Introduction
The practice of aeromedical certification of pilots and air traffic controllers with diabetes in most
Contracting States of the International Civil Aviation Organization, including Canada, has been fairly
consistent and has not changed for many years. Applicants with diabetes whose condition can be
controlled by dietary measures alone are permitted to fly and control air traffic. All others requiring
medication for this common disorder are assessed as “unfit” for such activities.
The Canadian Charter of Rights and Freedoms which was enacted in 1982 has a number of human rights
provisions, one of which states that “no person shall be discriminated against on the basis of disability”.
Given this constitutional background there have been an increasing number of challenges in the Courts and
Human Rights Tribunals on refusals to issue licences on medical grounds including diabetes
mellitus (DM).
The Civil Aviation Medical Branch (CAM) of Transport Canada is the medical body which advises
the Minister of Transport on medical fitness to fly or control air traffic. CAM decided that the time had
arrived to review its position on all types of diabetes, given the apparent improvement in the treatment and
control of the disorder.
In order to address this issue, a conference was convened in Ottawa on April 8, 1992. Present at this
conference were six eminent specialists in DM, members of CAM headquarters and regional medical
staff, members of the Aviation Medicine Review Board (AB), medical representatives from the airline
industry, the U.S. Federal Aviation Administration and the Canadian Diabetes Association.
This document reflects the proceedings of that one day conference.
The recommendations in this document may cause concern to some physicians, but it is felt that
with the implementation of these recommendations meaningful data in this area can be
developed without jeopardizing flight safety.
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