The final report into the Germanwings air disaster has found co-pilot Andreas Lubitz was urged to seek psychiatric help by a private doctor two weeks before the crash.
All 150 people on board the airliner died when it crashed in the French Alps in March 2015.
Prosecutors now believe Lubitz, who had a history of severe depression, barricaded himself into the cockpit and deliberately propelled the Airbus jet into a mountainside on March 24.
Cockpit recordings show Lubitz disabled the door-opening mechanism when the captain of flight 4U9525 took a toilet break 30 minutes into the flight from Barcelona to Dusseldorf.
Seconds later, he placed the jet on its fatal descent and ignored repeated hammering on the door, cockpit alarms and radio calls from the ground as the airplane sped lower before crashing.
Prosecutors have also found evidence that Lubitz, who also had eyesight problems and may have feared losing his job, had researched suicide methods and concealed his illness from his employer, sparking a debate on supervision and medical secrecy.
As a result of the findings, French investigators have recommended the rules around medical confidentiality be relaxed for pilots.
In the months before the crash, Lubitz visited 41 doctors, and none warned his employer or authorities that Lubitz might be too ill to fly.
He had previously been treated for depression and suicidal tendencies and documents seized by prosecutors show he partly hid his medical history from employers.
Lubitz had been flying on a medical certificate that contained a waiver because of a severe depressive episode from August 2008 to July 2009.
The waiver stated that the certificate would become invalid if there was a relapse into depression.
Doctors ‘refused to speak’ to investigators
Doctors who treated the Germanwings pilot for depression and mental illness refused to speak with French investigators.
The French investigators told relatives at a meeting in Barcelona that the German doctors were not required to talk about Lubitz’s medical conditions under German privacy laws and they didn’t, even though the 27-year-old also died in the plane crash.
The experts from France’s BEA crash investigation agency did obtain detailed German medical records about Lubitz but “they emphasised that the doctors, those who treated him, refused to give any information”, said Robert Tansill Oliver, who attended the Germanwings relatives’ meeting.
Germany’s confidentiality laws prevent sensitive personal information from being widely shared, although the law allows doctors to suspend patient privacy if they believe there is a danger to the person’s safety or that of others.
The BEA urged the World Health Organisation and European Commission to consider new rules that would oblige doctors to inform authorities when a patient’s health is likely to impact public safety.
They also want tougher inspections when pilots with a history of psychiatric problems are declared fit to fly.
“In Germany and in France, doctors are very attached to this notion of medical secrecy,” BEA director Remi Jouty told a news conference.
“But I hope there will be some moves there.”
Jouty added that the cockpit doors – that were disabled by Lubitz – were designed to ward off possible terrorism threats from the passenger cabin.
He said it was not possible to design a door lock that addressed risks from both passengers and crew.
Families demand apology
Relatives of those killed have pointed to a string of people they say could have raised the alarm and stopped Lubitz, going back to the days when he began training as a pilot in 2008.
Families of the Germanwings crash victims say they are still waiting for an apology from those they believe failed to prevent the crash that claimed the lives of 150 people almost a year ago.
In an interview on Friday, the father of 33-year-old Hewlett-Packard employee Sven Fischenich expressed anger at the airline’s refusal to acknowledge that it should have stopped a pilot with a history of mental illness from taking control of a plane.
“When something happens in a company, the person at the top is responsible, even if he wasn’t directly involved himself,” said Juergen Fischenich, 62.
Prior to the release of the final report, Germanwings and Lufthansa strongly denied wrongdoing, insisting that the 27-year-old was certified fit to fly.
Readers seeking support and information about suicide prevention can contact Lifeline on 13 11 14 or MensLine Australia 1300 78 99 78