Yup, murdered the only person involved in the collision that didn't actually cause it. Celebrated as a hero because "honor" is achieved by murdering an unarmed man who didn't kill your family, rather than the people in charge of the airline and ATC company that did. After all honor is defined by many as "murdering someone, regardless of what they did".

Not to justify the murder or anything, but I don’t think that Nielsen can be said to have zero responsibility. He voluntarily worked in such an unsafe environment.

Ultimately if you work in a safety-critical field and you don’t speak up when something is very wrong, then you are just as responsible as anyone else.

Plugging away at your job while maintenance people disconnect the phones from ATC is negligent inaction. Without a working phone line the ATC was clearly offline in a very literal sense and he should have recognized that and either passed the responsibilities to another ATC and/or closed the airspace.

They boiled the frog on him. They had redundancy - two controllers, two phone lines, two collision warning systems.

They removed one controller. That was... not great, but it seemed okay.

They removed one collision warning system, for a short window. That was... not great, but it seemed okay.

They removed both phone lines. They didn't tell him. That wasn't okay, but he couldn't know that until he needed them.

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This also disregards that someone is always in the chair. Okay, let's say he quits. Then they're short an additional controller, making the situation worse, and someone else is still sitting in the chair when the exact same thing happens. "He voluntarily worked in an unsafe environment" is just a deflection from the responsibility of the people who have the authority and the opportunity not to make the system unsafe. His only agency was to quit his job or not, which wouldn't have any effect on the outcome.

> This also disregards that someone is always in the chair. Okay, let's say he quits. Then they're short an additional controller, making the situation worse, and someone else is still sitting in the chair when the exact same thing happens. "He voluntarily worked in an unsafe environment" is just a deflection from the responsibility of the people who have the authority and the opportunity not to make the system unsafe.

I can sort of see different ways to look at these situations but I usually don't see them that way. While desperately holding together a broken system seems heroic, it assumes that help is on the way. Many times no help is on the way because the system is sort of barely functioning so there is no priority to improve it. If he left maybe the other controllers would all leave as well, ending the farce.

> His only agency was to quit his job or not, which wouldn't have any effect on the outcome.

He probably wouldn't have been murdered and blamed for the the outcome!

I agree with you, but it sounds like the maintenance causing systems offline happened relatively quickly with no prior communication. In which case Nielsen was stuck trying to manage the two urgent situations that had arisen at the same time.

The first line in the "causes" section of the official accident investigation blames ATC.

The murder of Nielsen is a tragedy, but that doesn't mean he wasn't responsible.

The reduction from 3 to 2 operators, the acceptance of long breaks when there were two operators so there was only 1 in the room for a prolonged period of time, the pressure to cut costs, the lack of understanding of what systems were down during the upgrade, the surprising loss of hard lines without a tested alternative, the lack of a supervisor concentrating on the upgrades at the time, the lack of appropriate assessment of the risks.

Most of it seems to come down to trying to cut costs and reduce conflict with the staff (the acceptance of the “long breaks” overnight)

None of that lands on the overworked controller trying to do 3 jobs

Those are discussed in the "systemic causes" section, but as my sibling comment notes the controller has some responsibility for those factors too.

I'm not spouting my own opinion here, just noting that what the report says is at odds with claims in this thread.

ATC being the company, its procedures, operating with limited staff, etc. Not the controller.

You're simply misreading it, ATC refers to the specific person(s) responsible at the time.

Perhaps you're tripping over "responsible", it helps to read it as "if you, future person, are in this situation, consider how you could avoid a similar accident, given your position in the system".

It does not necessarily mean "this person is incompetent", or "this person is criminally liable". That's outside the scope of such reports.

If it didn't mean that, then someone in the ATC chair in the exact situation tomorrow would need to helplessly watch the same tragedy play out in front of their eyes, would they not? Even if they'd have the benefit of hindsight in having read this report.

After all they'd be a powerless puppet strung along by systemic causes.

The article covers this at some length.