Medical Privacy Concern

[Sas]

OK. You're thick. Though not so much that you couldn't find a thesaurus to add a bit of an innapropriate mocking tone in a discussion of a husband and father of two dieing.

Well, I do not wish to mock this person's death at all, but I think it is a legitimate question. How exactly did this person lying on his medical form lead to his death? Given that you are using that as an example to backup an argument you are making, it would be helpful for you to elaborate on your example more especially seeing as you are using it as a warning to others not to lie on their medical. Cheers.

 

[adurso]

OK. You're thick. Though not so much that you couldn't find a thesaurus to add a bit of an innapropriate mocking tone in a discussion of a husband and father of two dieing.

Happens to be the way I speak. My question stands relevant to the discussion at hand. You have asserted that decendent's prevarication/falsification on a form was proximal causality to death.

Are you going to answer or continue ad hominum?

 

[NudeDiver]

It would be interesting to know if RJP - or any other "dive pro" for that matter, would ask all those medical questions if they came up with it on their own, as opposed to it being an agency requirement. You know, just another "thing" you have to do to follow someone else's rules.

You have asserted that decendent's prevarication/falsification on a form was proximal causality to death.

There isn't one. But good luck getting an answer. I'm still waiting for him to tell us what the difference is between being honest when filling out the form and providing a physician clearance and lying on the form and having a physician clearance in one's personal files, and how this amounts to a reckless disregard for one's own life and/or the life of others, let alone some variety of "negligence".

Blind obedience to forms - this notion that if something is on a form, you MUST answer - and provide the correct answer. Please. When I go to the doctor's office and fill out the form and get questions like, "Have you ever been hospitalized? Where and when?" - like I'm really going to list off some 15 odd instances that are completely and totally irrelevant to the fact that I drilled a hole in my finger and want it checked out.

Reminds me of when I got married. On the form it asked a few things and said (optional). I didn't fill them out. The lady on the desk pointed to the blanks and said, "you forgot to answer these". I said, "no I didn't." She went on to say that I had to answer them, and I indicated that no, I didn't. This went on and on - for like 20 minutes. I said, "look lady - the form says right on it - OPTIONAL. Do you know what OPTIONAL means?" After some consultation with her supervisor, the supervisor came out - same conversation - another 15 minutes or so. What is with these people? I asked them to go get a dictionary and look up the world OPTIONAL and see what it says. At some point, I think they did, because they disappeared for 10 minutes. Eventually, the first lady came back and said "fine - you can leave them blank - but no one has ever done that before." On the marriage certificate, for those items they put "REFUSED".

People. Forms. I dunno why one group is so in love with the other.

 

[boulderjohn]

I think that from the scuba industry point of view, as represented in this case by the RSTC, there is something of a dilemma here. They want the potential student to know up front that certain medical conditions are not good for scuba divers. For example, a woman trying to get pregnant should know that she should probably not be diving, and a typical woman signing up for a class would not have any way of knowing it. So they list it on the form. They want physicians to know that certain medical conditions are problematic, for most have no training in diving, so they put it on the form and give the doctor specific advice.

The problem is that this results in a few questions that are invasive.

They could put a list of conditions that should require a doctor's approval and leave it up to the student to pursue it (which is in essence what those who advocate lying are saying), but I believe the RSTCs fear is that students will not bother to read it.

And that will indeed happen. When a potential student signs up for a class with our shop, they are given the form and a complete explanation, with the key ideas marked with a highlighter as they listen. A few days before the class, they are called and reminded. Quite a few still show up for class with a blank form, and quite a few show up with yeses on the form and no doctor's approval, claiming (despite the highighter marks) that no one told them anything about it.

And the consequences can be serious. Let's say the new mom ends up with a child with birth defects (or worse) because her developing fetus could not handle nitrogen buildup the way her adult body could. That's obviously bad for the mother and child, but it is also bad for the shop that gets sued for not providing adequate warning of the risk.

A dilemma is a problem with no right answer, and the best answer to a dilemma is the lesser of two evils. I suspect that the RSTC believes that this level of privacy invasion is the lesser of two evils.

 

[Diver0001]

you're kidding yourself - IMHO.

You've never had to rescue someone for real, have you?

We have. One of our divers died during a dive because he had a serious heart ailment and lied about on the medical form because he *really* wanted do this...

Another was prone to panic attacks but lied about it. Without any warning at 25 metres (83 ft) he ripped his mask off, threw out his regulator and breathed water... This one we saved despite his best efforts to the contrary.

Another, one of our own staff members, nearly bit it from a heart ailment on a wreck dive in the middle of the North Sea. He knew he wasn't well but didn't want to hear what the doctor had to say.....

and THAT (the last one) is what the medical form is for. It's forcing people to seriously consider the risks and not to minimize them, hide them, or ignore them.

Like some of the others, I find your advice about lying lousy, to say the least.

------

That said, I find the OP's question very interesting. I've never thought about it before but doctors have a professional obligation to secrecy about their patients files. I would say they are held to a much higher standard than dive pros are in this respect.

Unfortunately I don't have an answer. We need this form or we can't train you. It's that simple.

It would be nice if there were another form for the MD to sign off on with the same list but with the requirement that the MD signs off that he/she has considered these risks. That way the MD could sign you off "fit for diving" without the dive pros being privy to the details of the doctor/patient relationship.

Unfortunately such a form does not exist.

R..

 

[diver 85]

To the OP-------take up gardening....when was the last time a shovel asked you if you were PG, or trying to get PG?......

 

[RJP]

You've never had to rescue someone for real, have you?

We have. One of our divers died during a dive because he had a serious heart ailment and lied about on the medical form because he *really* wanted do this...

Another was prone to panic attacks but lied about it. Without any warning at 25 metres (83 ft) he ripped his mask off, threw out his regulator and breathed water... This one we saved despite his best efforts to the contrary.

Another, one of our own staff members, nearly bit it from a heart ailment on a wreck dive in the middle of the North Sea. He knew he wasn't well but didn't want to hear what the doctor had to say.....

and THAT (the last one) is what the medical form is for. It's forcing people to seriously consider the risks and not to minimize them, hide them, or ignore them.

The first and the last cases cited above are pretty close to the case I'm talking about.

I don't plan on following the responses to this post saying "he would have died anyway" or "it was his choice" or "you pay your money, you take your chances" etc as those are absolutely ridiculous. They fact remains that if the guy I'm talking about had not lied on the form he would certainly not have died that day - because he would not have been on that dive. Plain and simple.

 

[D_B]

... interesting discussion, and points made for ether side

 

[NudeDiver]

We have. One of our divers died during a dive because he had a serious heart ailment and lied about on the medical form because he *really* wanted do this...

If you can show me where I advocated lying on the form simply because "you really wanted to do this" please let me know.

If you can show me where I advocated avoiding getting a doctor's approval, please let me know.

And once again, if you can show me a material, medically-related difference between being honest on the form and getting doctor approval, and lying on the form and getting doctor approval, please let me know that too.

 

[Diver0001]

If you can show me where I advocated lying on the form simply because "you really wanted to do this" please let me know.
.

http://www.scubaboard.com/forums/4326284-post2.html

The first post on this thread where your first sentence was "just lie on the form"

I'm sorry I didn't see this thread earlier so I could crawl down your throat when your memory was fresh but don't try to back-peddle now.... Or of you really feel that need to back off that opinion then feel free to say "Diver0001 was right and I take it back". I'll accept that too.

Incidentally, one of our DM's and one of our instructors quit their jobs after that first incident. I don't know you if you understand this but advocating 'lying on the forms' is like saying "just put a bullet in your head... the paramedics who have to scrape your brains off the pavement don't care.

They do.

The consequences of such a decision go deeper than you think.

R..