Recently, I took my son to the pediatrician. As usual, we signed in at the desk and then, for health privacy purposes, the receptionist peeled away the little slip where we put my son’s name.
Health information privacy is taken seriously, not only at the pediatrician, but at every doctor’s office across the United States. Doctors must adhere to the Health Insurance Portability and Accountability Act (HIPAA), which sets out strict provisions to safeguard the privacy of personal medical information.
Yet somehow, once a traveler with food allergies enters an airport, health privacy goes out the portal window. That person is asked to divulge medical information to receive necessary accommodations such as pre-boarding the aircraft, making an announcement, or creating a buffer zone.
Airline staff then share this personal information with others – gate agents, flight crew members, pilots and, in the most egregious cases, the information can be used to kick you off the plane.
Family Thrown Off Flight
Ana Govorko and her family learned this the hard way. On July 2, 2016, a pilot asked them to leave a Lufthansa flight bound for Italy, after Govorko showed the crew a doctor’s note to make them aware of her daughter’s severe food allergies. Both the woman and her travel agent had notified the airline in advance, and no red flags had been raised. However, once the pilot made his decision, the crew then shared the medical information with an airline supervisor at JFK Airport.
The supervisor came on board and took the family’s passports and boarding passes. The Govorkos were escorted off the plane, under the threat of security being called. The family had the child’s medications and had brought their own food, and the very next day, a different pilot allowed them to fly. Govorko later described to me “the unnecessary stress and humiliation that we were subjected to.”
Many have said to me that there is a simple solution – just don’t disclose the food allergy – and pack your own snacks and medication.
Trouble with Not Disclosing Allergies
There are significant problems with this approach. First, it is critical to pre-board the aircraft to clean your area from possible food contamination from the previous flight. It’s quite difficult to clean thoroughly during the general boarding. In order to pre-board, you’ll need to disclose the food allergy.
A large international study showed that taking such precautions quantifiably reduces the risks of in-flight reactions. Importantly, if you teach your child to hide a food allergy for fear of being asked to leave a plane, one day when traveling alone, they may make the same decision and be exposed to an allergen. The situation could turn critical, even fatal, as flight crew likely would not know an allergic reaction was taking place, and of the need to promptly administer epinephrine.
There is no sharing of medical details before such an individual is allowed to fly. But on my No Nut Traveler blog, I’ve seen an uptick in the number of passengers being asked to provide “fit to fly” letters for food allergies, to share details of their history of anaphylaxis, or having airline staff ask to inspect their medications.
Health Privacy vs. Disclosure
So how much medical information are you legally required to provide an airline’s staff, whom can they share it with, and when is your health privacy being violated? Can your medical information be used to kick you off a plane?
Mary Vargas, a disability rights lawyer with Stein & Vargas, says “airlines cannot refuse travel on the basis of disability alone.” They are allowed to refuse travel if, after using either medical knowledge or best available evidence, they decide there is potential risk to the health and safety of fellow passengers. Even then, she says this is only the case if reasonable modifications in policies or procedures “cannot mitigate that risk.”
The Air Carrier Access Act’s regulations also make clear that an airline “must not refuse transportation to the passenger if it can protect the health and safety of others by means short of a refusal,” says Vargas.
As for medical documents to show a person fit to fly, she says that can only be required when a person is traveling in a stretcher or incubator, needs in-flight oxygen, or when the condition raises doubt the person can complete a flight “without extraordinary medical assistance during the flight.”
In my view, it’s wholly unacceptable to use personal medical information to deny a food-allergic passenger the opportunity to fly like everyone else. We disclose this information so that we can take precautions to mitigate risks, and simply to make a crew aware.
It’s time for the airline industry to share the responsibility for the safety of food-allergic customers and develop a clear, consistent approach. We need airline staff to have training on food allergies and to be prepared in the event of an anaphylactic emergency by having auto-injectors board. What we don’t need is unnecessary privacy breaches, and uninformed medical judgments made on the fly.
Lianne Mandelbaum is Allergic Living’s airlines correspondent, and the founder of NoNutTraveler.com.