There have been a rash of news lately on tragic medical helicopter crashes, with 35 deaths since February 2008.
Who’s to blame?
MedPage Today reports on the National Transportation Safety Board hearings, where witnesses suggested that pilots were “not taking proper safety precautions, inadvertently flying into severe weather, and becoming disoriented at night.”
Several interesting questions were raised, including whether medical flights were overused rather than utilizing available ground transportation, or if hospitals were engaged in “helicopter shopping,” where hospitals would keep calling operators until they found one willing to fly in dangerous conditions.
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Pilots, especially if military trained, are prone to take a “mission” mentality which challenges them to overcome the obstacles to complete the given mission. They don’t have the medical background to make a judgement weighing the risks of the flight against the risks to the patient of declining. They must of necessity feel that the medical professionals have made that decision already.
But then the medical professionals do not have the aviation training to judge the risk of the flight.
Furthermore, they are trained to only take one life into account–that of their patient–and to exclude the interests of others in medical decision making. Clearly there are other lives at stake however.
If they shop around for a helicopter, then it is natural for the business to drift to the imprudent risk takers–maybe even driving others out of business.
The best solution is for doctors who often have patients who need these services to use one provider, and when turned down by them, stick with that decision and do the best that they can for that patient rather than putting multiple lives at risk.
That requires a kind of courage that is getting more and more rare–even in the medical profession. What will probably happen if the problem escalates is that the decision will be made by rigid regulation.
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