Has it been established what kind of dive medicals are being discussed? In my mind such a thing could range from an attestation of health to a complete dive physical with pulmonary function testing, ECG and a prostate exam.
There is precedent for requiring medical exams for certain activities. Kids have to get them before participating in sports in school.
@Germie has mentioned the requirements for dive medicals in the Netherlands. I'd be interested to learn more about how that works for recreational divers; the information I found on that was about commercial/professional diving.
There's also precedent for regulating safety in certain activities - motorcycle helmets and seat belts come to mind. If a requirement for a medical for recreational divers was somehow enacted, divers would be understandably upset, and then most of them would comply because they'd want to keep diving, just like motorcyclists in places where helmets are required. The wide variety (and levels of protection) of motorcycle helmets might be a good analogy for the variety of diving evaluations that would probably be seen if something like this happened.
The challenges as I see them would be regulatory and compliance-related. Recreational diving is largely unregulated beyond training and certification, for better or for worse. Who would enact the requirement? The training agencies? I can't imagine all of them agreeing to something like this. What type of dive medical would be required? If it's a complete dive physical by a provider trained in evaluating divers, what about those divers without access to one of those? If it's to be done by a primary care physician, again the question of access comes up along with the wide variation in knowledge about diving physiology that was previously mentioned.
I'm with
@kinoons w/r to the statistics. In order to even think about making a dent in recreational diving deaths related to a medical condition you'd probably need a requirement for a complete cardiac workup, ideally with an immersed stress echocardiogram. Regarding the specific diver mentioned by the OP, medical clearance would be predicated not on a provider's exam but on a truthful answer to a screening question about a history of seizures. Would that have happened in this case? I don't know the answer to that but there are quite a few threads on SB where divers discuss fudging answers to screening questionnaires when they gauge themselves fit to dive and think that a medical exam would be an unnecessary barrier.
Best regards,
DDM
In my country, diving has no laws. Everybody can go diving on their own, even everybody can start their own agency and everybody is instructor if they want. There are no rules.
For diving, there are no rules and no medicals needed. Also not if you want to do a commercial course from padi, ssi, iantd, or whatever. Then you have to fill in the 'no no no list' and it is ok. Some divecenters require a medical.
There is a national CMAS agency here. Till a few years ago, every member of this agency needed to have medical to participate in club dives or courses from this agency. The rules where quite easy: every doctor can sign of, but it is/was adviced not to let it do by your own housedoctor. There are some 'dive doctors' in my country which just have followed an extra course. For example from S.C.A.S. The basic level for doctors is a 4 day course. So they can earn their points that they need every year to stay 'confident'.
This is all for recreational diving, also the recreational instuctors. The guidelines say it is till 50 years old every 3 years and over 50 years every year.
Now the CMAS here said it is only needed for instructors, and then even the 3 and 1 year apply.
As I am CMAS instructor I have done several of these medicals and even if there are guidelines, I cannot say doctors follow them. In all medicals I had to blow the pipe for spirometry, they tested blood pressure and I had to fill in a list of questions like the 'no no no list'. Some asked me to stand on 1 leg (why? Even people in a wheelchair can dive), some did an eyetest like you do at the opticien when you buy glasses (the answer on my why was that they wanted to know if you can find the boat back. Yes, for sure never heard of optical masks? ) From others I heard that they check sometimes your pee, but none did it were I went. In 20 minutes you are outside again and it costs nowadays about 150 euro, no insurance pays it for me. From my experience, some doctors don't save/file any result, others save/file it too long. I came back after more than the 3 years to the same doctor and he took his old files about me. I said: what are you doing? He said, check if something has been changed. I said you are not allowed, you only can file/save things about me as long as this preventical medical is valid. So after 3 years and 1 day it must have been deleted. I am very strict with checking such things as my medical data have been already 3 times in dataleaks or hacking, happely no serious things, as I am healthy. But I will tell them if they don't follow the law correctly.
The reason why CMAS said it is only for instructors is that there is no single evidence that even 1 dead have been prevented. So now the normal dives only need a medical before starting to dive for a CMAS club and then only need to do a self check.
Germany is champion with dive medicals and rules I believe, and that is the reason I sometimes need a new one before the 3 years are due. There it is 2 years validation till you are 40 years old and over 40 it is 1 year.
When entering some divesites in Germany you need to show a medical.
Also France can be quite strict, but there it is more if you dive a non-CE CCR. But in 2010 they asked me for a medical. In Malta you need to bring one if you are teaching courses there as an instructor from abroad. The divecenter where you rent tanks from has to check it and has to fill in something that you are allowed to teach. On the worldchampionships underwaterphotography for CMAS they state you need to have a valid medical (not written duration of 1,2,3 years validity), but they did not check it last year.
On 1 competion day all competitors had to go to a doctor to let your bloodpressure checked and if it was too high, they had a pill for you. That gave some discussions and at the end everybody could compete. It gave a big delay in the diving schedule.
But for example, can a kid with tubes in the ears dive? I know a doctor that signs a medical off. They say: use a pro ear mask.
Can a person with diabetis type 2 do technical diving? I know several who do it without any problem. The guidelines state no deco, maximum 60 minutes, so only the recreational diving in my country. But all the research has been done on people with type 1 and only a very very small group (less than 20 people). So from what I see around me is that type 2 is no problem for doing technical dives. Some doctors sign a medical off without problem. Others will state only recreational diving. But what if your heart lies in technical diving? Do you quit or do you ignore the advice? Remember a medical is only an advice, never a real law.
I think the most important thing is that you have to look in your own eyes, are you really fit or not? Self overestimating can be a real problem.
The 'no no no list' can give handles to check if you are probably not fit. But if you area diving every week, you know what works for you in my eyes.
But nobody, even no doctor, can say that I will not get bent during my next decompressiondive, or that I don't have to worry about a heartattack before I am 96.
Also the trend in some diving groups to get tested for a PFO. Does this knowledge make you happier? What if it is found and you have been diving for decades without problems? Are you now worried for you next technical dive?
I think, if you are unsure about things, ask a doctor, don't lie to yourself about things and try to live as healthy as possible.