"Fitness to fly" is narrowly defined as "unlikely to suffer direct harm as a result of time spent on the aircraft." It does not include anything else, not even the likelihood that the patient will die because of lack of access to care within weeks. Where there is a question about fitness to fly, based on the best medical information available to the independent doctor, it is wholly appropriate for the doctor to notify the airline. Please inform the Medical Justice staff team if you would like to involve the airline or other outside agencies so that staff can advise the best course of action.

The final decision whether or not to carry a passenger is that of the pilot of the airplane. Most airlines have medical advisors who provide advice and ’clear‘ passengers as fit to fly, though there is little evidence to suggest that these advisors are ever actually advised about deportees. The key information that they require is the nature of the individual’s condition, its severity/stability, medication being taken and any pertinent information about mobility. The clearance can be done by telephone or by formal communication using the Med IF form available through travel agents or from the Internet which allows the medical information to be structured in a manner that can be processed by the majority of airlines. MedIF forms can be found www.britishairways.com/cms/global/assets/pdf/BA_Medif_123.pdf

Assessing fitness to fly: Guidelines for medical professionals from the Aviation Health Unit, UK Civil Aviation Authority can be found on www.caa.co.uk/aviationhealthunit and outlines the physiology of flying, particularly the impact on cardiovascular diseases, respiratory disease, pregnancy, diabetes and psychiatric conditions.

➢    appendix 2 -G – MDIF – fitness to fly form