Reflections on the appointment of a new CASA PMO
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Reflections on the appointment of a new CASA PMO
I 'tuned in' to the AOPA Panel discussion on Facebook that included the new CASA PMO, Dr Kate Manderson, on the evening of 13 October 21. I think Dr Manderson is around the fifth or sixth CASA PMO (however described) since I started flying in the mid-80s. Dr Manderson deserves genuine thanks for dedicating time to participating in the discussion, during what must be an extra busy time for her.
The discussion about "risk appetite" and "risk settings" and "what are we OK with?" are a manifestation of a fundamental and chronic problem in CASA. The problem has been acute in CASA Avmed for some time.
What the standard isn’t and what weight isn’t put on a PMO’s strongly-held opinion
The standard is not what CASA wakes up each day and decides it’s 'OK with' based upon strongly-held subjective opinions, no matter how ‘expert’. Unfortunately, CASA has been encouraged to believe the standard is whatever CASA decides it is, because CASA has been left to its own devices to create a regulatory regime that is now so complex and convoluted that challenging anything CASA does is prohibitively dangerous for the financial health of most individuals and, in some cases, for their physical and mental health. That has produced what systems safety experts and aviators call: normalised deviation.
One of Dr Manderson’s predecessors found out, the hard way, about the worth of his strongly-held subjective opinions, in ascertaining a pilot’s compliance with the legislated medical standard. The Tribunal Member in this 2013 AAT matter understood the law and put the then PMO in his place:
A cultural problem
The Tribunal’s trust was misplaced. That’s the nature of the Avmed beast these days. Avmed does not make mistakes; everyone else does. That’s why I didn’t say Dr Navathe ‘learnt’ the hard way.
I wrote to the recently appointed CASA CEO/DAS to invite her to arrange for removal of a few sentences from the DAME Handbook manifesting systemic unlawful behaviour that CASA has acknowledged as such. Just a few sentences.
The CASA response was the sadly-typical specious sophistry in defence of changing nothing. That is because the unlawful behaviour I identified continued after it was addressed only in my case and only because I commenced AAT proceedings the first time I was subjected to it, then threatened AAT proceedings the second time.
It’s analogous to ‘robo-debt’: Deal with the rare individuals who have the temerity to challenge our unlawful behaviour and shut them down before a potentially embarrassing AAT decision, but continue with the practice as a general rule. It’s all in the interests of hunting down and crushing dole bludgers, welfare fraudsters and the aviation-equivalent - pilots with ‘conditions’ - when the agency’s compliance with the law would get in the way of achieving the noble cause.
The simple and very telling test is this: When, in recent history, has any CASA Avmed doctor said: “I made a mistake. I apologise to you for my mistake.”?
When CASA acknowledged that it could not lawfully place the purported restriction: “For CASA audit” on my medical certificate, did the person responsible for that unlawful behaviour say: “Sorry. I did not realise that this could not lawfully be done. It will not happen again.”? Nope. That’s why it happened again and I had to threaten AAT proceedings again.
And this a simple example that could and should be easily rectified by any organisation with even a modicum of corporate competence and integrity. Try getting CASA Avmed to understand and accept that they cannot lawfully refuse to consider evidence and make a decision as to a person’s medical fitness during some arbitrary period CASA Avmed plucks out of wherever. In the most recent AAT matter in which I was involved – resolved in my favour – the Tribunal had to ‘pull up’ the Avmed doctor with a strongly-held subjective opinion on the issue and remind him of what the law actually requires. Any apology to me? Nope.
Submission #56 to the current Senate Committee inquiry into the general aviation industry, by a DAME, details appalling behaviour on CASA Avmed’s behalf. In one case CASA Avmed made a patent mathematical mistake and concluded that the medical certificate applicant had a hair test that was positive to methamphetamine. The applicant was also accused of being an “unreliable historian”, which is ‘Avmed-speak’ for “liar”. The DAME states, after having described just two cases of many of which he has first-hand knowledge:
Do you reckon there was any acknowledgement of the nature of or apology for this behaviour by CASA Avmed?
If a private medical practitioner behaved in the ways described by the DAME in these cases, the practitioner’s indemnity insurer would be writing cheques and their cover would eventually be withdrawn. If I were subjected to it by a private medical practitioner, I would be instructing lawyers to commence legal proceedings for damages.
These are manifestations of a cultural problem. Google: “Why Certain People Will Never Admit They Were Wrong”. This passage resonated for me:
Hands up who’d be happy to board an aircraft whose pilot in command could not tolerate the very notion that he or she is capable of making mistakes? Count me ‘out’ as a passenger!
We all make mistakes. On a flight the other day I realised I had not latched the aircraft’s canopy properly. Insufficient attention to proper checklist actions. A few flight reviews ago the ATO picked up the fact that I had not ‘signed off’ the daily inspection for my aircraft. I had conducted the inspection but forgot to endorse the maintenance release. Too focused on other aspects of preparation for a flight review. During the landing roll nearing the end of a flight review while I was the CASA General Manager of General Aviation Operations, I mistook the undercarriage control for the flap control, both of which were obscured by the dual control arm of the aircraft. Take it from me: undercarriage retraction during the landing roll is expensive and embarrassing! (Fortunately, I haven’t made that mistake again and the aircraft was repaired to fly another day. I went on to be part-owner of it for a while and was pleased to see it the other day, still going strong.)
CASA Avmed makes mistakes, too. But try finding any evidence that they’ve ever acknowledged or apologised for one.
A little glimpse through the CASA Avmed looking glass
Think about the mindset that creates forms like this, requiring instructors to be informants on student pilots. One of the behaviours CASA Avmed wants instructors to inform on is:
Funny, hey?
Yep, ‘funny’ as in ‘really strange’.
The form requires the instructor to express a view on whether the student’s behaviour is “normal” or not. I wonder where the instructor’s opinion rates in the NHMRC’s hierarchy of evidence. I do not wonder about what CASA Avmed does with any evidence detrimental to the student pilot’s interests.
I do hope the student – or their legal guardian in the case of a minor - is informed that the assessment is being made by the instructor and will be submitted to Avmed. And I wonder what protections an instructor has for the consequences of the opinions he or she expresses in the form.
The creators of this form are evidently completely divorced from a thing called “reality”. If a student pilot manifests the kinds of behaviours listed in the form, the student pilot is unlikely to pass the theory and practical exams that have to be passed in order to obtain a pilot’s licence.
CASA Avmed must be labouring under the misconception that before it invented the form and turned instructors into informants on student pilots, it was possible for a person with some of these kinds of symptoms to pass the theory and practical tests necessary to become a pilot:
- often fail to give close attention to details or make mistakes in theory lessons, pre-flight preparation or in-flight instruction
- often have difficulty sustaining attention in theory lessons or in-fight instruction
- do not seem to listen when spoken to directly
- do not seem to listen when asked questions in theory lessons or in-flight instruction
- do not follow through on instructions given in-flight
- have difficulty completing lessons
- do not pay attention to or follow through or complete checklists appropriately
- have difficulty organizing tasks and activities
- have difficulty prioritising tasks e.g. during pre-flight preparation
- inappropriately organise cockpit tasks e.g. aviate, navigate, communicate
- often avoid, dislike, or are reluctant to engage in tasks that require sustained mental effort
- have difficulty with studying theoretical aspects of learning to fly
- do not sustain attention to in-flight tasks
- cut in on other aircraft or be inpatient waiting for take-off
[The author of the form meant “impatient” but may have been distracted by other stimuli rather than concentrating on proof-reading the form. Further, the author of the form evidently hasn’t spent much time sitting in a stiflingly hot cockpit at a runway holding point, having called ‘ready’, watching a dot in the distance taking a couple of minutes to arrive at the threshold of the runway, triggering a further delay due to wake turbulence risk, while the instructor – in loud and ‘colourful’ language - speculates on the air traffic controller’s parentage and IQ.]
- have difficulty conforming to safe separation in circuit pattern
- have difficulty holding sustained attitudes/altitudes
- lose things necessary for tasks or activities
- misplace or leave behind headsets, slide rules, maps, flight plans
- forget to replace fuel caps, pitot tubes etc
[Plenty of pilots have forgotten to replace fuel caps, including me once. But I’ve never replaced a pitot tube - I’m not qualified to. Maybe pitot tube replacement is now part of the pilot syllabus?]
- have difficulty maintaining constant headings, altitudes etc because of distraction e.g. looking at things on the ground
- miss items on checklist, pre-flight checks
Does CASA Avmed seriously believe that, but for its beneficent intervention, the skies would be filling up with pilots with manifold behaviours from that list? Seriously?
I get it that ADHD and ASD are ‘conditions’ that have consequences in principle. That doesn’t turn those conditions into something to be micro-managed by CASA Avmed.
It’s like CASA Avmed’s bright idea that we now have to pass the eye test in the DAME’s clinic with two different pairs of eye correction, as if that ‘proves’ compliance with CASR 67.200. I don’t ‘front’ my DAME with either of the pairs of glasses I wear or have available while flying. Taking those pairs of glasses to the DAME’s clinic would be stupid. I need and keep those glasses in my aircraft, which isn’t parked in the DAME’s clinic.
(Purely coincidentally, I was sitting in a doctor’s clinic very recently, waiting for an ultrasound on my baby - not my real condition; I’m actually completely blind, but don’t tell CASA). The TV in the corner of the waiting room started playing an item about ADHD. I found it very informative. At the end there was disclosure of the common side-effects of the drugs usually given to children to ‘treat’ ADHD: Lack of appetite and difficulty in getting to sleep. I thought: Those are the drugs we need to fill kiddies with. What could possibly go wrong?)
People with fragile egos and a commitment to a noble cause sometimes struggle with being ordinary and accountable
Whether someone joins CASA as a doctor or lawyer (or butcher or baker or candlestick maker), the person is the subject of many statutory obligations and constraints on their activities. Those requirements and constraints cannot be complied with unless they are understood and accepted. Administrative law is actually about protecting people from the likes of CASA and the kinds of decisions that CASA Avmed is in the habit of making with increasing and unnecessary frequency. That’s why the AAT dealt with one of Dr Manderson’s predecessors in the way it did as I’ve quoted earlier.
My first hand observation is that doctors as bureaucrats often struggle with the concept of having to comply with legal requirements and constraints imposed on their decision-making. They don’t like their opinions being challenged. They don’t like being told that they are just ordinary bureaucrats making ordinary administrative decisions that are the subject of laws that have been around for decades. But they are, whether they like it or not.
The gap between the rhetoric and the practice
I welcomed the panel discussion about "evidence-based medicine" but thought: "If only...".
I noted the reference to the "global body of literature" and "consensus" but thought: "If only...".
And then there was the NHMRC hierarchy of evidence. That's the hierarchy CASA Avmed usually quotes just before proceeding to 'cherry pick' whatever 'evidence' it can find to put a person's medical ‘condition’ into the worst light and spinning that into a potential aviation catastrophe. The subjective opinion of someone in Avmed is magically elevated in the hierarchy. The consequent ‘risks’ demand the most intrusive, restrictive, costly and – in some cases – life-threatening impositions on pilots that Avmed can identify.
My most recent foray in the AAT arose out of a CASA Avmed decision the reasons for which were sprinkled with a bunch of high-sounding rhetoric and an evidence pyramid but were in substance based on ‘cherry picked’ studies and the Avmed doctor’s non-expert, strongly-held opinion. Australia’s foremost expert in the area in question described the decision as being based on “pseudoscience”. That’s why CASA backed down before a potentially embarrassing Tribunal decision.
My lawyer in the matter told me that the practical standard in CASA Avmed matters is this: “They’ll do whatever they like and will only back down if there’s a risk of them being embarrassed.” That’s the extent to which the integrity of the Avmed function has been compromised.
The discussion about “evidence-based medicine” led me to wonder…
Is the ‘non-CASA’ medical fraternity systemically incompetent?
A thing that perplexes me about CASA Avmed’s approach over the last decade or so is the implication that ‘non-CASA’ doctors and specialists are not practising evidence-based medicine, not reviewing the global body of literature to find out whether there is consensus and not aware of and applying the NHMRC hierarchy of evidence. Why else would CASA Avmed so frequently second-guess or dismiss the opinions of the ‘non-CASA’ medical fraternity these days? Perhaps CASA Avmed is ‘saving’ us from that fraternity’s systemic incompetence? Perhaps CASA is doing us pilots a favour?
I don’t understand why I can’t identify any medical professional independent of CASA who’ll say: “CASA Avmed is nailing it. We’ve so much to learn from CASA Avmed.” The statements they make are invariably to the opposite effect.
Even more perplexing is how someone from the ‘non-CASA’ medical fraternity becomes ‘more competent’ and ‘more expert’ than he or she would otherwise be, merely as a consequence of becoming a member of CASA staff. I’m guessing there’s some form of transmogrification, perhaps involving Kool Aide. Who’d know. All I can do is respectfully urge Dr Manderson not to attend any strange rituals or consume any bubbling potions proffered during the CASA induction process.
Conversely, I can’t work out how 20 more years of aeronautical experience and legal practise after bailing out of CASA makes me less qualified than I was, back then, to spot specious nonsense cloaked in aviation safety rhetoric.
But I digress …
The discussion about "risk appetite" and "risk settings" and "what are we OK with?" are a manifestation of a fundamental and chronic problem in CASA. The problem has been acute in CASA Avmed for some time.
What the standard isn’t and what weight isn’t put on a PMO’s strongly-held opinion
The standard is not what CASA wakes up each day and decides it’s 'OK with' based upon strongly-held subjective opinions, no matter how ‘expert’. Unfortunately, CASA has been encouraged to believe the standard is whatever CASA decides it is, because CASA has been left to its own devices to create a regulatory regime that is now so complex and convoluted that challenging anything CASA does is prohibitively dangerous for the financial health of most individuals and, in some cases, for their physical and mental health. That has produced what systems safety experts and aviators call: normalised deviation.
One of Dr Manderson’s predecessors found out, the hard way, about the worth of his strongly-held subjective opinions, in ascertaining a pilot’s compliance with the legislated medical standard. The Tribunal Member in this 2013 AAT matter understood the law and put the then PMO in his place:
[I]t could not be plainer that Dr Navathe is an advocate for his own decision. I do not propose to have any regard to his opinions. For the future I would trust that CASA’s Legal Branch would exercise independent judgement in deciding what witnesses ought be relied upon and the content of their statements. They ought, obviously enough, be confined to matters that are relevant and witnesses ought be those who can truly provide an independent opinion.
The Tribunal’s trust was misplaced. That’s the nature of the Avmed beast these days. Avmed does not make mistakes; everyone else does. That’s why I didn’t say Dr Navathe ‘learnt’ the hard way.
I wrote to the recently appointed CASA CEO/DAS to invite her to arrange for removal of a few sentences from the DAME Handbook manifesting systemic unlawful behaviour that CASA has acknowledged as such. Just a few sentences.
The CASA response was the sadly-typical specious sophistry in defence of changing nothing. That is because the unlawful behaviour I identified continued after it was addressed only in my case and only because I commenced AAT proceedings the first time I was subjected to it, then threatened AAT proceedings the second time.
It’s analogous to ‘robo-debt’: Deal with the rare individuals who have the temerity to challenge our unlawful behaviour and shut them down before a potentially embarrassing AAT decision, but continue with the practice as a general rule. It’s all in the interests of hunting down and crushing dole bludgers, welfare fraudsters and the aviation-equivalent - pilots with ‘conditions’ - when the agency’s compliance with the law would get in the way of achieving the noble cause.
The simple and very telling test is this: When, in recent history, has any CASA Avmed doctor said: “I made a mistake. I apologise to you for my mistake.”?
When CASA acknowledged that it could not lawfully place the purported restriction: “For CASA audit” on my medical certificate, did the person responsible for that unlawful behaviour say: “Sorry. I did not realise that this could not lawfully be done. It will not happen again.”? Nope. That’s why it happened again and I had to threaten AAT proceedings again.
And this a simple example that could and should be easily rectified by any organisation with even a modicum of corporate competence and integrity. Try getting CASA Avmed to understand and accept that they cannot lawfully refuse to consider evidence and make a decision as to a person’s medical fitness during some arbitrary period CASA Avmed plucks out of wherever. In the most recent AAT matter in which I was involved – resolved in my favour – the Tribunal had to ‘pull up’ the Avmed doctor with a strongly-held subjective opinion on the issue and remind him of what the law actually requires. Any apology to me? Nope.
Submission #56 to the current Senate Committee inquiry into the general aviation industry, by a DAME, details appalling behaviour on CASA Avmed’s behalf. In one case CASA Avmed made a patent mathematical mistake and concluded that the medical certificate applicant had a hair test that was positive to methamphetamine. The applicant was also accused of being an “unreliable historian”, which is ‘Avmed-speak’ for “liar”. The DAME states, after having described just two cases of many of which he has first-hand knowledge:
As a medical practitioner, I can accept that people make mistakes, but these cases are not mistakes, these are instances where AvMed doctors have brutalised individuals, for no particular gain, except the theoretical “safety of air navigation”, which on review, was never compromised.
If a private medical practitioner behaved in the ways described by the DAME in these cases, the practitioner’s indemnity insurer would be writing cheques and their cover would eventually be withdrawn. If I were subjected to it by a private medical practitioner, I would be instructing lawyers to commence legal proceedings for damages.
These are manifestations of a cultural problem. Google: “Why Certain People Will Never Admit They Were Wrong”. This passage resonated for me:
[W]hen people are constitutionally unable to admit they’re wrong, when they cannot tolerate the very notion that they are capable of mistakes, it is because they suffer from an ego so fragile that they cannot sulk and get over it — they need to warp their very perception of reality and challenge obvious facts in order to defend their not being wrong in the first place.
We all make mistakes. On a flight the other day I realised I had not latched the aircraft’s canopy properly. Insufficient attention to proper checklist actions. A few flight reviews ago the ATO picked up the fact that I had not ‘signed off’ the daily inspection for my aircraft. I had conducted the inspection but forgot to endorse the maintenance release. Too focused on other aspects of preparation for a flight review. During the landing roll nearing the end of a flight review while I was the CASA General Manager of General Aviation Operations, I mistook the undercarriage control for the flap control, both of which were obscured by the dual control arm of the aircraft. Take it from me: undercarriage retraction during the landing roll is expensive and embarrassing! (Fortunately, I haven’t made that mistake again and the aircraft was repaired to fly another day. I went on to be part-owner of it for a while and was pleased to see it the other day, still going strong.)
CASA Avmed makes mistakes, too. But try finding any evidence that they’ve ever acknowledged or apologised for one.
A little glimpse through the CASA Avmed looking glass
Think about the mindset that creates forms like this, requiring instructors to be informants on student pilots. One of the behaviours CASA Avmed wants instructors to inform on is:
May not sit still in pre-flight briefings. Hopefully does not get out of seat in flight!
Yep, ‘funny’ as in ‘really strange’.
The form requires the instructor to express a view on whether the student’s behaviour is “normal” or not. I wonder where the instructor’s opinion rates in the NHMRC’s hierarchy of evidence. I do not wonder about what CASA Avmed does with any evidence detrimental to the student pilot’s interests.
I do hope the student – or their legal guardian in the case of a minor - is informed that the assessment is being made by the instructor and will be submitted to Avmed. And I wonder what protections an instructor has for the consequences of the opinions he or she expresses in the form.
The creators of this form are evidently completely divorced from a thing called “reality”. If a student pilot manifests the kinds of behaviours listed in the form, the student pilot is unlikely to pass the theory and practical exams that have to be passed in order to obtain a pilot’s licence.
CASA Avmed must be labouring under the misconception that before it invented the form and turned instructors into informants on student pilots, it was possible for a person with some of these kinds of symptoms to pass the theory and practical tests necessary to become a pilot:
- often fail to give close attention to details or make mistakes in theory lessons, pre-flight preparation or in-flight instruction
- often have difficulty sustaining attention in theory lessons or in-fight instruction
- do not seem to listen when spoken to directly
- do not seem to listen when asked questions in theory lessons or in-flight instruction
- do not follow through on instructions given in-flight
- have difficulty completing lessons
- do not pay attention to or follow through or complete checklists appropriately
- have difficulty organizing tasks and activities
- have difficulty prioritising tasks e.g. during pre-flight preparation
- inappropriately organise cockpit tasks e.g. aviate, navigate, communicate
- often avoid, dislike, or are reluctant to engage in tasks that require sustained mental effort
- have difficulty with studying theoretical aspects of learning to fly
- do not sustain attention to in-flight tasks
- cut in on other aircraft or be inpatient waiting for take-off
[The author of the form meant “impatient” but may have been distracted by other stimuli rather than concentrating on proof-reading the form. Further, the author of the form evidently hasn’t spent much time sitting in a stiflingly hot cockpit at a runway holding point, having called ‘ready’, watching a dot in the distance taking a couple of minutes to arrive at the threshold of the runway, triggering a further delay due to wake turbulence risk, while the instructor – in loud and ‘colourful’ language - speculates on the air traffic controller’s parentage and IQ.]
- have difficulty conforming to safe separation in circuit pattern
- have difficulty holding sustained attitudes/altitudes
- lose things necessary for tasks or activities
- misplace or leave behind headsets, slide rules, maps, flight plans
- forget to replace fuel caps, pitot tubes etc
[Plenty of pilots have forgotten to replace fuel caps, including me once. But I’ve never replaced a pitot tube - I’m not qualified to. Maybe pitot tube replacement is now part of the pilot syllabus?]
- have difficulty maintaining constant headings, altitudes etc because of distraction e.g. looking at things on the ground
- miss items on checklist, pre-flight checks
Does CASA Avmed seriously believe that, but for its beneficent intervention, the skies would be filling up with pilots with manifold behaviours from that list? Seriously?
I get it that ADHD and ASD are ‘conditions’ that have consequences in principle. That doesn’t turn those conditions into something to be micro-managed by CASA Avmed.
It’s like CASA Avmed’s bright idea that we now have to pass the eye test in the DAME’s clinic with two different pairs of eye correction, as if that ‘proves’ compliance with CASR 67.200. I don’t ‘front’ my DAME with either of the pairs of glasses I wear or have available while flying. Taking those pairs of glasses to the DAME’s clinic would be stupid. I need and keep those glasses in my aircraft, which isn’t parked in the DAME’s clinic.
(Purely coincidentally, I was sitting in a doctor’s clinic very recently, waiting for an ultrasound on my baby - not my real condition; I’m actually completely blind, but don’t tell CASA). The TV in the corner of the waiting room started playing an item about ADHD. I found it very informative. At the end there was disclosure of the common side-effects of the drugs usually given to children to ‘treat’ ADHD: Lack of appetite and difficulty in getting to sleep. I thought: Those are the drugs we need to fill kiddies with. What could possibly go wrong?)
People with fragile egos and a commitment to a noble cause sometimes struggle with being ordinary and accountable
Whether someone joins CASA as a doctor or lawyer (or butcher or baker or candlestick maker), the person is the subject of many statutory obligations and constraints on their activities. Those requirements and constraints cannot be complied with unless they are understood and accepted. Administrative law is actually about protecting people from the likes of CASA and the kinds of decisions that CASA Avmed is in the habit of making with increasing and unnecessary frequency. That’s why the AAT dealt with one of Dr Manderson’s predecessors in the way it did as I’ve quoted earlier.
My first hand observation is that doctors as bureaucrats often struggle with the concept of having to comply with legal requirements and constraints imposed on their decision-making. They don’t like their opinions being challenged. They don’t like being told that they are just ordinary bureaucrats making ordinary administrative decisions that are the subject of laws that have been around for decades. But they are, whether they like it or not.
The gap between the rhetoric and the practice
I welcomed the panel discussion about "evidence-based medicine" but thought: "If only...".
I noted the reference to the "global body of literature" and "consensus" but thought: "If only...".
And then there was the NHMRC hierarchy of evidence. That's the hierarchy CASA Avmed usually quotes just before proceeding to 'cherry pick' whatever 'evidence' it can find to put a person's medical ‘condition’ into the worst light and spinning that into a potential aviation catastrophe. The subjective opinion of someone in Avmed is magically elevated in the hierarchy. The consequent ‘risks’ demand the most intrusive, restrictive, costly and – in some cases – life-threatening impositions on pilots that Avmed can identify.
My most recent foray in the AAT arose out of a CASA Avmed decision the reasons for which were sprinkled with a bunch of high-sounding rhetoric and an evidence pyramid but were in substance based on ‘cherry picked’ studies and the Avmed doctor’s non-expert, strongly-held opinion. Australia’s foremost expert in the area in question described the decision as being based on “pseudoscience”. That’s why CASA backed down before a potentially embarrassing Tribunal decision.
My lawyer in the matter told me that the practical standard in CASA Avmed matters is this: “They’ll do whatever they like and will only back down if there’s a risk of them being embarrassed.” That’s the extent to which the integrity of the Avmed function has been compromised.
The discussion about “evidence-based medicine” led me to wonder…
Is the ‘non-CASA’ medical fraternity systemically incompetent?
A thing that perplexes me about CASA Avmed’s approach over the last decade or so is the implication that ‘non-CASA’ doctors and specialists are not practising evidence-based medicine, not reviewing the global body of literature to find out whether there is consensus and not aware of and applying the NHMRC hierarchy of evidence. Why else would CASA Avmed so frequently second-guess or dismiss the opinions of the ‘non-CASA’ medical fraternity these days? Perhaps CASA Avmed is ‘saving’ us from that fraternity’s systemic incompetence? Perhaps CASA is doing us pilots a favour?
I don’t understand why I can’t identify any medical professional independent of CASA who’ll say: “CASA Avmed is nailing it. We’ve so much to learn from CASA Avmed.” The statements they make are invariably to the opposite effect.
Even more perplexing is how someone from the ‘non-CASA’ medical fraternity becomes ‘more competent’ and ‘more expert’ than he or she would otherwise be, merely as a consequence of becoming a member of CASA staff. I’m guessing there’s some form of transmogrification, perhaps involving Kool Aide. Who’d know. All I can do is respectfully urge Dr Manderson not to attend any strange rituals or consume any bubbling potions proffered during the CASA induction process.
Conversely, I can’t work out how 20 more years of aeronautical experience and legal practise after bailing out of CASA makes me less qualified than I was, back then, to spot specious nonsense cloaked in aviation safety rhetoric.
But I digress …
Last edited by Clinton McKenzie; 22nd Oct 2021 at 21:47.
Thread Starter
Dr Manderson nails it without naming it – cognitive bias
Dr Manderson nailed the issue at the heart of what is wrong with CASA's mindset and decision-making. Here it is, writ large, after Dr Manderson was asked about why it’s ‘OK’ for someone to with a ‘condition’ to drive a B-Double truck but ‘not OK’ for the same person to fly a light aircraft. Dr Manderson used the analogy of regulatory approval of covid vaccinations for very young children:
The answer is simple, Doc: Cognitive bias. It is, as you say: “the way we are put together”.
Cognitive biases are cod-ordinary, well-known and uncontroversial human propensities.
For example, humans ‘naturally’ over-estimate the probabilities of events with consequences that are ghastly to contemplate: Being attacked by a shark; Dying in the cliche '30,000 foot death plunge' in an aircraft. However, the result of that propensity can be harmful overreactions to the objective risks. I highly commend Cass Sunstein's paper Probability Neglect: Emotions, Worst Cases, and Law on this subject.
There are many other examples of cognitive bias that we need to understand if we are to avoid their harmful consequences. For us aviators, in particular, there's a very good article in the January 2015 edition of Flight Safety Australia called: “The fatal five”. The fifth is a form of cognitive bias called 'confirmation bias' of which aviators will be – or least should be – aware. It will get you into trouble in the real aviation world.
As another example, there is a way to avoid losing money due to the ‘gambler’s fallacy’ – another form of cognitive bias that results in people erroneously believing that a certain random event is less likely or more likely to happen based on the outcome of a previous event or series of events. Casinos and other gambling businesses are, of course, acutely aware of this form of cognitive bias. It’s why the Lotto people publish “Hot Numbers” and “Cold Numbers”. You avoid the financially disastrous consequences of this kind of cognitive bias by learning and making decisions based on matriculation-level probabilities.
The Perth city authority’s response to the Mallard tragedy is an example of both of these kinds of cognitive bias in action. The Australia Day flyover in Perth has simply been cancelled. CASA’s ‘Community Service Flight’ instrument is, in my view, another example, though there was at least an attempt to justify it on the basis of (highly contested) statistics.
An ASIC lasts only 2 years but an MSIC can last up to 4. I suppose that’s because a terrorist ‘inside the wire’ at Birdsville aerodrome poses a greater risk than a terrorist in charge of a ship full of ammonium nitrate in a city’s port.
The FAA does a pretty good job of avoiding harmful overreactions in aviation safety regulation. CASA? Not so much.
There is a way to avoid harmful overreactions caused by cognitive bias: You get disinterested people to assess the objective evidence and the objective risks then make decisions on that basis alone. And guess what? The law requires administrative decisions - like the decision by CASA to issue a medical certificate or not, or to impose a condition or to require some medical test - to be made that way.
The USA is pretty good at disinterested, objective evidence and risk-based decision-making in aviation regulation. That’s one of the reasons the USA has Basic Med and flight instruction without AOCs. It also helps that aviation is part of the USA’s ‘cultural DNA’ because aerospace capability is a fundamental input to its economic and military superpower status. The USA ‘gets’ that in order to enjoy the rewards, you have to take the risks and pay the costs.
Imagine where aerospace would be today if each tragedy resulted in a cancellation of any further similar activity. Analyse and learn - Yes. But keep the emotion out of it.
One of my favourite decision-makers in aviation is a (now deceased) British scientist named Conrad Hal Waddington, eponymous of the ‘Waddington Effect’. His analysis of the reliability of bombers in WWII showed that the mandatory preventive maintenance schedule was causing more problems than it was preventing. The ‘conventional wisdom’ at the time – ‘conventional wisdom’ being a euphemism for the intuition of experts with strongly held opinions - was that more preventive maintenance would catch and fix incipient problems before they became unserviceabilities. Waddington’s analysis led to recommendations to increase the interval between scheduled maintenance and to reduce the number of tasks carried out. That resulted in a 60% increase in effective flying hours of the RAF Coastal Command bomber fleet.
Waddington wasn’t an aeronautical engineer or an aircraft mechanic or even a pilot. He was a gifted developmental biologist, paleontologist, geneticist, embryologist, philosopher, poet and painter who wasn’t particularly interested in aviation. But that’s why he was able to conduct proper analysis which showed that the worst thing you can do to a complicated piece of machinery is pull it apart to find out why it is working well and try to ‘help’ it to keep working well. More mandatory meddling causes more problems than it prevents. The flight I fear most is the first one after my aircraft has been the subject of mandatory meddling. Most of the damage done to my aircraft over the years has been done during mandatory meddling.
What have we got out of CASA for so long? To use Dr Manderson’s term: 'Extra' careful. One of her predecessors called it: “The conservative approach”. Another CASA Avmed doctor said: “It is what the public would expect us to do.” That’s not objective evidence-based and objective risk-based decision-making.
A person with a ‘condition’ might be 'OK' to drive a B-double truck, but an aeroplane? Cognitive bias says: No!
Contemplating a B-Double crashing into a school yard doesn't scare people as much as contemplating a Cessna 172 colliding with a Jumbo Jet. And that's what could happen if Joe or Josephine the Cessna 172 pilot has a 'condition'. The B-Double jack-knifing into the playground won’t put the kiddies through the horror of the 30,000 foot death plunge and, in any event, that’s ‘someone else’s’ risk to manage.
Assuming the driver of the B-Double and the pilot at the controls of the Cessna 172 each suffer sudden incapacitation, the probabilities of the B-Double causing death or destruction are many orders of magnitude higher than the Cessna 172 causing death or destruction. This pilot was rendered unconscious by a carbon monoxide leak and walked away from a ‘landing’ while unconscious. There was no mid-air collision with a Jumbo Jet while the aircraft continued on its way with an unconscious pilot.
It might be ‘OK’ for you to drive a car that is three times the weight and carries double the number of passengers compared with your aircraft, and it might be ‘OK’ for you to do that in densely populated areas and on the highway in close proximity to busloads of school children, without having a battery of costly six-monthly medical tests. But as soon as you want to get into that Cessna 172 to fly to Birdsville with your partner and child it’s ‘not OK’ because you become a potential aviation catastrophe that’s too ghastly to contemplate. Cognitive bias says: No! Think about the kiddy in the Cessna death plunge.
The ever-expanding “large number of potential aero-medically significant conditions” – that’s a quote from the CASA DAME Handbook – create ‘risks’ that justify – nay, demand! - intrusive, restrictive, costly and – in some cases – risky and destructive impositions on pilots. That’s being extra careful. It’s the conservative approach. It is what the public would expect us to do. (Oh, and by the way, it keeps us in a job with endless busy-work that makes us feel important.)
CASA had a bit of amnesia for a while and overlooked the Waddington Effect during its ‘Community Service Flight’ changes. CASA was proposing to ‘increase’ the maintenance ‘standard’ of the private aircraft involved by requiring them to undergo more scheduled maintenance. Fortunately a reminder of the Waddington Effect made it to someone capable of listening and deciding on the basis of data rather than intuition. (Unfortunately, the same did not happen with the control cable AD. I paid $10,000 to have my Bonanza turned in to a death trap. Thanks CASA! And many maintenance organisations have incurred regulatory wrath on the basis of non-compliance with a light aircraft manufacturer’s maintenance schedule based on numbers plucked out of the air in the mid 50s and 60s but treated as ‘holy writ’.)
Imagine being a judge, faced with a safety authority conjuring up the risk of the 30,000 foot death plunge as a consequence of a ‘risk’ that the ‘authority’ is not ‘satisfied’ has been ‘appropriately’ mitigated. Judges are humans, too.
When the day comes that Australia has to stand up, alone, and defeat an armed attack by a serious force, Australia will again learn the real value of aviation infrastructure and expertise and the real cost of selling it off and regulating general aviation into the ground. DFOs don’t deter or defeat armed attacks. You can’t maintain and operate a defence force for very long unless you have a surge capacity in the form of civilian bodies and brains and facilities that do not rely on immigration and external supply chains. That’s why the USA encourages as many of its citizens and businesses it can to design, build and fly whatever flying machines they can possibly imagine.
Here are the words of a judge in the USA expressed in a 2015 case:
If only we had the same ‘cultural DNA’ in Australia. And we need more Waddingtons.
Dr Manderson nailed the issue at the heart of what is wrong with CASA's mindset and decision-making. Here it is, writ large, after Dr Manderson was asked about why it’s ‘OK’ for someone to with a ‘condition’ to drive a B-Double truck but ‘not OK’ for the same person to fly a light aircraft. Dr Manderson used the analogy of regulatory approval of covid vaccinations for very young children:
There's something about the way we're put together that we just don't want to take that risk with the little kiddies. We want to be extra safe. And extra careful. And extradifferent. ...
Why is it that we'll allow someone behind the wheel of a truck and not the controls of an aircraft? What drives that?
Why is it that we'll allow someone behind the wheel of a truck and not the controls of an aircraft? What drives that?
Cognitive biases are cod-ordinary, well-known and uncontroversial human propensities.
For example, humans ‘naturally’ over-estimate the probabilities of events with consequences that are ghastly to contemplate: Being attacked by a shark; Dying in the cliche '30,000 foot death plunge' in an aircraft. However, the result of that propensity can be harmful overreactions to the objective risks. I highly commend Cass Sunstein's paper Probability Neglect: Emotions, Worst Cases, and Law on this subject.
There are many other examples of cognitive bias that we need to understand if we are to avoid their harmful consequences. For us aviators, in particular, there's a very good article in the January 2015 edition of Flight Safety Australia called: “The fatal five”. The fifth is a form of cognitive bias called 'confirmation bias' of which aviators will be – or least should be – aware. It will get you into trouble in the real aviation world.
As another example, there is a way to avoid losing money due to the ‘gambler’s fallacy’ – another form of cognitive bias that results in people erroneously believing that a certain random event is less likely or more likely to happen based on the outcome of a previous event or series of events. Casinos and other gambling businesses are, of course, acutely aware of this form of cognitive bias. It’s why the Lotto people publish “Hot Numbers” and “Cold Numbers”. You avoid the financially disastrous consequences of this kind of cognitive bias by learning and making decisions based on matriculation-level probabilities.
The Perth city authority’s response to the Mallard tragedy is an example of both of these kinds of cognitive bias in action. The Australia Day flyover in Perth has simply been cancelled. CASA’s ‘Community Service Flight’ instrument is, in my view, another example, though there was at least an attempt to justify it on the basis of (highly contested) statistics.
An ASIC lasts only 2 years but an MSIC can last up to 4. I suppose that’s because a terrorist ‘inside the wire’ at Birdsville aerodrome poses a greater risk than a terrorist in charge of a ship full of ammonium nitrate in a city’s port.
The FAA does a pretty good job of avoiding harmful overreactions in aviation safety regulation. CASA? Not so much.
There is a way to avoid harmful overreactions caused by cognitive bias: You get disinterested people to assess the objective evidence and the objective risks then make decisions on that basis alone. And guess what? The law requires administrative decisions - like the decision by CASA to issue a medical certificate or not, or to impose a condition or to require some medical test - to be made that way.
The USA is pretty good at disinterested, objective evidence and risk-based decision-making in aviation regulation. That’s one of the reasons the USA has Basic Med and flight instruction without AOCs. It also helps that aviation is part of the USA’s ‘cultural DNA’ because aerospace capability is a fundamental input to its economic and military superpower status. The USA ‘gets’ that in order to enjoy the rewards, you have to take the risks and pay the costs.
Imagine where aerospace would be today if each tragedy resulted in a cancellation of any further similar activity. Analyse and learn - Yes. But keep the emotion out of it.
One of my favourite decision-makers in aviation is a (now deceased) British scientist named Conrad Hal Waddington, eponymous of the ‘Waddington Effect’. His analysis of the reliability of bombers in WWII showed that the mandatory preventive maintenance schedule was causing more problems than it was preventing. The ‘conventional wisdom’ at the time – ‘conventional wisdom’ being a euphemism for the intuition of experts with strongly held opinions - was that more preventive maintenance would catch and fix incipient problems before they became unserviceabilities. Waddington’s analysis led to recommendations to increase the interval between scheduled maintenance and to reduce the number of tasks carried out. That resulted in a 60% increase in effective flying hours of the RAF Coastal Command bomber fleet.
Waddington wasn’t an aeronautical engineer or an aircraft mechanic or even a pilot. He was a gifted developmental biologist, paleontologist, geneticist, embryologist, philosopher, poet and painter who wasn’t particularly interested in aviation. But that’s why he was able to conduct proper analysis which showed that the worst thing you can do to a complicated piece of machinery is pull it apart to find out why it is working well and try to ‘help’ it to keep working well. More mandatory meddling causes more problems than it prevents. The flight I fear most is the first one after my aircraft has been the subject of mandatory meddling. Most of the damage done to my aircraft over the years has been done during mandatory meddling.
What have we got out of CASA for so long? To use Dr Manderson’s term: 'Extra' careful. One of her predecessors called it: “The conservative approach”. Another CASA Avmed doctor said: “It is what the public would expect us to do.” That’s not objective evidence-based and objective risk-based decision-making.
A person with a ‘condition’ might be 'OK' to drive a B-double truck, but an aeroplane? Cognitive bias says: No!
Contemplating a B-Double crashing into a school yard doesn't scare people as much as contemplating a Cessna 172 colliding with a Jumbo Jet. And that's what could happen if Joe or Josephine the Cessna 172 pilot has a 'condition'. The B-Double jack-knifing into the playground won’t put the kiddies through the horror of the 30,000 foot death plunge and, in any event, that’s ‘someone else’s’ risk to manage.
Assuming the driver of the B-Double and the pilot at the controls of the Cessna 172 each suffer sudden incapacitation, the probabilities of the B-Double causing death or destruction are many orders of magnitude higher than the Cessna 172 causing death or destruction. This pilot was rendered unconscious by a carbon monoxide leak and walked away from a ‘landing’ while unconscious. There was no mid-air collision with a Jumbo Jet while the aircraft continued on its way with an unconscious pilot.
It might be ‘OK’ for you to drive a car that is three times the weight and carries double the number of passengers compared with your aircraft, and it might be ‘OK’ for you to do that in densely populated areas and on the highway in close proximity to busloads of school children, without having a battery of costly six-monthly medical tests. But as soon as you want to get into that Cessna 172 to fly to Birdsville with your partner and child it’s ‘not OK’ because you become a potential aviation catastrophe that’s too ghastly to contemplate. Cognitive bias says: No! Think about the kiddy in the Cessna death plunge.
The ever-expanding “large number of potential aero-medically significant conditions” – that’s a quote from the CASA DAME Handbook – create ‘risks’ that justify – nay, demand! - intrusive, restrictive, costly and – in some cases – risky and destructive impositions on pilots. That’s being extra careful. It’s the conservative approach. It is what the public would expect us to do. (Oh, and by the way, it keeps us in a job with endless busy-work that makes us feel important.)
CASA had a bit of amnesia for a while and overlooked the Waddington Effect during its ‘Community Service Flight’ changes. CASA was proposing to ‘increase’ the maintenance ‘standard’ of the private aircraft involved by requiring them to undergo more scheduled maintenance. Fortunately a reminder of the Waddington Effect made it to someone capable of listening and deciding on the basis of data rather than intuition. (Unfortunately, the same did not happen with the control cable AD. I paid $10,000 to have my Bonanza turned in to a death trap. Thanks CASA! And many maintenance organisations have incurred regulatory wrath on the basis of non-compliance with a light aircraft manufacturer’s maintenance schedule based on numbers plucked out of the air in the mid 50s and 60s but treated as ‘holy writ’.)
Imagine being a judge, faced with a safety authority conjuring up the risk of the 30,000 foot death plunge as a consequence of a ‘risk’ that the ‘authority’ is not ‘satisfied’ has been ‘appropriately’ mitigated. Judges are humans, too.
When the day comes that Australia has to stand up, alone, and defeat an armed attack by a serious force, Australia will again learn the real value of aviation infrastructure and expertise and the real cost of selling it off and regulating general aviation into the ground. DFOs don’t deter or defeat armed attacks. You can’t maintain and operate a defence force for very long unless you have a surge capacity in the form of civilian bodies and brains and facilities that do not rely on immigration and external supply chains. That’s why the USA encourages as many of its citizens and businesses it can to design, build and fly whatever flying machines they can possibly imagine.
Here are the words of a judge in the USA expressed in a 2015 case:
Not only is general aviation important to the national infrastructure, but it serves a critical role as the cradle of aviation. The security and economic vitality of the United States depends on this laboratory of flight where future civilian and military pilots are born. Airports such as Solberg blossomed in an era when local young men turned their dreams of barnstorming into air dominance in World War II and led this country into its golden age. These dreams still live in our youth, and general aviation endures as the proving ground for future pilots from all walks of life.
Finally, there is a certain freedom that defines general aviation. Men and women throughout history gazed longingly at the soaring effortless freedom of birds, pondering release from the symbolic bondage of gravity. Only here can a man or woman walk onto some old farmer’s field and turn dreams into reality. As Charles Lindbergh once said: “What freedom lies in flying, what Godlike power it gives to men . . . I lose all consciousness in this strong unmortal space crowded with beauty, pierced with danger.”
Thus, general aviation airports serve a myriad of public purposes. The record substantiates the importance of general aviation and Solberg Airport’s role in particular. The Defendant offered documentary and testimonial evidence, which this Court found persuasive in its determination of public purpose. The objective evidence demonstrated that general aviation generates over a billion dollars in revenue and creates thousands of jobs across the state [of New Jersey]. It has a substantial economic impact on communities and contributes directly to local business transportation capability. The evidence also demonstrated that New Jersey’s general aviation infrastructure provides many health, welfare, and social benefits: emergency medical services, schools, fire and emergency services, law enforcement, tour operators, and traffic surveillance directly benefit from general aviation airports.
Finally, there is a certain freedom that defines general aviation. Men and women throughout history gazed longingly at the soaring effortless freedom of birds, pondering release from the symbolic bondage of gravity. Only here can a man or woman walk onto some old farmer’s field and turn dreams into reality. As Charles Lindbergh once said: “What freedom lies in flying, what Godlike power it gives to men . . . I lose all consciousness in this strong unmortal space crowded with beauty, pierced with danger.”
Thus, general aviation airports serve a myriad of public purposes. The record substantiates the importance of general aviation and Solberg Airport’s role in particular. The Defendant offered documentary and testimonial evidence, which this Court found persuasive in its determination of public purpose. The objective evidence demonstrated that general aviation generates over a billion dollars in revenue and creates thousands of jobs across the state [of New Jersey]. It has a substantial economic impact on communities and contributes directly to local business transportation capability. The evidence also demonstrated that New Jersey’s general aviation infrastructure provides many health, welfare, and social benefits: emergency medical services, schools, fire and emergency services, law enforcement, tour operators, and traffic surveillance directly benefit from general aviation airports.
Last edited by Clinton McKenzie; 22nd Oct 2021 at 21:40.
Thread Starter
Let us pray and make a sacrifice to the aviation safety gods
Those of us who’ve been around for a while will know the ritual incantation before the sacrifice: “It’s in the interests of the safety of air navigation and that’s the most important consideration in the exercise and performance of CASA’s powers and functions.” It’s a statement that means nearly everything and almost nothing, depending on your perspective.
Imagine if, tomorrow, CASA Avmed woke up and decided that homosexuality is a “potential aero-medically significant” condition, and decided to require all applicants for medical certificates to:
- undergo a homosexuality test in the form a questionnaire compiled by Avmed, for completion by the applicant and one friend and one immediate family member, and
- in the case of applicants considered by Avmed to be homosexual – undergo conversion therapy.
In this hypothetical set of circumstances, would there be any causally beneficial outcome for the safety of air navigation? Not one iota, if you accept the implications of the overwhelming evidence. The fact that Avmed’s opinion is to the contrary does not change that.
In this hypothetical set of circumstances, CASA could do a survey of passengers disembarking from commercial aircraft and ask them whether they had a safe flight and whether they consider the Civil Aviation Safety Authority to be doing a good job. Would the glowingly-positive survey results mean that Avmed’s ‘initiative’ on homosexuality was - to use a word that is sprinkled with monotonous regularity throughout just about everything CASA says these days - “appropriate”? Not if you accept the implications of the overwhelming evidence.
The only things that would be achieved by this Avmed ‘initiative’ are unnecessary costs, unnecessary disruptions, unnecessary stress and much worse.
We would all hope that in this set of hypothetical circumstances the Parliament would finally intervene rather than continue with the bi-partisan abdication of responsibility to the ‘experts’ in CASA, but hopefully we’ll never find out. We would also all hope that this set of hypothetical circumstances is completely ridiculous and would never happen. But…
It wasn’t that long ago – in this century - that a triumvirate of zealots was allowed to go on a trans-Tasman crusade to rid the skies of people with CVD from the pilot's seat of civilian commercial aircraft. Not for those zealots the overwhelming evidence of the 21st century and objective risk assessment and mitigation.
The zealots had some powerful weapons in addition to their positions in government authorities: The intuition and cognitive bias of ordinary people. A pilot with any kind of ‘vision deficiency’ must surely be a 30,000 foot death plunge waiting to happen. Save us! Precisely the kind of weapons used against homosexuals in times past.
The stresses caused, the costs imposed, the careers and career aspirations destroyed and the suicides caused by the CVD crusade were all “in the interests of the safety of air navigation”. It must have all been ‘OK’ because surveys say CASA's been doing a great job.
And having eventually been embarrassed into shutting the CVD zealots down, did anyone say: "Sorry for what we did." “Sorry for what we allowed to happen.”? Nope.
As noted earlier, in my most recent AAT matter Australia’s foremost expert in the area in question said the CASA Avmed doctor’s decision was based on “pseudoscience”. That’s the kind of ‘science’ on which conversion therapy is based and conversion therapy is still legal in some countries that would otherwise be considered ‘progressive’. So let’s all hope that nobody who subscribes to that dangerous nonsense is ever let loose in CASA Avmed.
Two epiphanies
I've been up to my elbows - literally - in aircraft, in flying and in other activities affected by the regulation of aviation for 45 years so far. I suppose there’s a ‘risk’ that I’ve been part of the ‘lunatic fringe’ for all that time. I’ll let others make their own judgments on that question.
One of the epiphanies I had along the way was the realisation of the extent to which civil aviation in Australia is regulated on the basis of emotion and cognitive bias. For all of the high-sounding rhetoric, so much turns on that emotional 'drive' to make aviation 'extra' safe. Some lucrative careers in CASA happen to have been built on it, too. And that's been very damaging particularly to general aviation in Australia where participants are often practically powerless in the face of a government authority on a safety crusade. It’s a result of ‘harmful overreactions’ to the objective risks.
Another epiphany was the realisation that the primary solution was, and remains, simple (at least in principle): All CASA staff have to do is comply with the law. But that would entail them understanding and accepting it, first, rather than just paying lip service to it. As a matter of practicality, they don’t have to because any individual who wants to challenge them faces the formidable preliminary task of explaining, to a court or tribunal, what the complex and convoluted aviation safety regulatory regime is and actually means these days. And that’s the ‘easy’ bit! On the occasions on which I have no choice but to delve into and try to make sense of the current pile of regulatory paper I invariably end up shaking my head in despair.
Whatever the legalities and merits, individuals are going to suffer damage to their financial health and face risks to their physical and mental health if they take CASA on. I’m lucky because I can see through the smoke and mirrors and have the means by which to expose the reality. But CASA’s compliance with the law shouldn’t be down to luck.
A real risk to aviation safety – the yawning ‘trust gap’
A number of years ago I went with some colleagues to a session, run by an 'executive coach', arranged by the HR staff of the organisation within which I was then working. The ‘coach’ said the single best thing we could do for our performance was to have an afternoon nap each working day. All ‘backed up by science’ of course.
I couldn’t help but laugh out loud. When asked to elaborate on my response, I explained what the likes of (now erstwhile) CASA PMO Dr Navathe would do if he found out I had an afternoon nap at work each day. The ‘coach’ said that Dr Navathe’s response would be an overreaction. I said: “Quite so, but he doesn’t think so and he knows he’s right.”
It used to be that CASA Avmed relied primarily on the professionalism and judgments of the medical fraternity, including DAMEs and specialists with direct knowledge of and responsibility for the assessment of the fitness of individual pilots – a reasonable and available approach to administrative decision-making. Now CASA Avmed spends inordinate time second-guessing and dismissing the medical fraternity, demanding ‘management’ of ‘conditions’ in specific ways and requiring batteries of tests, contrary to what the individual is being advised is necessary, without CASA Avmed owing any clinical or professional duties to those individuals.
It used to be that we could choose whether to tick a consent box, on the medical certificate application form, for the information entered on the form to be used in research. That box is gone and the form now merely asserts that we consent by making the application. That’s not ‘consent’. That’s ‘duress’. My compliance or otherwise with the legislated medical standard is not affected by whether information about me is used in studies.
We’re all just a bunch of ‘conditions’ to be discovered and ‘managed’ after the solemn deliberations of a ‘complex case meeting’ in CASA Avmed. And given that CASA Avmed has identified a “large number of potential aero-medically significant conditions” – just “potential” mind you – the ‘extra careful’ response is obvious and pilots who want medical certificates are on the receiving end of it.
I describe us as ‘the guinea pig’ class. Organisms to be tested, studied and managed by CASA Avmed.
CASA Avmed will insouciantly demand that a pilot undergo tests that, for example, entail risks of stroke or death with probabilities many orders of magnitude higher than winning the lottery. After all, if we’re killed or disabled by the test, that’s a ‘good’ outcome for the safety of air navigation and another data point in a study.
Accordingly, I’m no longer surprised by the number of pilots who tell me they "tell Avmed nothing" (expletives deleted). That doesn't worry me, provided people are getting whatever medical services they need to deal with whatever medical issues they may have. There is, after all, no causal connection between CASA Avmed's state of knowledge or ignorance, or state of satisfy-edness or worried-ness, on the one hand, and the state of a person’s objective physical and mental fitness on the other.
Good luck in closing the yawning ‘trust gap’, Dr Manderson
What worries me most are the people who are now too scared to raise a potential medical issue with anyone in the first place, for fear that it will 'get back to Avmed'. There is a yawning ‘trust gap’ and CASA Avmed has become disintegrated from rather than being integral to the system of aviation safety. That's not in the objective interests of aviation safety.
I earnestly hope Dr Manderson reverses that situation, as I care very much about real safety in the real aviation world.
Safe flying, all, and good luck, Dr Manderson.
Those of us who’ve been around for a while will know the ritual incantation before the sacrifice: “It’s in the interests of the safety of air navigation and that’s the most important consideration in the exercise and performance of CASA’s powers and functions.” It’s a statement that means nearly everything and almost nothing, depending on your perspective.
Imagine if, tomorrow, CASA Avmed woke up and decided that homosexuality is a “potential aero-medically significant” condition, and decided to require all applicants for medical certificates to:
- undergo a homosexuality test in the form a questionnaire compiled by Avmed, for completion by the applicant and one friend and one immediate family member, and
- in the case of applicants considered by Avmed to be homosexual – undergo conversion therapy.
In this hypothetical set of circumstances, would there be any causally beneficial outcome for the safety of air navigation? Not one iota, if you accept the implications of the overwhelming evidence. The fact that Avmed’s opinion is to the contrary does not change that.
In this hypothetical set of circumstances, CASA could do a survey of passengers disembarking from commercial aircraft and ask them whether they had a safe flight and whether they consider the Civil Aviation Safety Authority to be doing a good job. Would the glowingly-positive survey results mean that Avmed’s ‘initiative’ on homosexuality was - to use a word that is sprinkled with monotonous regularity throughout just about everything CASA says these days - “appropriate”? Not if you accept the implications of the overwhelming evidence.
The only things that would be achieved by this Avmed ‘initiative’ are unnecessary costs, unnecessary disruptions, unnecessary stress and much worse.
We would all hope that in this set of hypothetical circumstances the Parliament would finally intervene rather than continue with the bi-partisan abdication of responsibility to the ‘experts’ in CASA, but hopefully we’ll never find out. We would also all hope that this set of hypothetical circumstances is completely ridiculous and would never happen. But…
It wasn’t that long ago – in this century - that a triumvirate of zealots was allowed to go on a trans-Tasman crusade to rid the skies of people with CVD from the pilot's seat of civilian commercial aircraft. Not for those zealots the overwhelming evidence of the 21st century and objective risk assessment and mitigation.
The zealots had some powerful weapons in addition to their positions in government authorities: The intuition and cognitive bias of ordinary people. A pilot with any kind of ‘vision deficiency’ must surely be a 30,000 foot death plunge waiting to happen. Save us! Precisely the kind of weapons used against homosexuals in times past.
The stresses caused, the costs imposed, the careers and career aspirations destroyed and the suicides caused by the CVD crusade were all “in the interests of the safety of air navigation”. It must have all been ‘OK’ because surveys say CASA's been doing a great job.
And having eventually been embarrassed into shutting the CVD zealots down, did anyone say: "Sorry for what we did." “Sorry for what we allowed to happen.”? Nope.
As noted earlier, in my most recent AAT matter Australia’s foremost expert in the area in question said the CASA Avmed doctor’s decision was based on “pseudoscience”. That’s the kind of ‘science’ on which conversion therapy is based and conversion therapy is still legal in some countries that would otherwise be considered ‘progressive’. So let’s all hope that nobody who subscribes to that dangerous nonsense is ever let loose in CASA Avmed.
Two epiphanies
I've been up to my elbows - literally - in aircraft, in flying and in other activities affected by the regulation of aviation for 45 years so far. I suppose there’s a ‘risk’ that I’ve been part of the ‘lunatic fringe’ for all that time. I’ll let others make their own judgments on that question.
One of the epiphanies I had along the way was the realisation of the extent to which civil aviation in Australia is regulated on the basis of emotion and cognitive bias. For all of the high-sounding rhetoric, so much turns on that emotional 'drive' to make aviation 'extra' safe. Some lucrative careers in CASA happen to have been built on it, too. And that's been very damaging particularly to general aviation in Australia where participants are often practically powerless in the face of a government authority on a safety crusade. It’s a result of ‘harmful overreactions’ to the objective risks.
Another epiphany was the realisation that the primary solution was, and remains, simple (at least in principle): All CASA staff have to do is comply with the law. But that would entail them understanding and accepting it, first, rather than just paying lip service to it. As a matter of practicality, they don’t have to because any individual who wants to challenge them faces the formidable preliminary task of explaining, to a court or tribunal, what the complex and convoluted aviation safety regulatory regime is and actually means these days. And that’s the ‘easy’ bit! On the occasions on which I have no choice but to delve into and try to make sense of the current pile of regulatory paper I invariably end up shaking my head in despair.
Whatever the legalities and merits, individuals are going to suffer damage to their financial health and face risks to their physical and mental health if they take CASA on. I’m lucky because I can see through the smoke and mirrors and have the means by which to expose the reality. But CASA’s compliance with the law shouldn’t be down to luck.
A real risk to aviation safety – the yawning ‘trust gap’
A number of years ago I went with some colleagues to a session, run by an 'executive coach', arranged by the HR staff of the organisation within which I was then working. The ‘coach’ said the single best thing we could do for our performance was to have an afternoon nap each working day. All ‘backed up by science’ of course.
I couldn’t help but laugh out loud. When asked to elaborate on my response, I explained what the likes of (now erstwhile) CASA PMO Dr Navathe would do if he found out I had an afternoon nap at work each day. The ‘coach’ said that Dr Navathe’s response would be an overreaction. I said: “Quite so, but he doesn’t think so and he knows he’s right.”
It used to be that CASA Avmed relied primarily on the professionalism and judgments of the medical fraternity, including DAMEs and specialists with direct knowledge of and responsibility for the assessment of the fitness of individual pilots – a reasonable and available approach to administrative decision-making. Now CASA Avmed spends inordinate time second-guessing and dismissing the medical fraternity, demanding ‘management’ of ‘conditions’ in specific ways and requiring batteries of tests, contrary to what the individual is being advised is necessary, without CASA Avmed owing any clinical or professional duties to those individuals.
It used to be that we could choose whether to tick a consent box, on the medical certificate application form, for the information entered on the form to be used in research. That box is gone and the form now merely asserts that we consent by making the application. That’s not ‘consent’. That’s ‘duress’. My compliance or otherwise with the legislated medical standard is not affected by whether information about me is used in studies.
We’re all just a bunch of ‘conditions’ to be discovered and ‘managed’ after the solemn deliberations of a ‘complex case meeting’ in CASA Avmed. And given that CASA Avmed has identified a “large number of potential aero-medically significant conditions” – just “potential” mind you – the ‘extra careful’ response is obvious and pilots who want medical certificates are on the receiving end of it.
I describe us as ‘the guinea pig’ class. Organisms to be tested, studied and managed by CASA Avmed.
CASA Avmed will insouciantly demand that a pilot undergo tests that, for example, entail risks of stroke or death with probabilities many orders of magnitude higher than winning the lottery. After all, if we’re killed or disabled by the test, that’s a ‘good’ outcome for the safety of air navigation and another data point in a study.
Accordingly, I’m no longer surprised by the number of pilots who tell me they "tell Avmed nothing" (expletives deleted). That doesn't worry me, provided people are getting whatever medical services they need to deal with whatever medical issues they may have. There is, after all, no causal connection between CASA Avmed's state of knowledge or ignorance, or state of satisfy-edness or worried-ness, on the one hand, and the state of a person’s objective physical and mental fitness on the other.
Good luck in closing the yawning ‘trust gap’, Dr Manderson
What worries me most are the people who are now too scared to raise a potential medical issue with anyone in the first place, for fear that it will 'get back to Avmed'. There is a yawning ‘trust gap’ and CASA Avmed has become disintegrated from rather than being integral to the system of aviation safety. That's not in the objective interests of aviation safety.
I earnestly hope Dr Manderson reverses that situation, as I care very much about real safety in the real aviation world.
Safe flying, all, and good luck, Dr Manderson.
Last edited by Clinton McKenzie; 22nd Oct 2021 at 21:53.
AVMED, Clinton McKenzie’s analysis and the CASA MO
Clinton’s analysis details in depth the many crying issues facing our much beleaguered General Aviation industry and the obvious drawbacks of the truly intolerable, very expensive and unworkable rules and unnecessary procedures that CASA is bent on maintaining.
No less an important issue being the unhealthy mental state of many who take to the air fearing to be caught out inadvertently committing any number of criminal acts that are lurking in CASA’s catch all regulatory volumes.
We’ve had a new CASA CEO, also known by the fatuous title of Director of Air Safety, since the 17th. of May. In her promotional or introductory literature she tells us that change will be “incremental” and that we are “inching” towards completion of regulations (yes the same that Mr. Carmody told us were finished).
CASA had an instrument of exemption that allowed the issue of a PPL with the Basic Class 2, but that was discarded. Noted by AOPA in August on it’s FB site AOPA is trying to get back the BC2 for PPL licence issue. It really is a tough decision, anyone can see the awful ramifications, and so even the easiest and uncontroversial reform it seems, certainly in a timely manner, is beyond the CEO and the new PMO, let alone the CASA Board. The latter of course has always been out of sight, and completely silent on any real issues that might curtail the unlimited power of CASA or produce any reforms that could help GA from sliding further into the bureaucratic mire.
Dr. Manderson talked to us about risk in terms of medical fitness and examination for certificates.
The conversations did not seem to come to the facts. Firstly that we’ve had a successful self declared car driver standard in place for around 30 years in RAAUS, let’s ignore that. Or the facts from the USA where their Basic C2, now with 66,000 PPLs, relies mostly on self declaration and sensibly allows IFR. Risk? See below.
No less an important issue being the unhealthy mental state of many who take to the air fearing to be caught out inadvertently committing any number of criminal acts that are lurking in CASA’s catch all regulatory volumes.
We’ve had a new CASA CEO, also known by the fatuous title of Director of Air Safety, since the 17th. of May. In her promotional or introductory literature she tells us that change will be “incremental” and that we are “inching” towards completion of regulations (yes the same that Mr. Carmody told us were finished).
CASA had an instrument of exemption that allowed the issue of a PPL with the Basic Class 2, but that was discarded. Noted by AOPA in August on it’s FB site AOPA is trying to get back the BC2 for PPL licence issue. It really is a tough decision, anyone can see the awful ramifications, and so even the easiest and uncontroversial reform it seems, certainly in a timely manner, is beyond the CEO and the new PMO, let alone the CASA Board. The latter of course has always been out of sight, and completely silent on any real issues that might curtail the unlimited power of CASA or produce any reforms that could help GA from sliding further into the bureaucratic mire.
Dr. Manderson talked to us about risk in terms of medical fitness and examination for certificates.
The conversations did not seem to come to the facts. Firstly that we’ve had a successful self declared car driver standard in place for around 30 years in RAAUS, let’s ignore that. Or the facts from the USA where their Basic C2, now with 66,000 PPLs, relies mostly on self declaration and sensibly allows IFR. Risk? See below.
A holder of a bare (say) CPL who hasn’t been near an aircraft in 20 years is most definitely not a pilot. Likewise, the holder of an MBBS who has spent 20 years polishing seats in a bureaucracy is most definitely not a doctor.
Basic Class 2, the Clayton’s, non IFR, reformed medical certification. News.
Apparently CASA has thrown us a crumb and now they will again accept a BC2 for the initial Private Pilot Licence.
Wow, aren’t they amazing? So courageous. Pardon the cynicism but we must have reform now to save what’s left of the CASA and COVID battered remains of GA.
Start with self declared car driver for PPL and CPL ag and instructors. Just to get started. And independent instructors, without learning to fly we don’t have an aviation industry.
These reforms are necessary in the interests of all Australians. GA and it’s airports are important elements of our National security, quite apart from notions of personal freedom and our prosperity which is dependent upon free enterprise.
Wow, aren’t they amazing? So courageous. Pardon the cynicism but we must have reform now to save what’s left of the CASA and COVID battered remains of GA.
Start with self declared car driver for PPL and CPL ag and instructors. Just to get started. And independent instructors, without learning to fly we don’t have an aviation industry.
These reforms are necessary in the interests of all Australians. GA and it’s airports are important elements of our National security, quite apart from notions of personal freedom and our prosperity which is dependent upon free enterprise.
Thread Starter
My favourite erstwhile PMO is Dr Navathe, as he provided regular insights into the mindset that has been driving the CASA Avmed function for quite some time. In one AAT matter he made the observation that a pilot licence ‘goes on forever’ and it’s actually the medical certificate that determines whether a pilot can or cannot fly. (It’s a nonsensical concept, simply on the basis of the laws of physics. What he meant was ‘lawfully’ be the PIC of an aircraft. Even then, all day, every day, thousands of pilots fly safely as PIC without a piece of squashed tree issued by CASA Avmed. But that’s not the substantial issue.)
The substantial issue is the messianic view that Avmed is the last bastion between the public and potential carnage caused by unfit pilots. Accordingly - so their logic goes - Avmed ‘must’:
- know ‘everything’ that could possibly be indicative of any and all of the large number of “potential aero-medically significant conditions” that, in Avmed’s opinion, exist out there
- require whatever is the ‘gold standard’ test to find out whether a pilot does or does not have any of those conditions, no matter how costly, intrusive or dangerous the test may be for the pilot, and
- in the case of a detected ‘condition’ – impose the most stringent requirements to ‘manage’ and monitor the condition, assuming the pilot is not ‘grounded’.
I’ve said it publicly before: Any idiot with access to the internet can do that. I always hasten to add that Avmed staff are not idiots. Far from it. But the fact is anyone with a low average IQ or better and access to the internet can do the things I’ve listed above.
A few medicals ago I said to the DAME, as we tried to make sense of the questions in CASA Avmed’s MRS: “This is just a system of entrapment.” He said: “Yep”. (That was in between the DAME’s frustrated observations that: “These questions are stupid.”)
People are more and more averse to answering Avmed questions in a way that will ‘trigger’ the ‘trap’ and Avmed, knowing that is happening, spends its days trying to come up with ever-more creative ways to set the ‘trap’.
As I say, the ‘yawning trust gap’ is a result.
Members of the public will intuitively believe that the Avmed approach I’ve set out above is keeping the skies ‘safe’. If only they knew the approach is actually driving problems ‘underground’. And imagine how the public would react if they understood that all day, every day, Boeing 737 sized aircraft full of passengers are sharing the skies and coming into proximity with aircraft that are:
- piloted by people who are not licensed by CASA and not certified medically fit by CASA
- not certified airworthy by CASA, and
- not under air traffic control.
That’s not to suggest those activities should stop. Rather, it is to suggest that if those activities are considered by CASA to be “acceptably safe” and “appropriate”, anything giving rise to lower risks must “safer” and “more appropriate”.
Last edited by Clinton McKenzie; 23rd Oct 2021 at 04:33.
There is a document on the ATSB site that addresses pilot incapacitation involved in accidents and incidents from 1975-2006
see: Pilot Incapacitation 1975-2006
From this document
Obviously CASA's strict medical policies make the risk of pilot incapacitation extremely small (0.19% of all accidents) because as we all know, pilots are 100% honest with CASA about their medical status and so CASA has been able to remove any pilot who is likely to be incapacitated, from the cockpit.
Imagine the carnage if they weren't so strict! Or heaven forbid, if pilots actually hid things about their medical status from their DAMEs! I know I tell them everything!
That is why every pilot uses their DAME as their GP so that nothing gets unreported.
Based on the paper, I think CASA's AVMED system would have a huge impact on flight safety if they regularly tested the standard of sandwiches served or snack machines used by flight crew given the largest % of incapacitation is from tummy upsets. This should be the next big area for CASA to be involved in.
see: Pilot Incapacitation 1975-2006
From this document
The results of this study demonstrate that the risk of a pilot suffering from an in-
flight medical condition or incapacitation is low. Such events account for only 0.6
per cent of all the occurrences listed in the ATSB database for the period 1 January
1975 to 31 March 2006. Furthermore, these events account for only 0.19 per cent of
all accidents, 1.0 per cent of all serious incidents, and only 0.05 per cent of all
incidents. The most common cause of the medical event or incapacitation for
affected flights was gastrointestinal illness, usually secondary to food poisoning.
Exposure of the crew to smoke and fumes, and loss of consciousness were the next
most common causes. All fatal accidents occurred in single-pilot operations, where
heart attack in the pilot was the most common cause of the subsequent accident.
flight medical condition or incapacitation is low. Such events account for only 0.6
per cent of all the occurrences listed in the ATSB database for the period 1 January
1975 to 31 March 2006. Furthermore, these events account for only 0.19 per cent of
all accidents, 1.0 per cent of all serious incidents, and only 0.05 per cent of all
incidents. The most common cause of the medical event or incapacitation for
affected flights was gastrointestinal illness, usually secondary to food poisoning.
Exposure of the crew to smoke and fumes, and loss of consciousness were the next
most common causes. All fatal accidents occurred in single-pilot operations, where
heart attack in the pilot was the most common cause of the subsequent accident.
Obviously CASA's strict medical policies make the risk of pilot incapacitation extremely small (0.19% of all accidents) because as we all know, pilots are 100% honest with CASA about their medical status and so CASA has been able to remove any pilot who is likely to be incapacitated, from the cockpit.
Imagine the carnage if they weren't so strict! Or heaven forbid, if pilots actually hid things about their medical status from their DAMEs! I know I tell them everything!
That is why every pilot uses their DAME as their GP so that nothing gets unreported.
The majority of pilot incapacitation events recorded by the ATSB do not involve a
chronic or pre-existing medical condition. That is, they are largely unforeseeable
events, often involving acute illnesses or injury. Many are not in themselves life
threatening, but are capable of impairing a pilot’s performance to the extent that
safe operation of the aircraft may be adversely affected. This study also confirms
the findings from other international reports that gastrointestinal illness is the most
common cause of in-flight incapacitation in the pilot population.
chronic or pre-existing medical condition. That is, they are largely unforeseeable
events, often involving acute illnesses or injury. Many are not in themselves life
threatening, but are capable of impairing a pilot’s performance to the extent that
safe operation of the aircraft may be adversely affected. This study also confirms
the findings from other international reports that gastrointestinal illness is the most
common cause of in-flight incapacitation in the pilot population.
What use is AVMED?
The table from the US National Transport Safety Board (see previous post) is instructive, over four years and 76,000,000 hours they show 12 accidents attributable to incapacitation in flight.
My calculator makes that one per 6.3 million hours.
The figures are so small so there’s no obvious trend or difference in the NTSB/AOPA table between the more stringent and more frequently tested categories and their (USA) Basic Class 2. In normal times they report between two to four airline pilot incapacitating events per annum. The figures given for 2020 indicate around 5670 flights per day, or, according to the FAA official figures 10,000,000+ scheduled passenger flights in FY 2019. When compared to the flight hours by private flyers, few would come near those hours flown by airline pilots and so it could be expected that they would suffer less numbers which, if anything can be derived from such tiny numbers, is shown by lack of events in the Basic Class 2.
What then is the purpose of AVMED? …………………………….. ….. …. … .. .
The public interest would be satisfied if licenced commercial passenger carrying pilots were certified by their GPs as not stark raving mad and having functioning limbs. Otherwise their employers will note the pilot’s condition as they walk to the aircraft. If found crawling, swaying or unable to find the cockpit they should recall them.
My calculator makes that one per 6.3 million hours.
The figures are so small so there’s no obvious trend or difference in the NTSB/AOPA table between the more stringent and more frequently tested categories and their (USA) Basic Class 2. In normal times they report between two to four airline pilot incapacitating events per annum. The figures given for 2020 indicate around 5670 flights per day, or, according to the FAA official figures 10,000,000+ scheduled passenger flights in FY 2019. When compared to the flight hours by private flyers, few would come near those hours flown by airline pilots and so it could be expected that they would suffer less numbers which, if anything can be derived from such tiny numbers, is shown by lack of events in the Basic Class 2.
What then is the purpose of AVMED? …………………………….. ….. …. … .. .
The public interest would be satisfied if licenced commercial passenger carrying pilots were certified by their GPs as not stark raving mad and having functioning limbs. Otherwise their employers will note the pilot’s condition as they walk to the aircraft. If found crawling, swaying or unable to find the cockpit they should recall them.
Thread Starter
There is a document on the ATSB site that addresses pilot incapacitation involved in accidents and incidents from 1975-2006
see: Pilot Incapacitation 1975-2006
...
Obviously CASA's strict medical policies make the risk of pilot incapacitation extremely small (0.19% of all accidents) because as we all know, pilots are 100% honest with CASA about their medical status and so CASA has been able to remove any pilot who is likely to be incapacitated, from the cockpit.
Imagine the carnage if they weren't so strict! Or heaven forbid, if pilots actually hid things about their medical status from their DAMEs! I know I tell them everything!
That is why every pilot uses their DAME as their GP so that nothing gets unreported.
Based on the paper, I think CASA's AVMED system would have a huge impact on flight safety if they regularly tested the standard of sandwiches served or snack machines used by flight crew given the largest % of incapacitation is from tummy upsets. This should be the next big area for CASA to be involved in.
see: Pilot Incapacitation 1975-2006
...
Obviously CASA's strict medical policies make the risk of pilot incapacitation extremely small (0.19% of all accidents) because as we all know, pilots are 100% honest with CASA about their medical status and so CASA has been able to remove any pilot who is likely to be incapacitated, from the cockpit.
Imagine the carnage if they weren't so strict! Or heaven forbid, if pilots actually hid things about their medical status from their DAMEs! I know I tell them everything!
That is why every pilot uses their DAME as their GP so that nothing gets unreported.
Based on the paper, I think CASA's AVMED system would have a huge impact on flight safety if they regularly tested the standard of sandwiches served or snack machines used by flight crew given the largest % of incapacitation is from tummy upsets. This should be the next big area for CASA to be involved in.
An example of an absurd regulatory disparity caused by cognitive bias
The [Discussion Paper] notes an ATSB report which found that “[a]round 75 per cent of [pilot] incapacitation occurrences happened in high-capacity air transport operations … with the main cause being gastrointestinal illness…”. The related Table indicates that in around half of those cases the pilot discontinued duties for the remainder of the flight.
Let us assume that the referenced ATSB report was based on an analysis of a statistically significant number of incidents. Let us also assume that pilot incapacitation creates material risks to aviation safety.
So far as I am aware, this is not a single syllable in the ever-growing volumes of civil aviation regulations that regulates the service of food to pilots of high capacity aircraft, before and during flight time.
The regulatory position is therefore this: A pilot who cannot pass one of the ‘tiers’ of colour perception tests is too ‘dangerous’ to be in the left hand seat at the front of a high-capacity international aircraft, despite evidence to the contrary, but it is acceptably ‘safe’ for a pilot with normal vision to be in that seat and to have been fed and be fed in a way that is not regulated by the civil aviation regulations, despite evidence that the most likely cause of him or her becoming incapacitated is gastrointestinal illness, with about a 50/50 chance of him or her then having to be removed from further duty on the flight.
The explanation for this absurd regulatory disparity is, I suggest, intuition tainted by cognitive bias. To the public, a sandwich and a glass of fruit juice are, intuitively, completely harmless. Contemplating a sandwich and glass full of fruit juice does not evoke thoughts of dreadful consequences. In contrast, to the public a pilot with a ‘vision deficiency’ must surely be a risk. When the dreadful consequences of a pilot with a ‘vision deficiency’ are contemplated, cognitive bias results in an over-estimation of the probabilities of the event occurring. However, an objective analysis of the absolute and comparative risks and probabilities supports precisely the opposite conclusion. On an objective analysis, the regulatory regime should put substantial focus on what the pilots of high-capacity aircraft are eating and no focus on CVD.
I should stress that I am not advocating for yet more civil aviation regulations to deal with the service of food to pilots. Regulations on the subject are not justifiable, given that pilots and operators of high-capacity aircraft are perfectly capable of understanding and putting in place strategies to mitigate gastrointestinal illness risk on their own initiative, and given the remote probabilities of the event and the controls that are in place if the event occurs.
However, precisely the same logic should apply to other risks, including medical-related risks, which are less probable and have lesser potential consequences for safety than incapacitation of the pilot of high capacity aircraft through gastrointestinal illness. Given the frequency and consequences of high-capacity pilot aircraft incapacitation due to gastrointestinal illness compared to other causes, there are lots and lots of those other risks, yet some of those other risks are the subject of regulatory micro-management.
The [Discussion Paper] notes an ATSB report which found that “[a]round 75 per cent of [pilot] incapacitation occurrences happened in high-capacity air transport operations … with the main cause being gastrointestinal illness…”. The related Table indicates that in around half of those cases the pilot discontinued duties for the remainder of the flight.
Let us assume that the referenced ATSB report was based on an analysis of a statistically significant number of incidents. Let us also assume that pilot incapacitation creates material risks to aviation safety.
So far as I am aware, this is not a single syllable in the ever-growing volumes of civil aviation regulations that regulates the service of food to pilots of high capacity aircraft, before and during flight time.
The regulatory position is therefore this: A pilot who cannot pass one of the ‘tiers’ of colour perception tests is too ‘dangerous’ to be in the left hand seat at the front of a high-capacity international aircraft, despite evidence to the contrary, but it is acceptably ‘safe’ for a pilot with normal vision to be in that seat and to have been fed and be fed in a way that is not regulated by the civil aviation regulations, despite evidence that the most likely cause of him or her becoming incapacitated is gastrointestinal illness, with about a 50/50 chance of him or her then having to be removed from further duty on the flight.
The explanation for this absurd regulatory disparity is, I suggest, intuition tainted by cognitive bias. To the public, a sandwich and a glass of fruit juice are, intuitively, completely harmless. Contemplating a sandwich and glass full of fruit juice does not evoke thoughts of dreadful consequences. In contrast, to the public a pilot with a ‘vision deficiency’ must surely be a risk. When the dreadful consequences of a pilot with a ‘vision deficiency’ are contemplated, cognitive bias results in an over-estimation of the probabilities of the event occurring. However, an objective analysis of the absolute and comparative risks and probabilities supports precisely the opposite conclusion. On an objective analysis, the regulatory regime should put substantial focus on what the pilots of high-capacity aircraft are eating and no focus on CVD.
I should stress that I am not advocating for yet more civil aviation regulations to deal with the service of food to pilots. Regulations on the subject are not justifiable, given that pilots and operators of high-capacity aircraft are perfectly capable of understanding and putting in place strategies to mitigate gastrointestinal illness risk on their own initiative, and given the remote probabilities of the event and the controls that are in place if the event occurs.
However, precisely the same logic should apply to other risks, including medical-related risks, which are less probable and have lesser potential consequences for safety than incapacitation of the pilot of high capacity aircraft through gastrointestinal illness. Given the frequency and consequences of high-capacity pilot aircraft incapacitation due to gastrointestinal illness compared to other causes, there are lots and lots of those other risks, yet some of those other risks are the subject of regulatory micro-management.
Last edited by Clinton McKenzie; 23rd Oct 2021 at 06:42.
Just quietly I reckon the major causal factor for a medical event in pilots - coronary, stroke, incapacitation, depression, sleeplessness, fatigue or just a good long bout of tourettes - is brought on by trying to understand CASAs Australian aviation regulations.....AVMED has a captive clientelle.
Australian version of Catch22.
Australian version of Catch22.
Pilot health
Just quietly I reckon the major causal factor for a medical event in pilots - coronary, stroke, incapacitation, depression, sleeplessness, fatigue or just a good long bout of tourettes - is brought on by trying to understand CASAs Australian aviation regulations.....AVMED has a captive clientelle.
Australian version of Catch22.
Australian version of Catch22.
If these exams were efficacious few would grumble, but we know the whole process is a charade.
A make work system that was born out of military selection (too many applicants for cushy and glamorous flying service) and survived by dint of habit, money, inertia, bureaucratic control and ego. As one senior pilot put the case you don’t need physical strength these days, a pulse is the main criterion.
Thread Starter
Each interaction with or insight into CASA Avmed in the last half a dozen or so years has involved some new insult to my intelligence or integrity, or some unlawful behaviour on CASA Avmed’s part. From two pairs of glasses required in the DAME’s clinic, to my ASIC photo showing up in the MRS, to patently absurd ‘restrictions’ that aren’t restrictions on my medical certificate, to decisions dictated by policy without regard to the individual merits of the case, to refusals to consider evidence and make decisions during an arbitrary period plucked out of wherever, to questions in the MRS described as ‘stupid’ by medical professionals, to the kinds of circumstances revealed by submission #56 to the current Senate Committee inquiry in general aviation: These are all manifestations of a cultural mindset ignorant or dismissive of the law and practical reality.
All in the name of one of the nobler of the noble causes of course: The ‘safety of air navigation’.
Thread Starter
