President Trump's older brother, Fred Trump Jr., was an airline pilot who struggled with alcoholism. P4HR's letter asks a direct question: if Fred had survived, achieved recovery, and sought to continue flying today, how would the modern FAA aeromedical system treat him—and would years of demonstrated recovery ever produce a clear, evidence-based path back to ordinary unrestricted medical certification?
Why P4HR is asking for Presidential review
P4HR is not asking the White House to order the issuance of a medical certificate to any individual pilot. We are asking the Administration to examine the structure, leadership, culture, and accountability of FAA aeromedical certification.
The concerns include Special Issuance certification, HIMS monitoring, substance-related and psychiatric review, testing, evaluator independence, medical-data practices, administrative delay, written reasons for adverse decisions, objective progression and completion standards, and meaningful independent review.
The rulemaking record
On August 19, 2026, P4HR filed a comprehensive Petition for Rulemaking under 14 C.F.R. Part 11. The FAA assigned Regulatory Docket No. FAA-2026-10399. The petition proposed objective standards, written reasons for consequential aeromedical decisions, meaningful monitoring progression and completion criteria, independent review, evaluator safeguards, reasonable deadlines, testing integrity, medical-data protections, and a genuine pathway to unrestricted certification when continued restrictions are no longer justified by current individualized risk.
On October 8, 2026, the FAA declined to initiate rulemaking. On October 14, P4HR filed a formal Petition for Reconsideration under 14 C.F.R. § 11.101, asking the agency to withdraw the denial and reconsider the petition in whole or in severable part—or at minimum explain the actual grounds for rejecting both the comprehensive proposal and its narrower alternatives.
Leadership and accountability
The signed letter asks for independent scrutiny of leadership and decision-making within the FAA Office of Aerospace Medicine. P4HR believes reform cannot be limited to rewriting policy if the underlying culture permits consequential medical decisions to be made without sufficiently transparent standards, individualized explanations, or effective external accountability.
The letter asks the Administration to determine whether objective medical evidence is being appropriately weighed; whether pilots receive meaningful explanations when favorable evidence is overridden; whether lawful criticism or advocacy has ever influenced medical decision-making; and whether leadership failures, retaliation, abuse of discretion, or disregard of material scientific evidence have occurred. Where misconduct or leadership failure is established, P4HR asks that responsible officials be held accountable, including removal where warranted.
The full reform package
P4HR's rulemaking petition and the proposed Pilots for HIMS Reform Act of 2026 are complementary. The petition asks the FAA to implement reforms within its existing authority. The proposed Act addresses broader statutory protections, independent oversight, enforceable accountability, procedural safeguards, scientific integrity, transparency, and durable limits that may require congressional action.
The complete P4HR letter on organizational letterhead.
The comprehensive 2026 rulemaking petition.
P4HR's proposed legislative framework.
P4HR's October 2026 account of the denial and Petition for Reconsideration.
Regulatory Docket No. FAA-2026-10399.
P4HR's request
P4HR respectfully asks the President and appropriate White House and Department of Transportation officials to review the rulemaking record and proposed legislation; direct independent examination of FAA aeromedical leadership and decision-making; require accountability where misconduct or leadership failure is established; and meet with P4HR so that affected pilots, medical professionals, and supporting evidence can be presented directly.
Aviation safety demands rigorous medical standards. American government demands accountability. Extraordinary governmental power requires extraordinary accountability.