (permalink)  
 
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and standby
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Old 19th Dec 2018, 21:29
  #107 (permalink)  
 
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Sorry Sunfish, http://www.airservicesaustralia.com/...up/s18-h44.pdf I'd already referenced it but if you need a hand hold over to the active document here it is. Maybe you define localise differently to me, maybe you're also "way out of your depth", maybe you can't be bothered to read the tabulated lists of how Australia either exceeds, does not meet or is of no effect against the ICAO standards i.e. the localisation...

A country, any country will have arrangements via legislation to adopt international agreements. ICAO standards (adopted in the Air Navigation Act https://www.legislation.gov.au/Details/C2016C00936 & the Civil Aviation Act https://www.legislation.gov.au/Details/C2016C01097 ) are no different to the Geneva convention (https://www.legislation.gov.au/Details/C2016C01093) or other international treaties we adopt into our sovereign processes. Someone (unless you are the ICC or at war) just doesn't generally get to apply a set of rules/norms/law without a domestic implementation of the international agreement.
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Old 19th Dec 2018, 21:44
  #108 (permalink)  
 
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Meaningless waffle Luke. My point is that CASA and you, refuse to apply international standards, the most important being a refusal to apply risk management approach to regulation.


CASA even has a report on the subject but refuses to apply it.

https://www.casa.gov.au/file/149106/...token=WVqD2Yb0


To put it simply, do the calculations for the benefit in dollar terms of the current medical regime versus the horrendous cost to the community of its application.




Last edited by Sunfish; 19th Dec 2018 at 22:04.
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Old 19th Dec 2018, 21:50
  #109 (permalink)  
 
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...and that's where our disagreements will remain extant. Your subjective position doesn't relate to the objective things out there that will continue to exist no matter how much you declaim the opposite.
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Old 19th Dec 2018, 21:53
  #110 (permalink)  
 
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The fact that any/many countrries have a localised version of international rules does not make them any better/worse than the original.
It would seem that the majority of non CASA aviation personnell would suggest that" OZification" of the FAA rules are very much a case of making things worse.
Mick
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Old 20th Dec 2018, 06:11
  #111 (permalink)  
 
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Originally Posted by Sunfish View Post
Meaningless waffle Luke. My point is that CASA and you, refuse to apply international standards, the most important being a refusal to apply risk management approach to regulation.
CASA even has a report on the subject but refuses to apply it.
https://www.casa.gov.au/file/149106/...token=WVqD2Yb0
To put it simply, do the calculations for the benefit in dollar terms of the current medical regime versus the horrendous cost to the community of its application.
Sunfish,
Well Said.
But it should be read and understood as a consequence of Bruce Byron's Directive 1 of 2007. ie: Part of the implementation of Directive 1 of 2007.

Once the system got rid of Byron and Vaughan, all this CBA nonsense (ie; complying with Government directives and the diktats of the Office of Best Practice Regulation (OBPR) was dropped like a hot brick.

Interestingly, one of the exercises done "back in the day", was to apply the then AS/NZ for Risk Management to a big swodge of "maintenance" rules ----- the result was most interesting, about 80% of the those rules would have been reduced to advisory material or dropped altogether , on the basis they were normal or standard trade practice.

Tootle pip!!

Last edited by LeadSled; 7th Jan 2019 at 21:22. Reason: typo
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Old 21st Dec 2018, 22:03
  #112 (permalink)  
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Update

On advice from my lawyer, I made an appointment with a DAME. The appointment was for last Friday morning (21 December). (The point of a DAME examination is not obvious to me - CASA will ignore the DAME’s opinion unless, of course, the opinion is against my interests. I guess it’s because my now-suspended medical certificate nominally expires on 30 January 2019. And, during the stay hearing in the AAT, CASA’s lawyer made much of the fact that I hadn’t seen a DAME after the embolisation procedure.)

I took half day of leave to make sure I was at the appointment early and with plenty of time to deal with whatever new bright ideas Avmed has come up with to deal with us presumptively lying and untrustworthy pilots. You know, stuff like the two-sets-of glasses requirement, because those of us who are in the habit of flying without an adequate spare set of glasses will of course stop doing so as a consequence of being forced to do a eye test with two separate pairs of glasses in a doctor’s surgery once every two years. And stuff like having to trace the lines in the Ishihara plates to trap the lying and dangerous CVD subhumans who memorise the numbers in the numbered plates. (Let’s face it: Those CVDs can’t be trusted.)

Managed to drive to the medical centre without having a stroke. Lobbed up to the counter in the medical centre.

Me: I’m here a little early for an appointment with Dr X, as I usually have to do some tests with a nurse before seeing the Dr.

Counter staff: Dr X is in India.

Me: Do you have an appointment in your system for me with Dr X this morning?

Counter staff: Yes.

Me: Sooooooo....

Counter staff: Sorry, Dr X is in India.

These kinds of interactions and the inexorably-expanding intrusion of Avmed’s intelligence-insulting and integrity-insulting ideas into doctors’ surgeries is why, as I said in my submission to the review of Avmed, the 2 yearly interaction with the Avmed system is now the single most stressful event in my life. (And I deal with a lot of stressful stuff, on a daily basis.) It’s like entering a different world in which logic, legal principle, courtesy and trust are mere bagatelles and barriers to “the safety of air navigation”.

Whilst the DAME’s stuff-up on this occasion is not Avmed’s fault, I still ‘look forward’ to another round of watching the DAME battle with the MRS while expressing the view that the questions asked are “stupid” (my DAME’s word from last time). I still ‘look forward’ to the nurse and I laughing at the nonsense of having to do eye tests with two separate pairs of glasses. Medical staff ‘get it’ that trying to police an operational requirement by treating it as a medical issue is patently stupid.

And note that on this occasion I’ve been forced to pay a fee to CASA for a service that CASA will not provide. CASA will not consider my application and issue a medical certificate, even if my DAME says I meet the standard. And I have to pay my DAME for his time (assuming he’ll be back in the country for the rescheduled appointment with me).

A wonderful Alice In Wonderland double bind: If you do not submit and pay for a medical certificate application and get and pay for an examination by a DAME, CASA will weigh that against you, but if you get an examination by a DAME and the DAME says you meet the standard, CASA will ignore the DAME’s opinion.
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Old 22nd Dec 2018, 14:26
  #113 (permalink)  
 
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I wonder which lucky IT consultants got the contract for the MRS. I applied for class 1 renewal earlier this year. About the same time the rules were altered to allow me to use a class 2. You beauty I thought. I'll get another 12 months automatically. If a lot of other people are in this same situation, think of the administrative savings. Recently, I wanted to put in another application for a class 1 renewal. Even though the MRS explicitly states that an application is only valid for 90 days, 9 months later the computer says 'no', you already have an application current. OK I say. This is starting to smell fishy, but I'll go along with it. Jump through the hoops and after a few days there's a problem, which seems to be related to how old the application is. So now well over 2 weeks have passed, no more correspondence and no certificate. Feel free to waste your time sending them an email. With christmas and new year now you wouldn't have to be Nostradamus to predict that I'm cooked for another 2 or 3 weeks minimum.
So my advise would be, get your renewal application rolling at the earliest opportunity, and the IT consultant can safely order a new car (Porsche?) or house because that contract has a long way to go.
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Old 23rd Dec 2018, 03:02
  #114 (permalink)  
 
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Has anyone who has been denied a Class 1 had a Class 2 issues instead by their DAME or CASA under the new Class 1 exemption (2018)? I jump through a number of hoops every year being under CASA audit for my Class 1, but now only need a Class 2 for my work. I have a horrible feeling though, that CASA and most DAME's treat Class 2 the same way; with the same level of 'aeromedical risk'.

If this is the case, it goes against CASA's own guidance material stating the new 'Class 1 exemption' is to allow pilots to continue their flying careers under the less restrictive Class 2 if they couldn't meet the requirements of a Class 1, or were finding maintaining a Class 1 'too onerous'.

Will be interesting to see if this is actually going to be the case, or is a Class 2 in CASA eyes only less onerous as you get to renew it every 2 years? I note that in the DAME's handbook, the two classes of medical seem to have identical requirements in the tables...

Last edited by Falling Leaf; 24th Dec 2018 at 05:53.
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Old 7th Jan 2019, 20:23
  #115 (permalink)  
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Update

Saw the Uber-specialist yesterday. $3,410.00 for 45 minutes. And you thought lawyers charge through the nose...

I look forward to his report in a week or two.
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Old 16th Jan 2019, 00:46
  #116 (permalink)  
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Update - Uber-specialist’s opinion

The uber-specialist’s opinion from his report dated 11 January 2019:

HISTORY
[deleted in the interests of brevity]

PERSONAL HISTORY
[deleted in the interests of brevity]

PHYSICAL EXAMINATION
[deleted in the interests of brevity]

DOCUMENTATION
[deleted in the interests of brevity]

OPINION

Mr McKenzie was a well-groomed, intelligent man, who presented his case in a very simple and unembellished fashion. It was Mr McKenzie whobrought his health status to the attention of CASA and it does appear that CASA has overreacted, although it has gone to the length of contacting Professor Mark Stoodley for an independent opinion and has reviewed the literature.

The report from Professor Stoodley is a typical response in an area that is essentially an evidence vacuum. The opinions provided, and also those relied upon by CASA, are based on very small sample studies and do nothing to look for bias or scientific rigour.

The risks that are posed by Mr McKenzie were serious and significant, prior to intervention and, subsequent to intervention all the available material, would indicate complete resolution of the problem. This does not negate the potential for recurrence but it must be accepted that what Mr McKenzie presents was asymptomatic, in the first place, and it is unclear how many other pilots have similar issues that are asymptomatic and diagnosed coincidentally. It is also questionable how many other pilots would show as much integrity and honesty as was the case with Mr McKenzie who brought his health status to the attention of CASA.

A totally arbitrary figure of one year has been imposed as the time for follow-up and follow-up investigation. Mr McKenzie had follow-up investigation much earlier at 3 months after the procedure, and I have no doubt would be happy to undergo further MRA investigations, on a more regular basis, if that were sufficient to convince CASA of his bona fide commitment to ensure both his own health and air traffic safety.

To impose arbitrary, essentially non-scientific qualifications on fitness to fly, appears contradictory to CASA’s commitment to impose rigorous scientific techniques to its assessment of pilots.

The rigour to which CASA has explored the validity of claims must be seen as a great credit to CASA, including the involvement of a Professor of Neurosurgery. Nevertheless the data upon which CASA and Professor Stoodley rely is, of itself, based on arbitrary dates and speculative risk factors which do not appear to apply to Mr McKenzie, who not only was shown to have complete resolution of the fistula at the time of performing the ONYX embolisation but the subsequent imaging 3 months later showed ongoing resolution without any recanalisation, which appears to be the major concern of all those wishing to stop him flying.

The point that needs to be considered is the fact that Mr McKenzie was asymptomatic at the time of his presentation, with regard to the fistula, and the hearing deficit was of a different aetiology. He did see an Ear, Nose and Throat surgeon, who organised the MRI, which produced the coincidental finding. Further, Mr McKenzie did follow through with neurosurgical opinion and spent a great deal of time considering his options and chose that which he felt was the safest and most reliable option.

Mr McKenzie has proven himself to be an absolutely reliable and straightforward witness and I have no doubt would be prepared to have further imaging, as may be required from time to time, and thus far he has had 3 month follow-up imaging that was normal, as was the imaging of the time of the procedure, and I am sure would be prepared to have further imaging if that could be agreed to be sufficient to allow him to reinstate his Class 2 license.

Having respect for all the risks, already identified both by CASA and Professor Stoodley, I tested Mr McKenzie’s higher centre function and he scored well above average. It is thus not a cognitive issues that is causing any concern.

Likewise there were no focal or lateralising neurological signs with no suggestion of raised intracranial pressure on fundoscopy and his hearing, that was the basis of the initial complaint, at least within the confines of an office examination, was completely normal. Corrected vision was likewise perfectly normal at N4 and 5/6, thus demonstrating that there was absolutely no current neurological basis upon which he should be denied access to flying, at this time, other than speculative risks based on poor quality data taken from small number surveys that have no relevance when applied to a single case.

This single case represents a completely normal individual with normal testing, who would be prepared to have further testing, if that was all that was required, to confirm his status, and that should be sufficient to respond to the arbitrary rules, based on pseudoscience from small case series. I would hope that commonsense would prevail to accommodate all who are involved.
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Old 16th Jan 2019, 02:07
  #117 (permalink)  
 
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From Clinton's original post:

I note also that CASA seized upon the specialist’s opinion about my not meeting the class 1 standard as being relevant to my not meeting the class 2 standard. Setting aside the obvious point that I don’t need to or want to meet the class 1 medical standard, this is yet another example of CASA relying on my specialists’ opinion as an objective truth only when it is unfavourable to me.
Does this suggest that if you are denied a Class 1 medical for any reason, say aeromedical risk, that you are also ineligible to be granted a Class 2?

I thought the whole purpose of the two different classes is that they represented differing levels of aeromedical risk. That is why CASA moved to allow DAMEs to issue Class 2 medicals on the spot, unless one had an excluded medical condition?
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Old 17th Jan 2019, 19:22
  #118 (permalink)  
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Having reviewed the Uber-specialist’s report in detail, even I am surprised by the extent of the express and implicit criticism of Avmed’s approach (although I obviously agree that the criticism is justified).

“To impose arbitrary, essentially non-scientific qualifications on fitness to fly, appears contradictory to CASA’s commitment to impose rigorous scientific techniques to its assessment of pilots.”

“Arbitrary rules, based on pseudoscience from small case series”.

“Speculative risks based on poor quality data taken from small number surveys that have no relevance when applied to a single case.”

Seems to me to identify some of the flaws in Avmed’s current approach quite accurately.

Avmed’s current approach is in my view a variation on what’s called “noble cause corruption”. It is in my view not corruption in the strict sense but rather bias and intellectual dishonesty.

According to Caldero and Crank (2004, p.17) noble cause is a “moral commitment to make the world a safer place.” This commitment is why most people join law enforcement agencies, and while this is an admirable goal, when the commitment to make the world a safer place becomes more important than the means to accomplish these goals, corruption may result.
Sound familiar?

We all know what the “noble cause” is: The safety of air navigation.

Avmed seems to me to believe that it’s OK to spin the facts in whichever way puts a pilot in the worst light, that it’s OK to spin whatever data they can find to portray risks to be as high as they could possibly be portrayed when it’s convenient, that it’s OK to spoon feed a supposedly independent expert some selected studies and selectively emphasised passages from studies, and that the law is for others and not them. It’s OK in their minds because it’s done for the noble cause of the safety of air navigation. It’s OK in their minds because it’s a “conservative approach” and “what the public would expect”.

There is no special expertise required to do that. It’s easy. And, sadly, it’s easy to make a comfortable living out of it.

Meanwhile I went to my appointment with the DAME and underwent the usual intelligence-insulting and integrity-insulting Avmed process. The two pairs of glasses bullshit is still being imposed - a signal example of Avmed over-reach. As usual most of the time was taken up by the DAME battling with the MRS, with me telling him again that I underwent routine lung function tests when I was in the RAAF 20 years ago and underwent occasional ECGs as part of whatever the RAAF thought they were for when I was in the RAAF over 20 years ago, and that I had my tonsils out when I was four years old, all of which stuff has been told to them over and over and over and over and over and over again before. Naturally the DAME had to charge extra because of the extra time taken. As with so much that CASA does these days, there was never any data to show that the MRS was a causally beneficial response to any safety risk. When I suggested to the DAME that the MRS was effectively an entrapment system, he agreed.

My overarching concern is not so much about the careers and life’s passions that are destroyed by Avmed unnecessarily - that’s just money and careers and aspirations and other mere bagatelles. And it’s not so much the stultifying and destructive effect is has on what should be a vibrant and expanding general aviation sector. It’s more that it’s got to the point where it’s creating risks to the safety of air navigation in fact, rather than Avmed’s delusional view of what that concept means. Avmed’s current approach creates an enormous incentive for pilots not to raise potential medical issues at all with anyone.
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Old 17th Jan 2019, 19:30
  #119 (permalink)  
 
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Avmed seems to me to believe that it’s OK to spin the facts in whichever way puts a pilot in the worst light,
Welcome to the world of “Policing.”

They willl never put anything positive “for you” in there... it’s how Police statements and briefs work. They are trying to charge you get get you convicted, so why would they put anything in their brief that may actually help you?

Once it’s there in writing and it is being read by you and others, you can’t simply have it removed and it looks bad. It will even have you thinking you are at fault if you read it enough.
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Old 17th Jan 2019, 22:03
  #120 (permalink)  
 
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Squawk, that is why “sex offender registries”, mandatory sentencing, strict liability and electronic health records are all such bad ideas; once an entry has been made “on paper”, the exact circumstances of the event and any mitigating circumstances are ignored. I am starting to see the associated corruption and work-arounds already appearing.
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