Genetic screening and Aeromedical issues

[astanley]

I'm in a discussion around the ethics of genetics and aeromedical issues.

Currently, under FAA standards, does the holder of a Class I medical have to self-ground (or be grounded) upon the discovery of a genetic marker that indicates a 100% likelihood of adult onset of a debilitating disease? By debilitating, I mean ALS or Huntington's.

My guess is that yes, a pilot has to self-ground, and the pilot would be subject to a OKC SI of shortened duration requiring some sort of motor-skill assessment and letter from the neurologist establishing that he was clear to fly. But, I'm not a doctor...

Cheers,

-Andrew

 

[poadeleted20]

You know of anything in Part 67 making "a genetic marker that indicates a 100% likelihood of adult onset of a debilitating disease" in and of itself disqualifying? If not, I think your question is answered.

 

[steingar]

There is no need to self ground until symptoms begin. The only debilitating genetic illness that will remain secret until symptomology is Huntingtons, and the Huntingtons Society suggests not geneotying to see if you have the allele. No need to see your future, it will show up in its good time. Seeing it won't help, as there is no treatment.

The only other completely penetrant debilitating genetic illnesses will show them selves quite early, and the symptoms are either disqualifying or they aren't. Thus the answer is no. You self ground for the presence of a symptom, not the possibility of one.

 

[Doggtyred]

I'm in a discussion around the ethics of genetics and aeromedical issues.

Currently, under FAA standards, does the holder of a Class I medical have to self-ground (or be grounded) upon the discovery of a genetic marker that indicates a 100% likelihood of adult onset of a debilitating disease? By debilitating, I mean ALS or Huntington's.

My guess is that yes, a pilot has to self-ground, and the pilot would be subject to a OKC SI of shortened duration requiring some sort of motor-skill assessment and letter from the neurologist establishing that he was clear to fly. But, I'm not a doctor...

Cheers,

-Andrew

The FAA medical system is geared towards avoiding SUDDEN incapacitation as well as current medical inability to perform tasks.

Neither of your two examples meet that goal simply by genetic discovery before onset of symptoms.

But the short answer is no. Once you become symptomatic and receive a diagnosis based on those symptoms, then the answer may change.

 

[bbchien]

Currently, under FAA standards, does the holder of a Class I medical have to self-ground (or be grounded) upon the discovery of a genetic marker that indicates a 100% likelihood of adult onset of a debilitating disease? By debilitating, I mean ALS or Huntington's.

My guess is that yes...... ....But, I'm not a doctor...

Cheers,

-Andrew

NOPE. And I'm an AME.

 

[steingar]

There are very few genetic diseases that have a certain prognosis on genotype. Huntingtons, Retinoblastoma, and Li Fraumeni are the only ones of which I can think offhand that might not be symptomatic at presentation, though the latter two would likely be preceded by tumors. There may be other candidates, but they are all enormously rare.

Most of the genetic diseases we'll encounter are alleles that predispose to various conditions, such as hypertension, depression, diabetes and cancer to name a few. However, such alleles are neither 100 percent penetrant or expressive, and all are affected by environment. Other common alleles, like color blindness, will present far earlier in life.

 

[gismo]

The FAA medical system is geared towards avoiding SUDDEN incapacitation as well as current medical inability to perform tasks.

Neither of your two examples meet that goal simply by genetic discovery before onset of symptoms.

But the short answer is no. Once you become symptomatic and receive a diagnosis based on those symptoms, then the answer may change.

Heck, AFaIK we are pretty much all genetically predisposed to die of something eventually. Denying a medical on that basis would ground us all before we ever got off the ground.

 

[gprellwitz]

Heck, AFaIK we are pretty much all genetically predisposed to die of something eventually. Denying a medical on that basis would ground us all before we ever got off the ground.

Love it! So true!