Don’t ask

Economically, guarded optimism is probably in order (except among aviation medical examiners). Some inactive pilots will return to the air, and at least a few prospective students who might have been intimidated by the prospect of the medical exam won’t be dissuaded from taking that first introductory flight. How large those numbers will actually be remains to be seen, but they’ll be more than zero. It’s probably too much to hope this will return general aviation to its glory days, but it can’t hurt.

The safety implications are a little harder to gauge. The direct effect on flight training will probably be negligible. CFIs (other than sport instructors) will still have to have current medicals while acting as pilot in command, so whatever protection that might provide will remain in place during dual instruction.

Medical incapacitation is extremely rare among pilots using their drivers’ licenses to exercise sport-pilot privileges, and since the relatively few solo hours flown by most students limits their exposure, it’s entirely possible that years could pass without our seeing a single incapacitation accident on a student solo. (Not that the current system provides perfect protection against that eventuality. In 2013, an apparently healthy 18-year-old student with no prior history and a fresh third class medical suffered a grand mal seizure while taxiing out for a solo flight. Fortunately, he escaped without injury.)

Effects in the wider world are also likely to be subtle. Opponents of medical reform have painted dire images of out-of-control aircraft raining down from the sky, which have little basis in either the factual record or common sense. In fact, there’s nothing to stop pilots without medical certificates from continuing to fly now—aside from the slight risk of being caught and punished and the more reliable motivations of personal honesty and an enlightened interest in self-preservation. Aviators are as aware as anyone else of whether they’re feeling well, and the vast majority prefer living to see another day. It’s a sound bet that those with any reason to anticipate a medical crisis will want it to happen somewhere other than in the cockpit.

Too little attention has been paid to the opposite possibility: that the relaxation of the medical requirement will actually help improve pilot health. How could that be? Bear in mind that the current requirement to disclose “all visits to medical professionals” and report diagnoses creates a perverse disincentive against seeking diagnosis and treatment of potentially sensitive conditions. The paperwork burden of the special-issuance process has been enough to make the prospect of living with recurrent chest pain, mood disorders, or substance abuse more attractive than the alternative for some unknown number of pilots—probably far more than ever show up in the accident reports. It doesn’t seem likely that the FAA (or Congress) prefers aviators to fly around with untreated coronary artery disease, clinical depression, or opioid addiction, but that’s been one unintended effect of requiring medical certification.

During the long struggle for reform, AOPA has paid exacting attention to identifying accidents precipitated by medical causes. As the new regulations take effect, you may be sure that we’ll continue to track them just as scrupulously, ready to evaluate the consequences of this seismic change in policy—and, as long as the facts support that, defend it against further distortions by the sky-is-falling crowd.

David Jack Kenny is manager of safety analysis for the AOPA Air Safety Institute.