Medical form: practical/ethical quandary

[redacted]

How do you know they didn't lie on their health forms then didn't lie about their fitness to the doctor!

What does it matter??

Sure, the initial health form for OW training may be considered an important part of the training as well as a liability release. Unfortunately, there are a lot more requests to fill out the same form from additional trainers as well as from some dive ops. These have little to no training value for the customer. These are just to reduce the liability of the dive facilitator.

I don't really like being deceptive when I fill out those forms. But I'll take that recourse over spending $4k just to sit on the beach. I believe we had a thread here that talked about a diver spending one day and whatever $$ to visit the local Dr. to get a medical clearance in Cozumel.

It is not a difficult choice. I do discuss these things with my doctor and, if he says don't, I don't. If he waffles or says it is OK, then the decision is mine. I don't need his signature. I don't need to make him liable for my decisions.

 

[flots am]

How do you know they didn't lie on their health forms then didn't lie about their fitness to the doctor!

You don't.

 

[Ricky B]

I am going to assume that all of you answering that it is none of the dive op's business what your medical history is and that it is okay for you to then lie on your questionnaire are lay people without medical training. ...

When you say "all of you" keep in mind that some of us (me in particular) emphasized that once we have consulted with a physician and gotten medical clearance to dive, it's our position that it is then none of the dive op's business. Since you appeared to have missed my mentioning this (several times already), I will repeat it. I have been diving (off and on) for 35 years (so far without dying). Within the last two years, I consulted with a physician (also a diver) who practices dive medicine. He ran certain tests, reviewed tests run by others, conducted a physical exam, and discussed my history with me. I am also physically fit. As I have said repeatedly, "in my circumstances" I think it none of the dive op's business once my physician has cleared me to dive.

It seems to me that most of the posters here (to whom you are attributing an I-know-better attitude) are also suggesting that there be a medical consultation if the questionnaire raises an issue.

 

[freewillie]

What does it matter??

Sure, the initial health form for OW training may be considered an important part of the training as well as a liability release. Unfortunately, there are a lot more requests to fill out the same form from additional trainers as well as from some dive ops. These have little to no training value for the customer. These are just to reduce the liability of the dive facilitator.

I don't really like being deceptive when I fill out those forms. But I'll take that recourse over spending $4k just to sit on the beach. I believe we had a thread here that talked about a diver spending one day and whatever $$ to visit the local Dr. to get a medical clearance in Cozumel.

It is not a difficult choice. I do discuss these things with my doctor and, if he says don't, I don't. If he waffles or says it is OK, then the decision is mine. I don't need his signature. I don't need to make him liable for my decisions.

I was actually trying to be tongue in cheek and a little humorous with my response. Wasn't trying to be serious and intended to be weak attempt being funny. I apologize if it came across as being argumentative. Sometimes my own family doesn't get my humor. My kids often don't think I'm that funny either, especially when I'm trying to be funny.

As to what does it matter, it goes to the OP's premise of being truthful. The doctor-patient relationship is based on trust and truthfulness. On both parties.

As to issues regarding liability I know that this is a highly litigious society. But if done properly the doctor should bear very little liability in clearing patients. My personal habit is to document as much as possible what the patient tells me they can and cannot do in terms of physical activity. I am not certifying that the patient won't have a cardiac complication with exercise or surgery, I am certifying that the patient is a LOW risk. I've cleared patients for surgery based on their responses and I've had only one patient suffer a heart attack. Since my notes clearly documented what the patient claimed they could do in terms of physical activity and that level of activity was more than adequate to clear a patient for surgery I was protected. I've also sent a few patients to stress testing despite their claims of physical activity. As Flots am's post indicates there are time when the patient does not meet the "eye ball" test. You take one look at them and you seriously doubt they are that physically fit.

---------- Post added July 29th, 2014 at 02:16 PM ----------

When you say "all of you" keep in mind that some of us (me in particular) emphasized that once we have consulted with a physician and gotten medical clearance to dive, it's our position that it is then none of the dive op's business. Since you appeared to have missed my mentioning this (several times already), I will repeat it. I have been diving (off and on) for 35 years (so far without dying). Within the last two years, I consulted with a physician (also a diver) who practices dive medicine. He ran certain tests, reviewed tests run by others, conducted a physical exam, and discussed my history with me. I am also physically fit. As I have said repeatedly, "in my circumstances" I think it none of the dive op's business once my physician has cleared me to dive.

It seems to me that most of the posters here (to whom you are attributing an I-know-better attitude) are also suggesting that there be a medical consultation if the questionnaire raises an issue.

Should have qualified that to read "all you who think it's okay to lie .." As pointed out earlier you don't have to fill out the questionnaire if you have a doctor's clearance. The form is not intended to actually allow a patient to dive once filled out, it is intended to screen patients who may not qualify to dive medically before they start classes. After that it's moot point.

If you've passed go so to speak and show up having had an appropriate medical evaluation then you are already cleared to dive medically. The form then actually becomes redundant. And at that point it really doesn't matter what the medical history is to the dive op and if for personal reasons by all means keep the history confidential.

 

[pdhenry]

Once upon a time I had an article written for physicians by someone, I thin from Dan, that went over all contraindications for diving and also what conditions, including medications, were not necessarily disqualifiers. I gave it to my them primary physician, who since retired and moved away. Does anyone know if this article ( or an update version of it or something like it, is around? Please advise. I'd like to get one to my current medical providers.
DivemasterDennis

The full RSTC medical questionnaire (6 pages) includes several pages for the physician explaining the rationale for contraindications for diving. It was sufficient for my (diving) PCP to assess and approve my fitness to dive despite having a few "YES" responses.

In answer to an earlier question - there is no qualifier regarding "...that would affect your fitness to dive..." in the questions. Just YES/NO.

Another thought - anyone know the position from DAN regarding dive accidents where you've been less then truthful on any medical questions?

 

[ev780]

I am going to assume that all of you answering that it is none of the dive op's business what your medical history is and that it is okay for you to then lie on your questionnaire are lay people without medical training. Full discloser in that I am a general internal medicine doctor. My perspective is different.

You would be mistaken.

Many of the responses also seem to imply that a medical form is an ongoing prerequisite for continued diving. You actually fill it out once just to determine if you are physically fit to start basic Open Water classes. Once you certify it is implied that one, your medical history does not change and two, if it does you may need to recertify based on that medical condition. For example, if you certified many years ago but then in your 50's had a heart attack you are now disqualified from diving for the immediate time after and based on how severe and what type may or may not be able to resume diving..

Again you would be mistaken. Most Dive ops I have used in recent years require it as part of the paperwork you fill out prior to a week of diving.

For those of you who think you know better than a medical profession what is appropriate and what is not it is a little like the blind leading the blind. Sometimes you don't know what you don't know. And you are still going to argue with someone who has much more training, education, and experience that you still know more than a doctor or medical professional.

Wow that shows some doctor hubris! I can assure you that a dive operator/instructor/divemaster is in no position to decide either. Again if it is such a big deal then require a current medical just like pilots. That is not going to happen because there is statistically little risk to diving.