Medical form: practical/ethical quandary

[lmorin]

IMHO, there is too much obligatory dependence on the medical profession in our society. One good reason to participate in rough and tumble sports is to gain a more complete understanding of how your own body works and whether or not it is working correctly. You are your own best advocate because you are (or should be) the most knowledgeable about your own body. Yes, bad things can go undetected and cause real problems, but if we're always worrying in an unwarranted fashion about the unknown or, even worse, the unknowable, nothing will ever be accomplished. In other words, assess your options and the various probabilities as accurately as possible, then act reasonably. IMHO.

 

[freewillie]

I don't really have a regular doctor (due to recent moves / lack of health issues / no health insurance), but I did see a GP at a walk-in clinic. He checked me out and said I seemed fine, but wouldn't sign my form because he didn't want to risk anything. He referred me to a spine doc. I don't blame him, he made the prudent decision.

The problem with trying to get your medical form signed at a walk in clinic is that they are not designed to sign medical waivers. They function to provide urgent care for minor medical conditions like coughs, colds, upset stomachs, sprained ankles, rashes, etc. They are not supposed to provide service that your regular primary care physician would or should be providing.

You don't necessarily need to see a spine specialist. A good primary care specialist should be able to sign the waiver. However, some primary care MD"s are so risk averse and fear of litigation may prompt them to send you to a specialist anyways. You are more likely to get a series of X rays from a spine specialist though, especially if you present as a brand new patient whom they (the MD) has never met before. But, if you have copies of your prior films to review you may not have to have repeat x rays done even if they were done several years ago. A good history with old films should suffice.

As for ongoing medical waivers with dive operators that shouldn't happen. You only need to do the medical waiver for your OW certification and maybe for any repeat training courses such as AOW or Rescue Diver. But, if you do the courses at the same LDS and use the same MD then you shouldn't have any further medical issues since the MD who is signing off on you is familiar with your medical history and condition.

I should know. As a primary care MD who happens to dive I am asked on occasion to sign the waivers. I also have certification for commercial truck driver's medical clearance and do preoperative medical clearances for any of my regular patients as well. Generally speaking the history includes what type of activities can you do without restrictions. Any limitations in activity by either symptoms like shortness of breath or chest pain would disqualify a candidate. Some patients have limitations due to arthritis and pain. Depending on the clearance it will dictate if they qualify or are disqualified for procedures or certification. If you can demonstrate full activity without restrictions you may qualify even without the x rays but would depend on the comfort level of the physician signing your medical waiver.

 

[Ricky B]

In my circumstances, I have absolutely no problem with lying in response to the questionnaire. I have been diving for 35 years now. I am physically fit and have no health issues worth discussing. Within the last two years, I have been checked out by an MD who specializes in dive medicine, discussed my history with him, had various tests by him (and other doctors), discussed my medications with him, and he has cleared me for diving.

There is no law that requires that the questions be asked or that I answer the questions. It's nothing more than self-imposed officiousness designed to protect the dive op from being sued. It's none of the dive op's business what my medical history is other than the dive op wants to protect his back. So I give the dive op the protection he wants by answering NO to each and every question. If it turns out that I have a medical condition that causes a problem, that's not the dive op's problem. Beyond that, the dive op has no legitimate interest in my medical history, and I am not going to share it with him.

I go through the questionnaire, mark each question NO, sign it, and hand it in.

 

[BDSC]

Yep. Just sign the thing NO and be done with it. It's that easy.

 

[freewillie]

In my circumstances, I have absolutely no problem with lying in response to the questionnaire. I have been diving for 35 years now. I am physically fit and have no health issues worth discussing. Within the last two years, I have been checked out by an MD who specializes in dive medicine, discussed my history with him, had various tests by him (and other doctors), discussed my medications with him, and he has cleared me for diving.

There is no law that requires that the questions be asked or that I answer the questions. It's nothing more than self-imposed officiousness designed to protect the dive op from being sued. It's none of the dive op's business what my medical history is other than the dive op wants to protect his back. So I give the dive op the protection he wants by answering NO to each and every question. If it turns out that I have a medical condition that causes a problem, that's not the dive op's problem. Beyond that, the dive op has no legitimate interest in my medical history, and I am not going to share it with him.

I go through the questionnaire, mark each question NO, sign it, and hand it in.

From a purely cynical perspective and personally having an attitude that personal injury lawsuits are running amok with frivolousness I would normally and whole heartedly agree with you.

But, from a medical perspective the medical questionnaire is actually designed to protect you as the diver, not the dive op. Think of it this way, if you die in a training accident and you lied on your medical form it is likely if not probable the LDS would bear little or no responsibility and would continue business as usual. Your family however would then have the unpleasant task of planning your funeral.

As divers age certain medical conditions become more important as risk factors for heart disease and strokes. Divers over 50 in particular are much more likely to have dive accidents involving cardiovascular disease and complications than actual dive related issues such as DCI or AGE. Lung conditions like asthma for any age diver, metabolic conditions like diabetes, or even psychiatric conditions like panic disorder would be either completely disqualifying conditions for diving or at the very least relatively contraindicated to dive training. The medical questionnaire is designed in large part as a screening tool to identify individuals with potential conditions that would disqualify them from diving.

The actual person they are protecting is you. Ironically, those of you who feel strongly that is okay to lie on your medical questionnaire may also feel strongly that if you suffer an injury from the dive operator for training you may then be first in line with a personal injury attorney suing for damages. Not all of you, but I'm sure there is someone in that group.

 

[BRT]

From a purely cynical perspective and personally having an attitude that personal injury lawsuits are running amok with frivolousness I would normally and whole heartedly agree with you.

But, from a medical perspective the medical questionnaire is actually designed to protect you as the diver, not the dive op. Think of it this way, if you die in a training accident and you lied on your medical form it is likely if not probable the LDS would bear little or no responsibility and would continue business as usual. Your family however would then have the unpleasant task of planning your funeral.

As divers age certain medical conditions become more important as risk factors for heart disease and strokes. Divers over 50 in particular are much more likely to have dive accidents involving cardiovascular disease and complications than actual dive related issues such as DCI or AGE. Lung conditions like asthma for any age diver, metabolic conditions like diabetes, or even psychiatric conditions like panic disorder would be either completely disqualifying conditions for diving or at the very least relatively contraindicated to dive training. The medical questionnaire is designed in large part as a screening tool to identify individuals with potential conditions that would disqualify them from diving.

The actual person they are protecting is you. Ironically, those of you who feel strongly that is okay to lie on your medical questionnaire may also feel strongly that if you suffer an injury from the dive operator for training you may then be first in line with a personal injury attorney suing for damages. Not all of you, but I'm sure there is someone in that group.

Telling them you have no issues when you may is relieving them of responsibility which is exactly what they want.

 

[freewillie]

Telling them you have no issues when you may is relieving them of responsibility which is exactly what they want.

You missed my point. I already conceded the point that it relieved them of the responsibility. I agreed with that.

My point was if you lie on your questionnaire you may be participating in a sport that you should not because of medical reasons. Sometimes those medical reasons can lead to fatal outcomes. It doesn't matter who is at fault or who is liable, if you are dead then you are dead. Furthermore, if you die because you lied on your questionnaire the fault is not with the dive operator (we agree that it relieved them of their liability) but with you for lying. That makes it an even bigger tragedy. You died because you did not feel the inconvenience of filling out a medical form was really that important or would actually have life or death consequences. You simply had the short sighted attitude that your medical history is none of their business.

 

[redacted]

You missed my point. I already conceded the point that it relieved them of the responsibility. I agreed with that.

My point was if you lie on your questionnaire you may be participating in a sport that you should not because of medical reasons. Sometimes those medical reasons can lead to fatal outcomes. It doesn't matter who is at fault or who is liable, if you are dead then you are dead. Furthermore, if you die because you lied on your questionnaire the fault is not with the dive operator (we agree that it relieved them of their liability) but with you for lying. That makes it an even bigger tragedy. You died because you did not feel the inconvenience of filling out a medical form was really that important or would actually have life or death consequences. You simply had the short sighted attitude that your medical history is none of their business.

The form does not matter other than as a means to protect the op. Somehow, when I wasn't looking, I got old. I discuss my ability to dive every time I see my doctor. His input is between he and I and should really be of no concern to some op that has little if any medical knowledge. Heck, I have had impaired hearing for over 50 years now. Wrong answer and the dive op wants a current (1 year) doctors statement!!! They don't care if it is signed by Dr Seuss as long as it is with the last year and says I can dive. So the answer is I have no hearing problems even though they have to look at me when they speak, loudly and clearly.

 

[Mike126]

I had my Dr sign off for my cholesterol and allergies. It's no big deal. It was good to understand the impacts of high cholesterol on diving. And yes, some dive ops do ask for it. I did not think of it as a release of liability as much as it was my own education.

For the OP, I would go to a GP or even an orthopedic and have it signed off. As you get older medical issues become more important to stay on top of.


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[cbm32]

I have a crap load of medical problems, including having had a laminectomy and spending five years in a wheel chair due to spinal cord damage, and the only time I have ever had to have a doctor fill out a medical form for me is when I got my OW. I just fill out the form and then tell them that nothing has changed since before I got my OW and no one has asked for anything more than that statement from me so far.