Medical form: practical/ethical quandary

[iztok]

Someone who wants to dive but does not have a current, signed doctor's clearance for a condition they know has no effect on their ability to dive. That means they also know that no one is being exposed to anny additional risk due to their condition. Do you still have a problem with that?

yes, because bold is not true

 

[flots am]

You are actually exposing dive professionals to additional risk by doing so. It is a YES/NO question and if you see MD then have him sign you are clear and be done with it.

If I knew any of my students has done that I would certainly not be taking him/her under water.

Risk of what?

---------- Post added July 25th, 2014 at 07:38 PM ----------

Iin the car after the diver's death. Even though the diver was not formally a student on that dive, the instructor was sued anyway. That lawsuit was downright ugly, and even though the instructor essentially won the case (small settlement), the ensuing nastiness had a significant negative effect on his life.

Yes, the impact was greater on the family, but that does not mean they were the only ones who suffered.

If anything lying on a medical form makes the diver's surviving relatives less likely to win a lawsuit.

The only reason it was "ugly" is because someone wanted money and the US legal system is adversarial.

Someone who wants to dive but does not have a current, signed doctor's clearance for a condition they know has no effect on their ability to dive. That means they also know that no one is being exposed to anny additional risk due to their condition. Do you still have a problem with that?

yes, because bold is not true

Actually it is true.

I'm completely fit to dive. I pass the physical twice a year, have my BP better controlled than most of the people you see on the street, walk every day and dive a few times a week. I present less risk than most of the random people you'll find in a class. In fact, my agency requires an updated medical form every two years and they get it. A real one signed by a real doctor who has known me for 20+ years.

The reason I don't check any boxes on the medical forms is because it's nobody's business but mine. I make an exception for my agency because I trust them to maintain privacy, While I don't trust any random stranger who happens to own a boat I'm diving from.

My health. My right to choose who gets to know what.

flots

 

[azmodan50]

Hmmm, so a completely unsafe diver can dive without jumping through hoops while someone with a medical condition that is under control has to.


Makes sense to me.

 

[iztok]

By not filling honestly (and not being MD to make qualified medical decision on it) you do not provide the dive professionals information asked. Feel free to build relationship on a lie, but instructor should have an opportunity to decide to take or not to take the risk with particular student or customer (when it comes to boat operator).

 

[knotical]

hmmm ... If I were inclined to lie on the form, I'm not sure I'd admit it in this public forum.

 

[Ricky B]

In the interest of not talking at cross-purposes, let's recognize that there is a difference between:

1. answering questions posed by a dive operator transporting you to a dive site and answering questions from someone who has an instructor-student relationship with you.

2. divers who have been checked out by a physician and cleared and those who have not.

3. divers who say, "I have been cleared to dive by my physician and I am not going to discuss any medical issues with you" and divers who lie.

4. medical issues and fitness.

I would have no problem telling an instructor who wanted me to fill out a questionnaire that I am not going to do so because I have been cleared to dive by a physician who specializes in dive medicine (and who is a diver himself). There is no way that a dive instructor (who is not a physician who specializes in dive medicine) is going to add any value to the mix. Any further probing by the instructor would be nosiness. If the instructor wants to refuse to teach me, I'll happily find another instructor who doesn't think he's more knowledgeable than a physician who specializes in dive medicine.

I would expect an instructor to make sure that the student is physically fit for diving, which the instructor can do by observation and swim testing. No medical degree required.

 

[iztok]

I would have no problem telling an instructor who wanted me to fill out a questionnaire that I am not going to do so because I have been cleared to dive by a physician who specializes in dive medicine (and who is a diver himself). There is no way that a dive instructor (who is not a physician who specializes in dive medicine) is going to add any value to the mix. Any further probing by the instructor would be nosiness. If the instructor wants to refuse to teach me, I'll happily find another instructor who doesn't think he's more knowledgeable than a physician who specializes in dive medicine.

There is probably no instructor in US that would take you as a student w/o signed medical form. If your MD cleared you, you should bring the form signed by MD. It doesn't go into any details just stating that MD finds you ok to dive.

 

[ev780]

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.

The problem is that there is no other option. Disclosing my medical history to a non-medical person (dive instructor, operator, dive-buddy, etc) is something I am not willing to do. We are left with two choices. Lie or not dive. I choose to lie.

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

Exactly! It is none of their business. I could just as easily forge a doctor's note.

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.

IMO...Hogwash!! Maybe during initial training getting educated on what medical conditions effect diving and vice versa is important. But not during a random trip where a dive op is doing nothing more than covering their ass. If it is so important to the industry then a medical exam should be required by the agencies to keep your card current. It is not, so the forms are just a weak attempt to shift liability and they know it.

As far as I'm concerned, my medical history is between me and my doctor. I am an adult and will therefore decide for myself if I think I am fit to dive. I have no problem assuming the risks and releasing any dive operator from liability if I die due to health issues.

Exactly! And the forms should have a checkbox and sign off to that effect.

 

[iztok]

Form is VERY generic. The questions are there because those conditions might expose one to higher risk during scuba diving. The 2nd side is simple MD form that MD can fill in w/o any specifics as well and state individual is fit for diving. In fact you can just bring MD signed second page w/o first one. This way no medical history is disclosed to the operator. Simply just form with MD stating you are fit. This should solve all the problems people have with the disclosure.

 

[boulderjohn]

Form is VERY generic. The questions are there because those conditions might expose one to higher risk during scuba diving. The 2nd side is simple MD form that MD can fill in w/o any specifics as well and state individual is fit for diving. In fact you can just bring MD signed second page w/o first one. This way no medical history is disclosed to the operator. Simply just form with MD stating you are fit. This should solve all the problems people have with the disclosure.

It depends upon your agency. The RSTC form is what is primarily being discussed here, but there are others. When I took TDI classes, I had to use the TDI form. Since I have a couple of yeses on the RSTC form, I was surpised to find I had none on the TDI form--but the doctor sign off page was exactly identical, both in content and format, to the RSTC form.

In contrast, when I was taking classes through UTD, I had to fill out an online form that was extremely invasive of my privacy. You would not believe the detail of the requirements. It also had no way for a doctor to sign off--it was up to the instructor to determine if your medical condition allowed you to dive. The form was very long and tedious, and you had to fill it out anew every blessed time you took a class. The last class I took was Ratio Deco--a 100% classroom course that did not put me near the water. I had to fill out the form anyway. When it came to the part where I had to list by name the prescription medications I was taking, I said "screw it" and left it blank. They were, after all, the same ones I was taking the last time I filled out the form a few months before. After the class, I went for a weekend of diving and roomed with a UTD instructor. He walked over to the sink, opened my toilet kit, and picked out the prescription bottles to see what I was taking because I had omitted it from the form of a class I had already completed. He was not the instructor of the Ratio Deco class I had taken, so he was obviously under orders from headquarters to check out my meds.