Medical Approval Issues

[Hawkwood]

You have to also keep in mind that an objective of the form is to also ensure that the individual, new diver or "experienced", is aware of the concern with a particular condition (medication, or whatever).

I recently had a student with an untreated hernia, although the Form had all "No's". She brought it up in passing, as we were discussing gear before we even got in the pool. "What's the big deal?" she asked, "I can easily lift and carry on my back more than this stuff weighs"...clearly she had know idea what the real concern was.

She was told she wasn't getting in the pool until she saw her doctor. Turned out he understood the concern and would not clear her. She was pissed at us, until things were explained to her by her doctor. She went on her trip and just snorkelled.

 

[JohnN]

You have to also keep in mind that an objective of the form is to also ensure that the individual, new diver or "experienced", is aware of the concern with a particular condition (medication, or whatever).

I recently had a student with an untreated hernia, although the Form had all "No's". She brought it up in passing, as we were discussing gear before we even got in the pool. "What's the big deal?" she asked, "I can easily lift and carry on my back more than this stuff weighs"...clearly she had know idea what the real concern was.

She was told she wasn't getting in the pool until she saw her doctor. Turned out he understood the concern and would not clear her. She was pissed at us, until things were explained to her by her doctor. She went on her trip and just snorkelled.

I think you've hit on my objection with the 'stock' medical questionare. It is absurdly broad while at the same time sufficiently myopic to miss the forest for the individual trees.

For example: "Are you presently taking prescription medications? (with the exception ofbirth control or anti-malarial)?"

Coupled with: "Frequent or severe attacks of hayfever or allergy?"

If you asked this question of someone with seasonal allergies 1 year ago that was prescribed Flonase (fluticasone propionate), They would have to answer "yes". If you asked the question today, the answer would be "no" (the drug has moved OTC). Has the risk profile appreciably changed in 12 months?

Ditto for: "Frequent or severe suffering from motion sickness (seasick, carsick,etc.)?" I'm a spewer, but the formulation of scopolamine that is available in the US is prescription only (Transderm), however oral scopolamine is legal for OTC and easily available (just not marketed in the US)

I think I appreciate your desire to try to protect yourself legally, my issue is that there should be different standards for beginning divers vs more experienced divers (and I've had dive operators make me fill out the silly medical form before I could dive)

 

[tursiops]

Perhaps something could be added to the form like: "I agree to accept responsibility for omissions regarding my failure to disclose any existing or past medical condition."

What effect would something like that have?

Are you being sarcastic?
This is exactly what the form says!

 

[RJP]

Interestingly - as with many seemingly contentious issues - the prevalence of people who struggle with the concept of completing the medical form in the real world is far, far lower than it is among those with strongly held beliefs that post on ScubaBoard.

Personally, the only people I've ever encountered who were unable to get physician clearance to dive after answering "YES" to anything on the medical form... were people who genuinely should not have been medically cleared to dive.

 

[tursiops]

Interestingly - as with many seemingly contentious issues - the prevalence of people who struggle with the concept of completing the medical form in the real world is far, far lower than it is among with strongly held beliefs that post on ScubaBoard.

Personally, the only people I've ever encountered who were unable to get physician clearance to dive after answering "YES" to anything on the medical form... were people who genuinely should not have been medically cleared to dive.

I 100% agree.
I have 4 YES answers...and have for years. No issue....when I do my annual physical, my doc happily signs it.
I have students on overseas trips who get their signatures before the trip. Never been a failure to get one.
I had a student in Roatan who decided after arriving there she wanted to do PPB; she went to a local doctor, got her signature.

What I disagree with - violently -- is the dive boat that asks for such forms with no advance warning, on the way to a dive site.
------------------------
P.S. I actually carry a copy of my signed medical on all dive trips....I only need one per year. No big deal.

 

[ev780]

Son, we live in a world that has forms, and those form have to be completed by divers with pens. Who's gonna do it? You? You, Lt. Weinburg?

I have a greater responsibility than you could possibly fathom. You weep for the RTSC, and you curse the agencies. You have that luxury. You have the luxury of not knowing what I know. That telling the truth, while tragic, probably saved lives. And the existence of the medical form, while grotesque and incomprehensible to you, saves lives.

You don't want the truth... because deep down in places you don't talk about at parties, you want your doctor to sign that form. You need your doctor to sign that form!

We use words like injury, and death, and liability. We use these words as the backbone of a life spent teaching scuba. You use them as a punchline.

I have neither the time nor the inclination to explain the need for telling the truth on the medical form to a man who ascends and descends under the very instruction that I provide, and then questions the manner in which I provide it.

I would rather you just said "no thank you" and went skiing instead. Otherwise I suggest you pick up a pen, and write "YES" on the form. Either way, I don't give a damn what you think you are entitled to.

:cool2:

As one of those annoying movie quote guys, this is freaking hilarious!!!!!!!

While I'm not a lawyer my understanding is that would have no effect on reducing liability... since a dead person can't accept responsibility for anything. Legally you cannot sign away the right of your widow, your kids, your estate, etc to sue someone.

In fact, to me it would seem on it's face to have the opposite effect Instead of protecting, including such language sends a pretty clear message that it is acceptable to "not disclose" as long as you tick this box. "As a dive professional you know the risks of diving far, far better than the deceased did. I mean, they hadn't yet had any training on dive physiology, physics, etc when the were asked to sign the form... right? So please explain to the jury, Mr. RJP, why you gave the deceased the option to not disclose the fact that he has asthma. In doing so, didn't you actually deprive him of the benefit of your expertise - the very expertise he was paying you for - in determining whether he was fit to dive?"

This is why I was advised to have students attest to the fact that they filled out the form truthfully, rather than asking them to accept responsibility for lying on it. They cannot be expected to understand the implications of diving with various medical conditions BEFORE they have taken the course. But they can certainly be expected to know whether they lied on the form.

I have said it before and I will say it again, my medical history is between me and my physicians! Not some 22 year old, wet behind the ears, SCUBA instructor/divemaster who is just earning a paycheck between college and the real world. Or worse, some flunky counter person who could give a damn. NO. NOT GOING TO HAPPEN. The whole form needs to be scrapped and re-written in the vein of "I understand that 'the following.........' may effect my diving and or increase the risk of ....blah....blah....blah.

But the minute they add a checkbox they are asking questions that are too personal and frankly they are not in a position to judge. The people mentioned above have no qualifications to judge my health and no privacy training in order to handle my protected health information. Therefore we are in a catch 22 and I chose my side. The rest of you can choose whatever side you want and live with your decision.

"F" em. Not going to play the game.

 

[Hawkwood]

...

I think I appreciate your desire to try to protect yourself legally...

Nope, I wasn't trying to protect myself at all. She already answered "no"...I'm clear.

I was trying to protect her. I believe we were successful with that.

 

[drrich2]

So it seems that you do in fact understand that you are willfully increasing your instructors liability by lying on your medical form?

I see your logic. It could also be argued that lying on the form provides the instructor 'full deniability' of the condition, which disclosure does not do.

When it comes to conditions highly unlikely to compromise one's ability to complete the course, I wonder what % of instructors actually want to know? And what % of the dive shops/op.s many of them work under actually want to know?

Be interesting to find out, but I imagine impossible from a practical standpoint.

Richard.

 

[redacted]

I have said it before and I will say it again, my medical history is between me and my physicians! Not some 22 year old, wet behind the ears, SCUBA instructor/divemaster who is just earning a paycheck between college and the real world. Or worse, some flunky counter person who could give a damn. NO. NOT GOING TO HAPPEN. The whole form needs to be scrapped and re-written in the vein of "I understand that 'the following.........' may effect my diving and or increase the risk of ....blah....blah....blah.

But the minute they add a checkbox they are asking questions that are too personal and frankly they are not in a position to judge. The people mentioned above have no qualifications to judge my health and no privacy training in order to handle my protected health information. Therefore we are in a catch 22 and I chose my side. The rest of you can choose whatever side you want and live with your decision.

"F" em. Not going to play the game.

That may be a bit harsh.

For the new diver, it does serve to inform them of most of the medical considerations important to scuba. It does seem excessively broad may create an unnecessary burden but I guess it was either that or better training of dive professional. And the form makes it clear that the diver is responsible for any incorrect answers. I think it is probably a good thing for new divers.

But I do not like the subsequent use of that form for certified divers by some dive shops and ops, especially when they hand it to you along with your CC receipt or even later. So, the few questions that I might have answered YES on have already been discussed with my doctors and my pharmacist dive buddies and we have determined that there is no problem. It is just much easier to answer NO and avoid silly problems. I have no reason to bother them with signing some medical form.

 

[tursiops]

I have said it before and I will say it again, my medical history is between me and my physicians! Not some 22 year old, wet behind the ears, SCUBA instructor/divemaster who is just earning a paycheck between college and the real world. Or worse, some flunky counter person who could give a damn. NO. NOT GOING TO HAPPEN. The whole form needs to be scrapped and re-written in the vein of "I understand that 'the following.........' may effect my diving and or increase the risk of ....blah....blah....blah.

But the minute they add a checkbox they are asking questions that are too personal and frankly they are not in a position to judge. The people mentioned above have no qualifications to judge my health and no privacy training in order to handle my protected health information. Therefore we are in a catch 22 and I chose my side. The rest of you can choose whatever side you want and live with your decision.

This is part of why I really don't even want to see the medical form; let the student look at it, and if there are any YES answers, then don't even show me the form.....just give me the doctor's signature. The only purpose of the form is for me (the instructor or diveboat captain) to advise you (the student or diver) if you need a doctor's signature. The purpose of the form is NOT to have me evaluate your medical fitness. So give me back a medical form that is all NOs, or give me a doctor's OK for you to dive.