Heart disease would certainly be a red flag - at a minimum, further investigation and testing would need to be done to determine what exactly is going on. Most likely, a pilot’s medical authorization would be revoked, but appeals could be made and actually there are quite a few pilots out there who have had a heart attack, cardiac bypass surgery, and so forth and been allowed to return to flying once it is established their condition is stable and not a threat to others. They can’t get authorization to return to flying 747’s full of passengers, they certainly could return to some level of flying. Again, provided that they are determined to be medically fit to do so.
An alcohol consumption rate of a six pack a day would also be a red flag - they might require random drug tests for a period of time, or attendance at some sort of substance abuse program even if there is no legal evidence - i.e. DUI’s - of a problem. Certainly, if you have a DUI in your background they’re going to look very hard at your alcohol consumption patterns. Yeah, conceivably they might pull your flying privileges for that, particularly if there are other health problems or signs the drinking is causing damage.
Pilot’s are required to give the FAA access to their driving records - how you behave on the road can, and in some cases has, affect whether or not you get to fly legally. I have seen pilots wail about this - usually those who are crappy drivers. Well, if you can’t handle a car in two dimensions I’m not sure we should trust you to handle a much faster vehicle in three dimensions.
You can certainly loose your flying privileges without losing your driving privileges. It is also theoretically possible to loose your driving privileges *without * losing the flying - but I can’t recall an actual such occurance. It would probably be a situation where a pilot is, say, in a wheelchair and moves from one state to another - he would retain his Federal permission to fly, but might run into a snag at getting re-licensed to drive in his new state, depending on what rules and regulations apply. Or a pilot with a vision defect (he’s one-eyed, perhaps) that was determined not to be a problem flying but, again, may run afoul of local driving laws that would prevent him from driving until he, say, installed extra mirrors on his car.
Anyhow - if a pilot is denied medical authorization he/she can appeal. In some cases this might even involve a “medical checkride” or issuance of a Statement of Demonstrated Ability (meaning you are capable of doing the job safely even if you don’t perfectly meet some standards) but that typically involves medical reasons that aren’t affected by behavior. So you might see that for someone missing a limb, but not for drinking. If your drinking is causing a problem then stop. If you can’t stop, then you have a serious problem. If you love drinking more than flying - or driving - then… well, I guess you’ve made a choice.
What it comes down to in my mind is that if you don’t have a drinking problem you can give up the booze. Sure, you might miss it - but a responsible person who wants to keep driving, or needs to drive to get to a paritcular job they don’t want to give up, will make the choice to drop the beer. If you do have the sort of drinking problem where you can’t give it up, you may not be safe to be on the road.
Is the whole system of FAA medical authorization to fly OK? Hmm… in broad concept, yes - the standard is twofold: 1) can you control the machines and 2) are you a hazard to others (note that you are permitted to risk your own neck in the air - it’s bystanders the FAA is worried about). If you dispute the FAA’s determination you are given the opportunity to actually demonstrate you can meet those two standards.
The devil is in the details, of course - there’s plenty to dispute about the picky details.
In sum, I’d say the FAA is a bit too strict in some areas, and the DMV is too lenient. I’d like both systems to meet somewhere in the middle. Be a little more stringent with the auto drivers, certainly.
