Given the nature of his work and his condition, should the health care providers have reported his condition to his employers and not depended on him performing his professional duty of self-reporting?

A young man enters pilot training and needs to take a leave of absence owing to mental health issues, which he describes as “burnout.” Following therapy he is allowed to return to his studies and completes the course. After graduation he applies for a position with a small regional air- line, fully disclosing his previous problems. He completes the application and health examinations and is found to be fit for service and employed. He again begins to suffer from depression and suicidal thoughts and seeks professional outpatient care. Although as a pilot he is required by professional duty to self-report any health condition to his employer that would restrict his ability to perform his duties, he fails to do so. As a result, the unthinkable occurs, and he crashes his plane, killing himself, the crew, and all the passengers. The health care providers in this case knew that the young pilot was having difficulties that would preclude him from flying a plane and, therefore, had given him a note providing him a medical release from duty that day. However, given the level of professionalism of his duties, and the need for personal privacy and medical confidentiality, the established process called for self-reporting, which the pilot did not do.

a) Given the nature of his work and his condition, should the health care providers have reported his condition to his employers and not depended on him performing his professional duty of self-reporting?

b) Would you be willing to generalize your decision to other positions such as bus drivers and train engineer?