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What's It Doing Now?

Bernd Sieker

"Pilot Error" is often publicly reported as "the cause" of an accident whenever a member of the flight crew did something which had consequences for the chain of events. We maintain that there is never a single cause, and every mistake a pilot may make has causes, and other factors contributing to it. We use the notion of a "necessary causal factor" to investigate the causes of accidents, and almost invariable there is a combination of both technical and human causal factors. I will look in some detail at accidents in which a combination of a technical problem, misleading or missing indications, and inappropriate (but often understandable) crew actions contributed to an accident, and also some in which unprecedented actions of the human crew turned a problem with potentially fatal consequences into a survivable accident. Automation in modern airliners has become so reliable and useful that it may be argued that it leads to a deterioration of hand-flying skills and, perhaps more importantly, of decision-making skills. Sample accident cases will include Asiana Flight 214, Spanair Flight 5022, Turkish Flight 1951, TAM Flight 3054 and others. I will also briefly touch on technical and ethical problems with self-driving vehicles highlighted by the recent Tesla crash as well as increasing automation in General Aviation and its consequences. In conclusion I will look at ways to improve safety and maintain the very high standard currently achieved in commercial aviation.

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