Mandatory reporting of impaired doctors is established in a number of jurisdictions and has generated a polarising debate. It has been said that forced reporting “threatens to erode the scope of ethical action”. The Germanwings air crash has reignited the debate and this paper reviews some of the arguments surrounding mandatory reporting and confirms that it is unlikely to work to achieve its goal. ISSUES INVOLVED Patients have suffered due to the actions of impaired clinicians but it is unlikely this would have been prevented with mandatory reporting. The co-pilot involved in the Germanwings disaster had a recognised pre-existing psychiatric illness that was known to his employers, thereby confirming notification had occurred and doctors did not believe he posed undue risk. It is argued that obligatory notification is forcing those who are impaired to either deny or conceal their problem, thereby further alienating them. This is especially so as those obligated to report them will often ignore the signs to avoid involvement. In addition, there is strong evidence to suggest that therapists are resistant to follow expectation for mandatory reporting, especially as it contravenes the ethical consideration for confidentiality of the therapist-patient relationship. There is also acknowledged confusion as to the threshold for reporting and a risk of suit in defamation. SOLUTION There is need for a compassionate approach to obviate mandatory reporting but to allow reporting if, in good faith, this seems to be the only viable option. This may encourage those who are impaired to seek help when needed. There should be indemnity for reporting if it is done in ‘good faith’.