Tuesday, September 4, 2007

Where the Buck Stopped

The BBC report of the verdict in the case of the 1972 Swiss mid-air collision in clear skies makes for interesting reading. This accident resulted in 71 fatalities, most of whom were Russian children on holiday. The air traffic controller responsible for the plane in which the children were flying was later stabbed and killed by the father of two of those children. The trial involved eight defendants: four managers and four controllers. The bottom line is that the managers were found guilty and the controllers were acquitted. For my money this constitutes a clear understanding of the nature of negligence and where it lies and deserves to become a case study in the areas of managerial decision making and decision support technology. The prosecution case was that the collision was due to a "culture of negligence," rather than any failure on the part of a specific controller. Indeed, "negligence" may be too polite a term for a management policy that created virtually impossible conditions for the controllers:

The trial revealed that minutes before the crash a single air traffic controller was in charge of 15 planes: He made 118 radio contacts with them, and he was guiding a plane into land.

The only question that remains now is whether or not the punishment associated with the verdict did, indeed, "fit the crime:"

Three of the four managers convicted were given suspended prison terms and the fourth was ordered to pay a fine.

A culture of negligence often goes hand-in-hand with a "culture of what-you-can-get-away-with;" so we must ask whether or not these measures are going to be punitive enough to deter similar incidents in future mission-critical situations.

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