Q.- Doctor, didn't it occur to you just in America, that with your splendid radio network, you could readily have received volunteers for your experiments by advertising for them by air, and, if this did occur to you, why didn't you do it?
A.- That obviously is impractical to collect people from all over the country and to bring them to one point for purposes of an experiment.
Q.- I am not requiring that people should be collected from all over the country; but America has such large cities that you could find thirty, forty or fifty volunteers in one city alone. Now, why was that not done?
A.- Well, sometimes that is done.
Q.- But you didn't do it. You used conscientious objectors.
A.- Yes, that's right, because the conscientious objectors were available at that time and we did not have unemployed to use.
Q.- There were unemployed people in prisons - thousands of them.
A.- Yes, we used the unemployed in prisons, and also the conscientious objectors.
MR. McHANEY: If the Tribunal please, personally I think the point being pursued by Dr. Sauter has been covered in exhaustive detail, He has been repeatedly asked the same things, the same question, and I also object to his arguing with the witness. If he restricts his questions and puts his questions shortly and precisely, I am sure he will get a short answer, but we usually get a question, plus four or five sentences of argument.
THE PRESIDENT: Counsel should avoid asking argumentative questions. The subject has been pretty well covered; but counsel may proceed.
BY DR. SAUTER:
Q.- I shall turn then to another theme, although I do remember cases where individual questions were asked by the prosecution and were kept on the floor for two or three times as long as this question of mine which the witness has still not answered.
Witness, you told us this morning that in the case of these experiments in which Ruff, Romberg and Rascher were involved, - the last being dead-, you said that Ruff bore the greatest responsibility, then came Romberg, and finally, Rascher. Did I understand you correctly, or did you mean something different?
A.- No, that is the order of seniority gave, on the basis of scientific experience.
Q.- Before you expressed this opinion, Doctor, did you make certain of the role and what authorities Dr. Rascher had in the Dachau con centration camp, and did you take that into consideration the special circumstances under which Rascher lived there?
A.- I believe so. I read the record and the documents regarding that point.
Q.- What I am referring to, Doctor, is not in the record or in the reports. What do you know about Rascher's position in Dachau and about his relations with the Reichsfuehrer SS Himmler who was in charge of all concentration camps? Do you know about these relations?
A.- I am only familiar with that which I have read in the record and in the documents.
Q.- In what record? You mean, the record of the trial?
A.- The record of the trial.
Q.- The record of this trial, you mean?
A.- Yes, in the record of this trial.
Q.- And in the reports?
A.- And the documents.
Q.- Do you know from this record who, at the time when the experiments in Dachau began, Dr. Rascher was subordinate to officially?
A.- In the early part, he was scientifically subordinate, according to my information, to Dr. Weltz.
Q.- What do you mean, at the beginning? When?
A.- That is, in December and January, February of the time of the experiment or of the year of the experiment.
Q.- Why do you still embrace the point of view that Dr. Ruff was responsible for Rancher since Rascher who was subordinate to no one?
A.- I said that, in so far as scientific responsibility is concerned, Ruff was senior and Romberg was second and Rascher was third.
Q.- That's what you said. But I want to know you reason for saying it.
A.- Because of their experience in scientific work in aviation medicine.
Q.- How have you figured out how much experience Stabsarzt of the Luftwaffe Dr. Rascher had? Rascher was a Stabsarzt of the Luftwaffe and Ruff was a civilian. How do you know that Rascher knew much less about the field of aviation medicine in which he was working that Ruff did?
A.- I know that Dr. Ruff has been working in the field of aviation medicine for some time and has done important work in that field, and I learned from reading the record that Dr. Romberg had been his assistant for several years, and no one had ever heard of the work that Rascher had done in experimental work in aviation medicine, and, from the record, he had no training in experimental work in aviation medicine that was anywhere equal to that of Dr. Ruff and R. Romberg.
Q.- You are speaking of the scientific responsibility. We have heard today of the legal responsibility, the moral responsibility, and now we are hearing about the scientific responsibility. Do you base this assumption of yours only on the fact that this concluding report of July, 1942, was also signed by Ruff as chief of his institute or do you assume that or. Ruff was present at the experiments in Dachau and continuously collaborated in the experiments there? What do you assume?
A.- I assume that Dr. Ruff signed the report in his capacity as head of the institute and as a scientific collaborator, but not as a collaborator who took part directly in the experiments at Dachau.
Q.- Did you take into consideration, witness, the fact that Dr. Ruff has stated, under oath, and has not been contradicted, that through throughout the whole experiments he was only present at Dachau for one single day in order to assure himself that the experiments wore being carried out in an orderly fashion and to check on this?
A.- Yes.
Q. Than, please tell me, if you consider Dr. Ruff responsible, how could Dr. Ruff, who was in Berlin, in your opinion, prevent culpable acts in Dachau of which he knew nothing? You just said that he was responsible? that means primarily responsible?
A.- I believe he was responsible because he was the senior man in this group of investigators.
Q.- Doctor, if you are here in Nurnberg and your assistant, with whom last month you discussed some experiments and other, and who is carrying out these experiments in America, commits a crime while doing so, do you hold yourself to be responsible if you are here in Nurnberg and can't prevent the crime? Please, were you the responsible person or not?
A.- If he is associated with me in some experiment that ho is conducting I believe it is my responsibility to return immediately to my laboratory to study the truth of the report and the circumstances surrounding it, and then have that carefully investigated, At least, my responsibility extends that far.
Q.- Your responsibility consists of this, that if you find out about abuses or offenses you should return to America, investigate the case and draw the necessary conclusions? In that you say is your responsibility. Do I understand you correctly?
A.- Yes.
DR. SAUTER: Mr. President, in that case I have no further questions. I should like you to permit the defendant Dr. Ruff to ask a few medical questions of the witness which he can settle more expeditiously and expediently than myself.
THE PRESIDENT: The defendant may propound medical questions to the witness.
BY DR. RUFF:
Q. Dr. Ivy, you reported yesterday and also this morning something about some fatalities that had occurred in American aviation research. Now, I should like to ask you that aside from these deaths, regarding which you have already testified to here, do you know of any others in addition to the death of the major who had a fatal accident when parachuting from a greet height and the five or six deaths that occurred during training?
A. I know of no other deaths.
Q. Don't you know of the one death that took place during the course of the centrifugal experiment in which the experimental subject was thrown down by the centrifugal machine and thus was killed?
A. I am not familiar with that.
Q. You are not familiar with that. Then do you know about the two cases of death that Professor Alexander, the expert for the prosecution, told my counsel, Dr. Sauter, about? These were two deaths in a low pressure chamber ascent in which experimental subjects in different experiments, of course, died because allegedly an oxygen reduction valve became iced over and for this reason the experimental subjects received no oxygen. Do you know of those two deaths?
A. Was that in the course of experimental work or routine indoctrination? Those two deaths may have been included in the five or six deaths to which I referred.
Q. I don't believe so. I am about to turn to the six fatalities that occurred during indoctrination. The case was described by the medical experts, by the prosecution expert, and it was said that of course there was a very precise investigation into this matter but that finally further investigation was quashed because it was discovered that this valve had been frozen over. Would you consider such a freezing of the valve with the consequent death of the experimental subject at a height of say 12,000 meters - would you consider that an extenuation for the observing physician or sergeant?
A. I do not understand what is meant by the expression "extenuation for the attending physician or sergeant". The meaning of "extenuation" is not clear.
Q. Let me express myself differently. If such a valve fails, would that constitute for you an act of providence that led to this accident and a reason for declaring that the sergeant in question was morally and legally innocent of any crime?
A. I should say that was a mechanical failure and not a human failure.
Q. Dr. Ivy, let me remind you that from the moment when the supply of oxygen is interrupted until death occurs at a height of 12,000 meters there is a rather long lapse of time. How long this time is neither of us knows probably, but at any rate it is a considerable period of time. During this time in the first place the subject becomes altitude sick, he has cramps, he falls unconscious, etc. This lapse pf time should be long enough for the crew operating the low pressure chamber to bring the subject back to a safe altitude again. Is that not so?
A. Yes, those presumptions are reasonable. I can't say that they are accurate because I do not know the exact circumstances surrounding these alleged deaths.
Q. Then let me turn to the next fatality.
THE PRESIDENT: I am going to ask the witness if he finished his answer to the preceding question. Did you finish your answer?
THE WITNESS: I did but I don't know whether it got through to the recorders.
THE PRESIDENT: I think it did.
BY DR. RUFF:
Q. Dr. Ivy, I come to the next fatality which occurred within the framework of aviation medicine within America. In these five or six cases that are alleged to have taken place during training indoctrination was your documentation for which you have said regarding them - what papers are you referring to - were any papers on these deaths published?
A, I believe there was a report, mimeograph in nature, that was released. I am not acquainted with any publication of that data in a scientific journal. I have heard the matter discussed on two occasions in meetings of sub-committees of the Committee on Aviation Medicine of the National Research Council.
Q. Perhaps I can be of assistance to you and tell you the publication. At least, I think it is that we are talking about the same cases. The title is "Collapse at High Altitudes", written by Mashland, and appeared in the Air Surgeon, November 1944, on page 3. However, you did not see the paper in this periodical?
A. Not in that periodical.
Q. Now, let me put a few cases from this to you and ask you whether we are talking about the same cases. The first case did not happen in the low pressure chamber but in a medical experiment in an aeroplane. The director of the experiment had the subjects carry out gymnastic exercises in the plane at 35,000 feet. Following this exercise bends occurred; there was a collapse; when they returned to earth, there were severe headaches and subsequent death. Is this one of the cases you are also referring when we talk about these five or six fatalities?
A. I am quite sure that we are referring to the same report, except I believe I saw it in mimeographed form and not in the publication "The Air Surgeon".
Q. Then another collapse is described not in a training flight but a high altitude flight for medical purposes which had the same outcome as the first; then the third case is an ascent in a low pressure chamber to 38,000 feet and at that altitude there was collapse and various other symptoms and finally death. Mashland. in the paper I just mentioned writes about the history and treatment of such collapse as may arise in such cases as these. The other two fatalities were much of the same nature and I need not go into them.
Now, I only have this one Question. Are you familiar with an unpublished report by John Grey from the AAF School of Aviation Medicine, Randolph Field, Texas, of 3 October 1944, "The Present State of Decompression Sickness"? This is not a publication but an internal report. Do you know this report?
A. Dr. Grey has submitted quite a large number of reports from the School of Aviation Medicine at Randolph Field. I do not have in mind the contents of the particular report to which you are referring.
Q. I did actually name the title, and I assume that you have yourself especially concerned yourself with decompression sickness and consequently are familiar with the modern literature on the subject. This is a report "The Present Status of the Problem of Decompression Sickness".
A. I have probably read the article but I do not recall the contents under that particular title.
Q Now, do you not recall having been able to see at least between the lines in this report something about fatalities or possible fatalities?
A Well, I know that the subject of collapse after routine exposure to high altitude in the performance of high altitude tests was of special interest to the field of physiology at the school of medicine at Randolph Field. I also know of one of the occasions, at the meeting of the sub-committee on decompression sickness at which this matter of most high-altitude collapse was under discussion, Dr. Gray received his training in physiology under my instructions.
MR. HARDY: Your Honor, if the witness Ruff desires to question Dr. Ivy on this particular report of Dr. Gray, then I ask that he submit a copy of the report to Dr. Ivy so he can refresh his recollection.
THE PRESIDENT: Has the witness his copy of the report by Dr. Gray? If so, he should submit it to Dr. Ivy for identification.
BY TEE DEFENDANT RUFF:
Q We would have put this in as evidence if we had it, At the Aereo-Medical Center of Heidelberg this report was available to me in 1945 and I only have the excerpt from it that I made at that time. We are trying to get the original and will then put it in as evidence.
Dr. Ivy, when you spoke of these six fatalities during training this morning, I said that not all of these fatalities took place in training or indoctrination, but let us not that in the indoctrination or training six fatalities did take place; is that not so?
A That is my recollection.
Q The people who were used for such training indoctrination were for the most part members of the Air Force; were they not?
A Yes, cadets, in the process of training.
Q Who were being trained, that they were under training means also that theretofore they had received a very careful medical examination; isn't that so?
A Yes, that is correct.
Q Now, you said this morning that in these very healthy young persons who were subjected to such an experiment for the sake of their indoctrination there was a fatality that would simply have to be taken as something done by fate. Do you know that in Germany that we carried out thousands of experiments and examinations for training purposes and that we have not had one fatality at all?
A I did not know that you had no fatalities. I knew that you carried out training experiments in altitude chambers, but not nearly on the same scale as was carried on in the United States.
Q In the point of numbers the United States carried out probably more experiments as compared to Germany, that is true, but we too carried out thousands of experiments without one single death. The difference in the experiments in the United States and in Germany was that in the United States, the persons being trained were subjected to 12,000 meters for a considerable length of time while in Germany they were subjected to that altitude for only ten or fifteen minutes, and I personally assume that in ...
THE PRESIDENT: You not been asking the witness questions, you have been in effect testifying, making statements yourself. If you have a question to ask the witness, propound the question to him.
BY DEFENDANT RUFF:
Do you know wherein possibly the difference lies from the fact that you had fatalities in America and in Germany we did not?
A The time factor was probably significant. We were training our men in long flights at high altitude and in bombers for 3, 4 and 5 hours.
Now, let us turn to the last fatality, the one you mentioned yesterday, in which a major descended by parachute from a great height and died thereby. I unfortunately did not take down his name at the time. You paid that this unfortunate man of course was carefully examined after his death; what killed him on the descent, what was the cause of that?
A That was uncertain, and on the basis of my knowledge of the circumstances surrounding this unfortunate death and my knowledge of the physiology changes associated with free fall through the air, I suspect that he fainted. He was very fatigued before he went to altitude and. had been advised that the jump should be postponed to another day, but he went on through with the jump.
Q Was this an experiment in which at the beginning the parachute was not to be opened at the beginning of the ascent?
A Yes, so called free falling; he did not have with him an automatic parachute opening devise. Now perhaps it would have been possible and already you have intimated that he was unconscious and could not operate his parachute; wasn't it just possibly namely that the opposite happened, that he opened his chute immediately or that it opened by mistake and for this reason the man fell ill of altitude sickness?
A No, in this case the parachute did not open, it was the case of Major Boyton.
Q Before this practical experiment, had you carried cut a low pressure chamber experiment to determine the oxygen problem involved?
A Yes, as a matter of fact before the pre-fall experiment, which I performed in 1940 and 1941, we studied the question of oxygen requirements during free fall and we supplied our jumpers with a mask and a bail-out-bottle of oxygen.
Q I should like to anticipate a bit, Dr, Ivy, yesterday you told the Tribunal when you were asked whether our experiments for research at great height were necessary, and I shall repeat your answer more or less in its meaning, you said no that was not necessary, it could all have been calculated at the time, but you yourself carried out such experiments in order to ascertain how the oxygen situation is; why did you not rely on your calculations?
A That answer "no" pertained only to one portion of the experiments, which you did and that was slow descent from high altitude, that is descent by early opening of the parachute.
Q Then I misunderstood you yesterday, I understand you to mean that the free falling experiments that my colleague Romberg carried out in Dachau and are mentioned in Document No. NO-402you consider necessary for the clarification of this problem?
A I qualified my answer in this way and I said the slow descent experiments were unnecessary in my opinion because of the hazards they entailed and that instead of doing that particular experiment on human beings and that I should rely on results on animals and make the necessary calculations with the human beings in order to determine the amount of oxygen it would be necessary to supply under these conditions. I did not object to the other experiments you did, which I did not feel they were nearly as hazardous as the slow descent from high altitude.
Q Very well, I shall return shortly to this question. Now you said previously to my counsel, Dr. Sauter, that so far as you knew explosive decompression experiments were carried out in America to the height of roughly 50,000 feet; did I understand you correctly?
A I recall, I said 47,500, which is a little below 50,000, but approximately 50,000.
Q Can you cite me the most recent American paper on this subject?
A There are some preliminary reports published in the Federation proceedings for Biology in Medicine by Dr. Hitchcock. All of the results on that subject will not become available until the Committee on Decompression Sickness of the National Research Council publishes a monograph on the subject of decompression sickness and the findings made by American scientists during the war.
Q As I understand from my examination by my counsel and by the prosecution, you were an. active member of the Committee; is that so?
A Yes.
Q Then for certain the expert in Wright Field is know to you?
A Yes, that is right.
Q Would you please name him to me?
A Dr. J. J. Smith did the first work on decompression sickness, Dr. Hitchcock of the University of Iowa collaborated with the Wright Field group and, I believe, Dr. Dempsey - I do not recall his military title. I believe he is a Lieutenant Colonel, - was interested particularly in explosive decompression.
Q Do you know that in 1944 H. M. Sweeney reported from Wright Field on decompression?
A That is the man's name when I said Dempsey, I got Sweeney and Dempsey mixed up.
So far as we know that is the most recent American publication on explosive decompression and the limit there is stated to be roughly 50,000.
A Yes, and it is the most complete American report and covers the most experiments, except those of Dr. Hitchcock, which have not yet been reported. Dr. Sweeney followed Dr. Smith on the work on explosive decompression in the laboratory at Wright Field.
Q Dr. Ivy, we have been saying now for some time that explosive decompression experiments are made during indoctrination and for other purposes; would you please describe briefly to the Tribunal why this is done and why flying practise makes such explosive decompression experiments necessary?
A The Tribunal, I believe, is familiar with the expression pressure cabins in airplanes; pressure cabins are being used to some extent on pressure plants in the United States in commercial aviation. In the pressure cabin the pressure is maintained at an altitude equivalent to that of ground or some predetermined altitude at which the administration of supplemental oxygen is unnecessary, such as 10,000 feet. We shall assume we have passengers, in a pressure cabin in which pressure is being maintained at an altitude equivalent to 10,000 feet and the plane is flying at an altitude of 40,000 feet; the question arises what would happen to the passengers or occupants of the plane if the seal of the pressure cabin was suddenly fractured and what would he the relation of the size of the fracture in this seal to the danger of the passengers.
Is that clear?
THE PRESIDENT: It is time for the evening recess. The Tribunal will be in recess until 09:30 o'clock tomorrow morning.
(The Tribunal adjourned until 14 June 1947 at 0930 hours.)
Official transcript of the American Military Tribunal in the matter of the United States of America against Karl Brandt, et al, defendants, sitting at Nurnberg, Germany, on 14 June 1947, 0930, Justice Beals presiding.
THE MARSHAL: Persons in the court room will please find their seats.
The Honorable, the Judges of Military Tribunal I.
Military Tribunal I is now in session. God save the United States of America and this honorable Tribunal.
There will be order in the court room.
THE PRESIDENT: Mr. Marshal, will you ascertain if the defendants are all present in court.
THE MARSHAL: May it please your Honor, all the defendants are present in the Court.
THE PRESIDENT: The Secretary General will note for the record the presence of all defendants in court.
Counsel, how long do you anticipate that your further cross examination of this witness will take?
DR. SAUTER: Mr. President, I estimate that Dr. Ruff will require perhaps half an hour, if the Tribunal permits. Following Dr. Ruff, I myself, should like to ask two or three more questions, so that we will be finished in about three-quarters of an hour.
THE PRESIDENT: Very well, you may have that time allocated to you.
I would ask Dr. Steinbauer -- you may remain at your seat, Doctor.
DR. STEINBAUER: I believe I need about an hour.
THE PRESIDENT: Very well, an hour will he allocated to Dr. Beiglboeck.
I understand that Dr. Servatius will conduct the cross examination of the witness on at least some of the general subjects. Will any other counsel cross examine the witness upon any general matter?
DR. FLEMMING: I will need about ten minutes.
THE PRESIDENT: That will be allocated to you.
DR. NELTE: I will need about a quarter of an hour.
THE PRESIDENT: Very well, that may be allocated.
Counsel may proceed.
DR. SAUTER: I should like to have Dr. Ruff ask a few more medical questions.
THE PRESIDENT: Dr. Ruff may propound the questions to the witness.
DR. ANDREW C. IVY - Resumed CROSS EXAMINATION (Continued) BY DR. RUFF (Defendant):Q Dr. Ivy, yesterday you explained to the Tribunal what conditions and practice explosive decompression comes about and you had said that if a plane is flying at high altitude and the pressure cabin is damaged, this explosive decompression occurs.
Now, what happens to the persons in the plane if they have survived this explosive decompression? What happens to them after that? To make the question more precise I might add the following: Let us assume that the plane is flying at 17,000 meters.
A They can either take a dive to the ground or they can bail out. In the American Air Forces they bail out, they disconnect from the oxygen supply of the plane and plug in with the oxygen supply of the bail-out bottle before leaving the plane.
Q Professor Ivy, if this explosive decompression occurs at 17,000 meters then the crew has only a very short period of time for bailing out, is that correct?
A Yes, that is correct.
Q Because even with oxygen the crew becomes unconscious very quickly at 17,000 meters, is that right?
A Yes, that is correct.
Q Could you. perhaps indicate how much time passes from the moment of explosive decompression until unconsciousness sets in -still at 17,000 meters?
A That will depend upon the size of the fracture or damage of the plane, the rate at which the explosive decompression occurs. If it occurs relatively slowly they will be able to connect with their oxygen supply and will be able to get out of the plane before they lose consciousness in the course of perhaps 30-35 seconds. That period of time will vary.
Q Yes, I quite agree with you. Now, if we assume that a whole pane of glass is broken, if there is a comparatively large hole in the cabin, would you agree with me that this time which we in German aviation call time reserve at this altitude is about 10 or 20 seconds?
A I agree with that under those conditions.
Q Now, Professor Ivy, if for reasons of aviation medicine one makes experiments with explosive decompression is it not sensible to carry out experiments on the course of the parachute descent following explosive decompression?
A Yes, I think up to a certain point.
Q Do you agree with me if I say that only explosive decompression experiments for 17,000 meters again, are senseless in practice if one does not at the same time investigate the question of rescue after explosive decompression?
A Yes, that is correct.
Q Now, Professor Ivy, in America explosive decompression experiments were carried out through about 17,000 meters--47, 000 feet. Can you confirm this second part of the problem, experiments for parachute descent from such altitudes were also carried out?
A Yes, up to a certain point they were carried out but were not carried out the way you carried out your slow descents from 15 kilometers or approximately 49,000 feet, which requires subjecting the subjects to a long period of oxygen lack.
Q . The experiments to this end were not carried out in America because the American Air Forces oxygen equipment is available for parachutes so that the person is equipped with oxygen after bailing out, is that correct?
A. Yes, that is correct.
Q. Now in order to avoid any misunderstanding which might arise on the basis of one question asked by the prosecutor, I ask you on the basis of theoretical calculations can binding finds be made as to the exact altitude from which oxygen equipment for a parachute is necessary?
A. An approximately correct answer can be obtained by calculations.
Q. By calculations. Would you please briefly explain to the Tribunal what physiological factors would have to be considered in such a calculation?
A. One has to consider the questions of partial pressure of oxygen in the inspired air at the various altitudes, when the subject is breathing 100% oxygen at high altitudes, you would have to consider the ambient pressure in making the calculations of the pressure of the 100 % oxygen as I have indicated previously in my testimony; in order to obtain a 100% saturation of the blood with oxygen above an approximate altitude of 12,000 metres it is necessary to breath the 100% oxygen under pressure, so that breathing 100% oxygen between an altitude of 12 kilometres and 15 kilometres there would be some under-saturation of the blood with oxygen, even though the subject were breathing 100% oxygen. That would have to be taken into consideration and the rate of fall with the parachute open would have to be taken into consideration. The only place that the blood would not be 100% saturated would be in the region above 12 kilometers. I believe that is as simple as I can make the matter.
Q. Now, Professor Ivy, you mentioned two factors which have to be considered in these calculations.
Do you agree with me if I say that in addition to these two factors, the carbon dioxide in the lungs has to be considered because this influences the amount of oxygen in the lungs?
A. That will influence. The percentage composition by the partial pressure oxygen when you breath 100% oxygen can be determined the carbon dioxide and water vapor content would have to be taken into consideration in the calculations.
Q. Yes, you mentioned a fourth factor. That is the water vapor which also has to be considered. Now the speed of occurrence of altitude sickness may be influenced by the circulation too.
A. By altitude sickness do you mean the symptoms due to lack of oxygen only?
Q. Yes, only the symptoms of lack of oxygen otherwise that becomes too complicated.
A. Yes, the circulation is a factor, but there is no reason why the circulations should be significantly disturbed due to these conditions which we are discussing.
Q. I believe you misunderstood me, Professor Ivy. I asked whether this circulation time, that is the time a particle of blood needs to go through the entire circulation once and back to the lungs, whether this time is not also a factor.
A. Yes, that's always a factor, whether we are up in the air or on the ground.
Q. Then that would be the fifth factor. Now would you agree with me again that the respiration of the aviator in question, that is, the frequency and depth of respiration is responsible, would also influence the results of the calculations?
A. Yes, that influences results of such calculations whether you arc in the air or on the ground.
Q. Now, would one also not have to consider the so-called adap tation to altitude?