An Australian couple garnered attention this week after recounting their experience of sitting next to a deceased woman’s body for four hours during their flight from Melbourne to Doha. Mitchell Ring and his wife, Jennifer Colin, shared their story on the news program “A Current Affair,” explaining that a fellow passenger collapsed during the 14-hour journey. Despite efforts to revive her, she did not regain vital signs. “They did everything they could, but unfortunately, the lady couldn’t be saved, which was pretty heartbreaking to witness,” Ring remarked.
In-flight medical emergencies can vary in severity, and unfortunately, some outcomes can be fatal. Jay Robert, a former flight attendant and founder of A Fly Guy, stated, “A death on board at 35,000 feet is one of the most dreaded scenarios for flight attendants, often following a medical emergency that is already stressful to manage.” He added that witnessing a young passenger’s death can be particularly traumatic for those on board.
Although such incidents attract media attention, in-flight deaths are relatively uncommon. A 2013 study in the New England Journal of Medicine revealed that there was one in-flight medical emergency for every 604 flights over a three-year span, with a 0.3% mortality rate among the 10,914 affected passengers. This equates to approximately 36 known deaths during that period, averaging about one per month, with 30 occurring mid-flight.
Robert noted that the likelihood of encountering a death in the air increases for crew members on wide-body aircraft on long-haul flights, where there are more passengers and fewer opportunities to divert, coupled with the effects of a pressurized environment and prolonged sitting.
So, what procedures are followed when a passenger dies during a commercial flight? Experts, including Robert, outline the protocols that crew members must adhere to in order to handle the situation with care and professionalism.
The crew must implement emergency medical protocols. Dr. Paulo Alves, global medical director of aviation health at MedAire, explained that airlines develop these procedures in accordance with international aviation regulations and guidelines from authorities like the International Civil Aviation Organization and the International Air Transport Association (IATA). While specific protocols may differ among airlines, flight crews are generally trained to provide basic life support, notify the pilots, and seek assistance from medical professionals.
“We have AEDs [automated external defibrillators] on board for use if a passenger becomes unconscious and stops breathing, and we’re all trained in CPR,” said Heather Poole, a flight attendant and author of “Cruising Attitude: Tales of Crashpads, Crew Drama, and Crazy Passengers at 35,000 Feet.” She added that if no medical professional is available on board, they can reach out to a physician on the ground.
Airlines often utilize services like MedAire’s MedLink to consult with on-call medical professionals during emergencies. IATA guidelines suggest that crew members and any medical professionals on board should administer CPR until it is deemed unsafe due to turbulence or landing conditions, the passenger has been handed over to emergency services, or the individual is presumed deceased.
“Crew members are not authorized to declare a person dead,” Alves clarified. “However, if certain criteria are met—such as the individual not responding or breathing, CPR having been performed for over 30 minutes, and an AED used without restoring circulation—the person may be presumed dead.” He mentioned that a medical volunteer on board might also assist and potentially determine whether a passenger has passed away.
In the event a passenger is presumed dead, there are established best practices for treating the body with dignity. When a medical emergency occurs, the crew must inform the captain, who will consult with the airline’s operations center to decide whether to continue to the planned destination or divert to another airport. This decision involves various logistical and humanitarian considerations.
“A death on board does not automatically necessitate a diversion to another airport,” stated Markus Ruediger, assistant director of corporate communications at IATA. “Diverting to a third country—neither the flight’s origin nor destination—can complicate the repatriation of the deceased. Airlines are also required to notify the relevant authorities of the death on board.”
There are specific procedures for respectfully securing the deceased’s body while minimizing disruption to other passengers. “To handle the body with dignity and respect, while ensuring minimal disturbance to fellow travelers, the crew covers the deceased with a blanket,” Alves explained. “Nearby passengers may be relocated if space allows, and the body may be moved to a less crowded area, such as an empty row, if available. Otherwise, the body is secured in the original seat with the seatbelt fastened to prevent movement during the flight.” He added that crew members wear personal protective equipment to maintain hygiene and safety while managing the body.
Protocols may differ for longer flights with extended travel times. Robert recalled that during his tenure with a major international airline operating some of the longest flights, the on-board equipment included a kit with a body bag and toe tags. “If the pilots decided to proceed to our destination, we would need to prepare the body for storage,” he noted. “This involved relocating the deceased to a private area where the body could be laid flat for the remainder of the journey without other passengers noticing and without obstructing an exit. It was crucial to keep the body flat, as postmortem stiffening begins about two hours after death, and flights could still be lengthy.”
The aircraft Robert worked on typically had first-class suites with flat beds and privacy doors, which crew members would use if one was available. “We were trained to use the onboard wheelchair, which we discreetly wheeled backward through the cabin to transport the body to an appropriate location,” Robert said. “Once the body was in the body bag, we zipped it only to the neck, as the individual wouldn’t be officially declared dead until after landing. We could cover the head with a blanket out of respect.”
Throughout this process, the crew must prepare for the handling of the body upon landing. “During this time, the crew communicates with ground staff at the destination airport to ensure proper management upon arrival,” Alves noted.
In cases of emergency landings due to medical situations, passengers are usually advised to remain seated until health professionals board to assist the affected individuals. However, IATA recommends a different approach if the passenger is presumed dead. “Disembark other passengers first and ensure that family members stay with the body,” its guidelines state. “Do not disembark the body until the appropriate local authority has arrived to handle the situation and ground personnel are available to assist the family.”
It’s essential to recognize the emotional trauma surrounding such situations. While flight attendants are trained in basic life support and how to respond to various medical emergencies, they also learn how to provide emotional support during these distressing events. “A significant part of our training on in-flight deaths was learning how to communicate the news to those traveling with the deceased,” Robert recalled. “We had scripts to follow loosely and practiced how to inform someone that their travel companion had died. A lot of care goes into this process.”
Flight attendants are aware of the distressing nature of the situation for the deceased’s loved ones and for other passengers. They are prepared to comfort and talk to any passengers who may be struggling emotionally. “A medical emergency is incredibly stressful for the crew,” Poole noted. “On my last flight from London to New York, a passenger had a seizure during dinner service. One moment we were serving meals, and the next, we were rushing for oxygen and paging for a doctor. Twenty minutes later, we returned to serving drinks and collecting trash. It can be overwhelming.”
Passengers should understand that during a medical emergency, the crew’s priority shifts, and service may be paused. “I have literally been on the floor trying to save a passenger while others tapped me on the shoulder asking for drinks,” Robert shared. “Additionally, please refrain from using your phones during these sensitive moments. Not everything needs to be filmed and posted on social media. Someone traveling with a person who dies in flight doesn’t need to relive that nightmare online.”
Flight attendants also have access to resources to help them cope with the emotional stress following an emergency situation. Poole emphasized, “We have support available to help the crew manage the emotional toll.”
It’s crucial to recognize the professionalism and compassion of flight crews in these challenging circumstances.
