“Most accidents originate in actions committed by reasonable, rational individuals who were acting to achieve an assigned task in what they perceived to be a responsible and professional manner. They have probably committed these same unsafe acts before without negative consequences because the existing conditions at the time did not favour an interaction of the flawed decisions or
Peter Harle, Director of Accident Prevention, Transportation Safety Board of Canada and former RCAF pilot, ‘Investigation of human factors: The link to accident prevention.’ In Johnston, N., McDonald, N., & Fuller, R. (Eds.), Aviation Psychology in Practice, 1994.deficiences present in the system.”
It’s too easy to read accident reports and quickly blame the pilot. We must remember that flying is complex, and there are few solid bright lines of right/wrong. As investigators and managers, we should strive to understand and improve the systems. And as pilots not dismiss accident and incident reports as ‘bad apples’ or ‘weak sticks’, but have an open mind and resolve to make our own personal safety systems better.