From the pilot who flies 747s to the student pilot flying a Piper Cub, a pilot self certifies they are healthy to fly prior to getting in that cockpit. This system works and works well. The FAA has tried to regulate safety and predict sudden incapacitation by imposing medical standards on pilots. The rules were established without significant cause 60 years ago and have been promulgated by bureaucracies afraid to acknowledge a futile effort. Almost every pilot I have failed on a FAA physical provided the cause for that failure in their self reporting of the problem to me.
Some pilots are dishonest and slip through the system.
This will not change for the better or worse with self certification. Dishonesty, unfortunately, will always be with us. Otherwise, why would I support a change which will reduce the number of pilots coming into my office. Brent Blue, M.D. Senior Aviation Medical Examiner Jackson Hole, Wyoming Dr. Blue is AVweb's aeromedical consultant.