I have Asthma and I want to Scuba dive!

[sdiver68]

Lots of personal attacks on this board, which is a shame. If you really want to ensure the safety of all divers, you should probably require abdominal ultrasounds to check for abdominal aneurysms, chest CTs to check for blebs that could lead to a spontaneous pneumothorax, and of course an echocardiogram to ensure they don't have an undiagnosed cardiomyopathy. They probably all kill more divers than asthma or asthma like conditions.

You should have no problem with a diver who undestands their own medical history, determines that scuba diving puts them at no greater risk than anyone else (which in my case is true, you can have a copy of my pulmonary function tests), and gets appropriate medical checkups. You are not (likely) a physician, so stop pretending like this puts you and the rest of your students at risk when you don't know any of the details. It is irresponsible at best.

If you are a ticking time bomb and you know it, you should be disclosing this. If you happen to raise a false alarm on some stupid point on a form that has already been okay'd with a diving specialist, what's the point of getting in to a heated debate with some dive op who doesn't have any medical training and doesn't understand? It has happened to me many times
before, even with a note. I am not advertising that anyone should lie, I just mentioned that under my specific set of circumstances I do not disclose that I get wheezy around my uncles cats because it has nothing to do with diving and simply overlaps with other conditions they are trying to screen for.

Just because it's the Internet doesn't mean you should go running around putting other people down because you may disagree with them. Why can't we just get along?

Fully endorse this post, except those labeling non-disclosers (new word) as liars are themselves lying.

BTW, do you know how DAN and other specialists are coming to the conclusion that the term 'Asthma' is way too broad to contraindicate diving? Because many asthmatics have been diving for years with no statistical evidence of higher risk. Because many people grow out of childhood asthma, or at least go from a higher severity level to a low one with age. Because modern drugs can counteract all the symptoms of Asthma.

The ONLY thing you owe to the diving community is to be properly cleared by a Dr. who understands your personal situation and diving physiology.

 

[Splash-X]

Sorry, this story defies logic. Let's assume the gentleman has been cleared by a Dr which seems to be the 1 thing everyone can agree on regarding the disclosure issue.

1) Diver still has seizure
2) DM still saves guy

Exactly how did his answer on the form affect the outcome? It did not, unless the DM also refuses people with properly disclosed and Dr. signed forms.

Often times dive operators use a waiver form as well as a short few questions about your diving history like most recent dive, current dive rating, overall number of dives, etc.

The answers to these questions help dive operators guage how many staff to place with a group. It may even dictate that a dive operator require that a customer purchase the service of a dedicate DM or pair them up with an experience diver to keep a very close eye on someone.

IMO, if the dive operator was informed about the condition the staff may have been better prepaired for the situation. I'm not saying that this applies to every situation because we can throw cases out there where this may not have made a difference as accidents do happen no matter how careful we are.

 

[sdiver68]

IMO, if the dive operator was informed about the condition the staff may have been better prepaired for the situation. I'm not saying that this applies to every situation because we can throw cases out there where this may not have made a difference as accidents do happen no matter how careful we are.

You make some good points, all items to be weighed and most probably why there is no generic 1 size fits all answer.

 

[scuga]

You make some good points, all items to be weighed and most probably why there is no generic 1 size fits all answer.

My thoughts exactly.

 

[Crowley]

BTW, do you know how DAN and other specialists are coming to the conclusion that the term 'Asthma' is way too broad to contraindicate diving? Because many asthmatics have been diving for years with no statistical evidence of higher risk. Because many people grow out of childhood asthma, or at least go from a higher severity level to a low one with age. Because modern drugs can counteract all the symptoms of Asthma.

The ONLY thing you owe to the diving community is to be properly cleared by a Dr. who understands your personal situation and diving physiology.

Do you know that DAN and other specialists have already come to this conclusion? Many asthmatics dive safely and comfortably for many years without any incident. I know an asthmatic instructor who takes regular medication, all under the approval of the local hyperbaric physicians. She carries a signed medical with them anytime she dives somewhere new, and has it renewed annually. As you say, she is cleared by a doctor who understands her personal situation and is a diving specialist

Sorry, this story defies logic. Let's assume the gentleman has been cleared by a Dr which seems to be the 1 thing everyone can agree on regarding the disclosure issue.

1) Diver still has seizure
2) DM still saves guy

Exactly how did his answer on the form affect the outcome? It did not, unless the DM also refuses people with properly disclosed and Dr. signed forms.

At the risk of hijacking, I would like to explain this a bit more thoroughly. I used to work at the dive centre where SeaArch did his training. I was not personally involved with the incident but had to deal with some of the aftermath. The guy was not cleared to dive, and in fact admitted afterwards that he had had epileptic fits whilst driving, riding a motorcycle, and skiing, all resulting in accidents. He admitted that he KNEW he was not fit to dive.

If he had disclosed, he would have had to get proper medical clearance before we accepted him for training, if he did not already have proof. As he had active epilepsy, he would most likely have been refused. If he had been underwater at the time, he most likely would have died; fortunately the incident occured on the surface.

After leaving hospital, he attempted to restart his training at another local dive centre, presenting them with yet another medical where he had not disclosed his condition. Fortunately, one of the staff there (a former employee at my place) recognised him and within the hour every dive centre in town was aware of this person.

The DM was in training (the incident occured whilst he was assisting on a Rescue Diver course) and had to receive counselling after the accident.

The point those of us who argue for the disclosure are trying to make is that if you have a condition which might be a problem for diving (and yes, we know a LOT more about asthma these days), even if you are fully aware and comfortable with the condition, please bring along a proper hyperbaric physician's clearance to dive.

I repeat, the form is not a silly way for dive centres to cover their asses - it helps the diver also. If the diver declares, they are signed off by a physician and an accident happens, there is legal recourse which will assist in gaining - for example - insurance payouts. If the diver does not declare and has an accident, they may well find that their insurance company is not going to pay up. Nothing.

And again I repeat - we WANT people to dive; to put it bluntly, it's good for business, but accidents are not. The medical + physician's approval makes everybody happy. We actively welcome the changes in philosophy and treatment regarding conditions such as asthma, epilepsy and Diabetes, all of which were for a long time, completely contraindicated to diving. The diving industry will follow suit as research and development continue.

Safe diving,

C.

 

[sdiver68]

At the risk of hijacking, I would like to explain this a bit more thoroughly. I used to work at the dive centre where SeaArch did his training. I was not personally involved with the incident but had to deal with some of the aftermath. The guy was not cleared to dive, and in fact admitted afterwards that he had had epileptic fits whilst driving, riding a motorcycle, and skiing, all resulting in accidents. He admitted that he KNEW he was not fit to dive.
C.

No, not hijacking at all. Everyone agrees that medical clearance is a must and the OP is doing the right things to be evaluated. The situation where someone is not cleared or even knows they are not fit to dive and does so anyway is just idiotic and I carefully reserve such strong terms.

 

[izibo]

If he had disclosed, he would have had to get proper medical clearance before we accepted him for training, if he did not already have proof. As he had active epilepsy, he would most likely have been refused.

For arguments sake, I assume you are trying to say that the dive shop would have refused him anyway (as opposed to the physician). This is my big problem with how dive ops do their medical waivers today. More and more, individuals are losing their ability to make a decision for themselves. I believe in making an educated, individual decision specific to the situation. There are risks associated with everything we do, and if someone makes a well-informed decision to perform an activity, that is their choice and it should be respected.

Again, I fully support people getting medical checks and being in control of their own safety. My problem is that dive operators can discriminate against people if they make a disclosure, even if they have a signed doctors letter. I've had three (count em!) incidents where my childhood "asthma" diagnosis that I don't even carry an inhaler for has prevented me from diving on a vacation, even with a doctors note. So, now I don't disclose it. Is this the ideal solution? No, but it's the only one that guarantees me protection from uninformed dive ops who think that they know best.

In my ideal world, people would be encouraged to disclose their problems provided there was no threat of recourse by the dive op. After all, it should be a team effort, yes? I also think that while a medical consult should be strongly encouraged, it shouldn't be an absolute requirement. If someone is capable of making an informed decision, why make them jump through even more hoops? All you do is waste time, money, and medical resources.

It really would make more sense for a dive op to know that someone was epileptic and plan for it, but if you make it known that you are going to not take epileptic divers, even with a doctors release or make people jump through 20 hoops, people simply wont disclose their health problems.

 

[pasley]

... I believe in making an educated, individual decision specific to the situation. There are risks associated with everything we do, and if someone makes a well-informed decision to perform an activity, that is their choice and it should be respected.

We agree there are risk. Were we disagree on the point of the right of the Dive Instructor and/or the Dive Operator to manage their risk exposure. In many instances they (dive instructor) have no choice as the Certification Agency says these conditions are not acceptable as students and to accept them is to so so without our blessing and of course our liability insurance coverage. Consider your above partially quoted statement in light of the following:
1. The heirs or the diver themselves, can and often will, sue the certifying instructor and dive shop that certified a diver with a pre-existing condition that is contraindicated for SCUBA Diving. You can sign all the waivers in the world and that will not stop your heirs from suing. (win or lose, the fight is expensive for the instructor/dive op and may put you out of business and drain the bank account).
2. The individuals dive decision also affect others including his/her dive buddy and potentially places them at risk (emergency at depth and resulting emergency ascent etc). Again the instructor/dive op may find themselves sued by the buddies heirs for allowing the original diver to get certified an therefore endangering their loved on. Will they win? Who knows, but the cost of the fight is killer.
3. The individuals dive decisions place at risk the dive master and any other diver who would be called upon to effect a rescue or body recovery.

...My problem is that dive operators can discriminate against people if they make a disclosure, even if they have a signed doctors letter.

again see item 1 above. Doctors are often clueless about what risk various conditions have in SCUBA diving. Therefore the certification agencies expect the instructor to apply judgment. If a doctor says NO it is no. IF a doctor says yes, it is maybe if approved by the instructor. I have had doctors approve for SCUBA a potential diver with 2 seizures within 10 months of the approval from an as yet undiagnosed condition! Another had a double pnemothorax less than 2 years ago and lacks sufficient breath to clear a mask. I rather doubt a hyprobaric doctor or knowledgeable dive doctor would have approve either of these potential students.

... childhood "asthma" diagnosis that I don't even carry an inhaler for ...uninformed dive ops who think that they know best.

I understand your position. The Army no longer accepts recruits with any history of asthma because they have found that even asthma that has not been an issue for years has come back in the desert. The dive operation is not uninformed...they are merely exercising risk management for their business. You want to blame someone, blame all those (divers and heirs) who went before you and then after exercising their "rights to exercise their own judgment" turned around and sued the dive operation or instructor or DM for not saving them from themselves and the courts and juries that passed out huge judgments (no I do not have examples, but you know that is how we got here).

In my ideal world, people would be encouraged to disclose their problems provided there was no threat of recourse by the dive op.

What about adding "and no threat of recourse by the diver or their heirs" to that statement?

It really would make more sense for a dive op to know that someone was epileptic and plan for it...

Plan for what? A seizure at depth is a funeral.(period). With a seizure you may spit out the regulator and lock up the jaw. You may hold you breath, you may pass out etc. The survival rate that I have read is equivalent to not happening.

but if you make it known that you are going to not take epileptic divers, even with a doctors release or make people jump through 20 hoops, people simply wont disclose their health problems.

There is no stopping stupid. At the end of the day the SCUBA Instructor/Dive Op turned down their business both out of their personal risk management and concern for the safety of the diver. When a diver is turned down for a medical reason, the instructor councils them on the reason and why they should not seek to SCUBA dive.

 

[izibo]

Read the PADI medical release:

The information I have provided about my medical history is accurate to the best of my knowledge. I agree to accept responsibility for omissions regarding my failure to disclose any existing or past health condition.

This is written in giant bold print millimeters above where you sign. I'm fairly sure that any jury trial would side with a dive operator if you have signed a statement like that.

If you can provide any evidence whatsoever that a diver who knowingly had a pre-existing condition sued a dive operator after lying to them and won, let me know. I don't even need a copy of the case report, I would accept a link to a story or any small shred of support for your position.

I really do appreciate that dive operators really want to protect themselves, but this isn't what I am arguing. Dive operators should be protected when an individual makes a choice to scuba dive unless they have done something that is negligent (bad air, leading divers in to danger, etc). That is just one of the reasons why there are medical releases, to protect dive ops.

The threat of a lawsuit is not an effective argument about anything, considering that anyone can sue anyone for absolutely anything. Hell, look at the lawsuit that ScubaBoard is involved in right now for evidence about this.

 

[pasley]

Read the PADI medical release:



This is written in giant bold print millimeters above where you sign. I'm fairly sure that any jury trial would side with a dive operator if you have signed a statement like that.

Yes that does offer some protection if a potential diver conceals the condition. It does not address the reckless endangerment of the dive buddies or dive operators who have to do the rescue that may result if the undisclosed condition dose present a problem at depth.

If you can provide any evidence whatsoever that a diver who knowingly had a pre-existing condition sued a dive operator after lying to them and won, let me know. I don't even need a copy of the case report, I would accept a link to a story or any small shred of support for your position.

here you go: 10 Ways To Save Your Life | Scuba Diving Magazine Again winning is not the argument here, it is the expense of the trial, the emotional toll an the loss of business. Even if you win, you loose. Anecdotal evidence also tells us that the certification agencies forms and rules were developed out of judgments from the courtroom. My real estate forms for example are reviewed and modified 2x a year as a result of litigation in the state and the resulting attempts of our attorneys to revise the forms to better protect us in the event of litigation.

I really do appreciate that dive operators really want to protect themselves, but this isn't what I am arguing. Dive operators should be protected when an individual makes a choice to scuba dive unless they have done something that is negligent (bad air, leading divers in to danger, etc). That is just one of the reasons why there are medical releases, to protect dive ops.

The key here is this, the potential student is not a SCUBA Diver yet...you don't know what you don't know. A potential student puts down on a form a medical condition that is a contraindication for diving. They lack the knowledge to adequately determine the risk and their lies the potential basis of the lawsuit - lack of informed consent. Again they may or may not win but the cost.

The threat of a lawsuit is not an effective argument about anything, considering that anyone can sue anyone for absolutely anything. Hell, look at the lawsuit that ScubaBoard is involved in right now for evidence about this.

On this point we disagree. The threat of a lawsuit in the conduct of your professional business is IMHO sufficient reason to attempt to manage your risk. Risk management is my right. Yes anyone can sue for anything, You can't do anything about that. But a dive professional has the right to attempt to manage that risk.