“Pilot Error” - Its Impact On Accident Prevention

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The term “pilot error” as used by accident investigators and media sources blames the pilot for the aircraft accident. Used in this way it is a perjorative term and is not being used to describe a pilot error as a factor in aircraft accidents, but as the sole cause of the accident. Accident investigation can serve one of two functions. It can apportion blame - to find a scapegoat, an individual, on whom to hang the sole responsibility, thus providing a neat ending and an easy target for insurance and litigation claims. Or, accident investigation can offer an opportunity to discover the causes that led to the final failure. In the example below the alternative approaches to the investigation and reporting of a single hypothetical event illustrates how different conclusions may be reached. EVENT INVESTIGATION CONCLUSION Kieran Perkins drowns • Kieran Perkins identified as a well trained and able swimmer • He is responsible for his own drowning Kieran Perkins drowns • Kieran Perkins identified as a well trained and able swimmer • a previously unidentified rip was identified where he was swimming • Area to be declared unsafe for swimming If Kieran was blamed for his own drowning and the investigation ended there, then others may die because the major cause, a rip current, was not identified. Accident investigation - apportion blame, or identify causes to prevent accidents! Blaming the individual immediately responsible for the situation prior to the accident does not necessarily enable strategies to be implemented for future prevention. The term ‘pilot error’ when used to describe and attribute the causal factors of an aircraft accident implies the blame rest only on the pilot, that no other factors contributed to the accident. If the aim of accident investigation is to determine the cause, then all the associated factors need to be investigated.

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