Medical Privacy Concern

[don Francisco]

While I'm of the opinion that the main purpose of the medical form is as a liability waiver, let's not discount the informed part of "informed consent"

Most non-divers have no idea that certain medical conditions which are non problematic on an everyday basis might be contra-indicated for diving. Part of the purpose of the form is to properly inform them of these unknown risks, and send them to obtain expert medical advice as to their fitness to dive. As a practical matter, for a variety of reasons including the fact that many doctors don't know much about the physiology of diving, it won't effectively screen all conditions or divers, but it at least meets the test of fair warning.

 

[OldNSalty]

Wow, Monday morning and still going strong.

Do we have a declared winner yet?

 

[don Francisco]

Stalemate!

 

[BabyDuck]

below is general 'you', not directed at anyone specific...

the 'i need to know as dm' argument is silly. the form is filled out once, before class. do you think that if a person lies *or* tells the truth on this form, and now does *or* does not have a heart condition or diabetes or whatever, that you as a dm on a random dive boat will know?? even 20 years later when a formerly fit person is now not so fit? do people file on your boat and tell you their histories or you make them go to another boat? do you think people who were able to answer 'no' legitimately when they got certed think to remind their doctors every year (or 2 or 10, when they go for checkups - when was *your* last one?) that they dive and skateboard and competitively pogo-stick and make sure they're still safe to do these things with new medical problems? hell, common seasickness meds cause drowsiness - i'd say that's likely to be contraindicated to diving, wouldn't you?

and what does it matter? if someone's brought to the surface unconscious, the abc's are what you do. there's no mention in them about high cholesterol or seizures. 'why' isn't very important in the moment, treat what you see. if someone's acting weird and you happen to know they're diabetic, maybe giving them some juice would be appropriate, but maybe this is the first time they've ever had sugar problems or maybe they're having a stroke or something and you're insisting on giving them a candy bar...

yes, i think there needs to be some way of medically screening people for contraindications to diving. no, i don't think the form is helpful past the time frame of certification. yes, the instructor should know if you have a history of panic attacks or asthma. no, there's no need to have to tell them if you have ductal breast cancer or ascus or colon polyps - what bearing does that have? what are they gonna do about it?

and i think the privacy thing is pretty much moot, just because i don't think there are bored shop staff rifling through old forms to see who says they have what disease - but if you have an issue you don't want out in the world, i think it's reasonable to worry about this.

 

[Standingbear56]

I can't speak for any other posters, but let me be absolutely clear. I'm not advocating simply lying to get around the form. What I'm saying is that if one does his due diligence, and reviews his physical condition with his regular physician, who then renders a knowlegeable medical opinion that there in no contra-indication to diving, than whether he lies on the form or not is immaterial, since nothing will have changed either way.

Unfortunately there are others on here who did imply that. The RSTC form states the following: "Have you EVER had or do you currently have" (emphysis mine). If the student ever had a condition listed, and the student and his/her regular physician (who is more than likely NOT a specialist in diving or barotrauma) decide that it is a non issue and the student puts down "NO", then he/she has lied. This has been upheld in court.

As for the instructors need to know, that too depends on materiality, and in any case you can't have this both ways. On the one hand, instructors say they quickly scan and file the form and MD letter without reviewing the details, aparantly saying they don't actually need to know specifics.

Since the instructor has the final say if someone can take his/her course, they had better know the specifics.

On the other hand, most instructors, unless confronted with a glaring problem, aren't qualified to render any medical opinion, which is why divers are told to get an MD letter. If dive professionals took it upon themselves to render a medical judgement, they'd be buying into an obligation and possible legal liability.

They can contact DAN and speak to a physician who is a specialist in diving and barotrauma and get a second opinion. This way it is the specialist who renders the judgement, not the instructor.

Considering I've contacted some of the physicians and personally explained the possible medical consequences to some of the conditions their patients marked off, yet were cleared to dive with, it's interesting how many of them don't even read the form either. (woman 1 month pregnant for instance) Because of my call, several have revised their clearences from fit to dive to not fit to dive. The title MD doesn't mean they don't make mistakes or don't get lazy. This is why it is the instructors duty to understand the possible consequences of the different conditions mentioned on the form and why the instructor has the final say, not the MD.

So, we're back to square one, If you are fit to dive the medical form is simply a legal release. If you are not fit to dive, stay out of the water. If anything on the form gives you pause, get a qualified professional opinion before signing up for a dive.

totally correct

Nice try. While it is possible that anything can happen in the universe, even American juries, known to have far less than half a wit amongst all 12 members combined, are unlikely to conclude as a matter of law that because you chose to implement a comment from some random stranger on some random website, that the random stranger is somehow the direct and proximate cause of your death - or whatever else it is that happened to you thousands of miles away. That this one random comment, from no authority figure whatsoever, from someone who has absolutely no duty of care to you or responsibility for you by even the broadest stretch of the imagination, somehow, through the forces of magic, God, Satan or otherwise, is enough to put responsibility on this stranger - over and above eeeeeeeeverything else that might happen in such an incident, and outweighs the decision of a responsible adult, having been warned of the dangers of SCUBA diving, having been given the invasive "medical release" to read over and sign, having sat through a class and undoubtedly and repeatedly been warned about the dangers of SCUBA diving - and - oh by the way, having had the initiative to get on the internet and do some research about the issue and come to some personal conclusions about what to do. Yeah. Good luck with that.

You have no idea how much I wish you were correct on this. Unfortunately some half wit American jury has already done this, so it's not a Nice Try, it's Been Tried and Lost. The random, uninterested party was held to a degree of responsibility, and was fined accordingly. So it can happen again - to anyone, unfortunately.

 

[BDSC]

I'm sticking with the invisible ink idea!

 

[DBailey]

Wow, Monday morning and still going strong.

Do we have a declared winner yet?

Yes, me.

At this point, until the standards of the agencies (namely PADI for my information) change, there isn't much getting around the medical form. PADI requires the medical form to be completed. If needed, the doctor's sign-off sheet needs to be completed.

After reading all 18-19 pages, I am seeing three types of divers:

Diver A is truthful on the medical form, and gets the doctor's sign-off if needed.

Diver B lies on the medical form for privacy reasons, but discusses the condition(s) with a doctor to see if they are fit to dive.

Diver C lies on the medical form and really doesn't care about discussing it with a doctor. Diver C knows that to dive all of the answers need to be "No".

To me, I am going to instruct Dive A, B, and C the same. If the situation arises, I am going to rescue Diver A, B, and C the same. To me it doesn't matter if there is a medical condition present or not. I am not going to commit to memory any medical conditions of my students for three reasons:

1. It won't alter my resuce plans.
2. I don't want to confuse different condition with different students. All students look the same underwater.
3. It is not possible for me to learn the proper resuce techinques for condition XYZ.

What I want is an informed diver. Diver C is a danger to us all. I would seriously consider bringing criminal/legal action against Diver C if I had to resuce him/her. Diver C would be putting me (the rescuer) in a situation that he/she shouldn't be if the condition would have been discussed with a doctor. At least Diver B discussed the condition with a doctor.

To sum it up, the physical form means very little to me other than it is required paperwork. The knowledge and actions that the form can generate is invaluable.

 

[NudeDiver]

Unfortunately some half wit American jury has already done this, so it's not a Nice Try, it's Been Tried and Lost. The random, uninterested party was held to a degree of responsibility, and was fined accordingly. So it can happen again - to anyone, unfortunately.

A). Like I said, ANYTHING can happen.

B). Show me the evidence.

 

[Standingbear56]

A). Like I said, ANYTHING can happen.

B). Show me the evidence.

A) Unfortunately all too true
B) Violation of a sealed case + HIPPA (and NO, I'm not making this up)

 

[NudeDiver]

OK - well, for lack of any actual evidence to the contrary, I'm forced to discount your claim accordingly.