Dive Medicals

Should dive medicals be mandatory?

  • Yes

    Votes: 11 14.7%
  • No

    Votes: 64 85.3%

  • Total voters
    75

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A nice discussion.

Then the question is, do you think you can avoid heartattacks or other medical problems? One of the doctors I went to for a medical said to me: I sign you off for being fit to dive for 3 years, but do me one favor: don't get a heartattack directly here outside, because this is the real truth about a medical, now you are fit, in 3 seconds maybe not anymore.

You hear fit sportpeople in all kind of sports collapse, falling down, dead. A diver I know which was younger than me died 2 weeks ago. He got unwell under water, was able to walk to his car without problems, got there a heartattack and died.

I get this reasoning a lot from people. Usually these are people with a bad habit such as smoking or obese people who always "know" someone who got really old whilst smoking lots or eating lot without exercise.

The goal of a medical is not to prevent some obscure rare illness that strikes down an athlete and is impossible to prove. The goal is always to find those who obviously are high risk patients. It usually is not a problem to identify those. Also most conditions are treateable e.g. with proper treatment you can still dive without an unreasonably high risk.
 
@Damiazuk, I am over 45 and have no 'yes' on the form and I am not lying.

Lucky you. You made me look: the new one seems to have "I had covid" and, like, guess what?

But even without that:
- high cholesterol level: define "high", with or without supplements/medication?
- family history of hear attack of stroke: how far back/sideways? At what age? Fatal?

There's small stuff like "recurrent back problems" and then we have the winner:
- Recreational drug use or treatment for, or alcoholism in the past five years.

Like, d'oh.
 
No, unless you have some potential condition that contradicts diving. I have to get one for scientific diving every two years. An annual physical can be beneficial, but mandatory, no.
 
Should dive medicals be mandatory?
When discussing whether something should be mandatory, a big question is what it's intended to do, since that's to be weighed against imposing a requirement infringing the liberty of people who want to participate in the activity without having to do it. In these discussions the main focus tends to be on reducing death rates, but there's a lot more to it. From past discussions, I'll try to highlight a range of concerns. This may be a bit scatter-brained. My comment are solely regarding adults; minors aren't assumed to be legally competent and responsible to the extent of adults, so more regulatory oversight for them can be legit. I will assume 'dive medical' means get evaluated in-person by a physician of nurse practitioner to assess fitness for diving so this person can bar you from it if he/she considers you unfit for it. I'm talking about certified divers going diving, not people taking classes under the care of a dive professional, which introduces added ethical concerns.

1.) In theory, dive medicals are supposed to identify people at unacceptably high risk (which there seems to be no objective quantified parameter as to how, where and why that line is drawn) for diving. It is assumed the physician or nurse practitioner is competent in evaluating the matter and takes the time and effort to really understand this and thoughtfully perform the task and solely with the diver's interest in mind (often wrong), and that all good, right-thinking adults would of course defer to the professional assessor's judgment. There are a range of problems:

-----A.) Some care givers aren't knowledgable about diving, have busy caseloads, and will largely sign off quickly on the diver's say-so.

-----B.) Some care givers are intimidated at the prospect of putting themselves in the path of a potential malpractice suit if the diver dies diving, and may lean too far toward protecting themselves, or refuse to do it at all.

-----C.) For some people, getting such things is inconvenient and costs more time, effort and money than they care to pay.

-----D.) Some people are more willing to tolerate risk to do what they enjoy than 3rd parties (e.g.: care givers, dive op.s, dive op. insurance companies) would prefer, and wish to dive despite the recommendation.

-----E.) Not everyone is inclined to aid and abet a 3rd party over-ruling their personal liberty. This is similar to the seat belt and motorcycle helmet laws for adults - do you believe 3rd parties have a moral right to compel you to such when it's largely you who face the consequences? If motorcycles have higher fatality rates than cars, instead of requiring helmets, why not outlaw motorcycles? Is the discrimination rational or political?
I think this is a very important discussion the dive industry needs to have, particularly following a recent high profile death.
2.) The unspoken presumption that the relational scuba diving fatality rate is unacceptably high and must be reduced is not a given. Is it worse than rock climbing? What's the 'right' death rate? It won't be zero.

To put this in perspective, and with the disclaimer I don't know what recent high profile death you refer to, let's say I respond to you telling me there's been a death scuba diving by saying 'Gee, that's sad. So?' I don't think we're supposed to 'change the world' every time somebody dies pursuing a hobby. If there's an obvious lesson to learn, try to get the word out.

3.) Dive operators use liability waivers and medical questionnaires to protect themselves from potential lawsuits. Some don't seem to care whether you lie on your form, as long as they either have a form saying you had no issues of a care giver form saying your issues weren't issues for diving. Either way, their butt is somewhat covered.

4.) Dive insurance providers for dive operators. In America, our culture is often viewed as blame-externalizing and 'litigious' (i.e.: 'sue-happy'), prone to lawsuits without legitimate moral merit but extremely costly to defend against. Someone makes an informed decision to dive despite the risks and dies, the aggrieved family blames the operator rather than the diver despite that being silly and wrong, sues, and the dive operator could go bankrupt fighting even if it wins.
-----The is a legit concern, as it not only adds to operational expenses but it's become hard to some operators to even secure coverage! The issue is not exclusive to the dive industry.

-----So should we capitulate or refuse to capitulate, championing individual liberty and self-determination though we're probably not going to over-throw America's blame-externalizing, sue happy culture? (Disclaimer: not all dive-related law suits are without merit).

5.) If you dive with risk factors and die on a dive, a dive guide or buddy might pursue your sinking body, imperiling themselves with risk for the bends, etc... Your death may traumatize sensitive fellow divers (maybe even some staff), and disrupt their day trip or liveaboard. If you're hard to find, the search may be bothersome, time consuming, expensive and stressful.

6.) No man is an island - the diver might have a spouse, minor children, etc..., and what you do has indirect effects on others. But where does that stop? To what extent can regulators control your life choices because of indirect effects to others. This is often argued with helmet laws - the motorcyclist might be at higher risk to become a quadriplegic financial drain on the rest of us, etc... Seriously? Does that happen often enough to drive major health and legal policy?

7.) There's a perception the U.S. dive industry consumer base is shrinking and needs to more effectively draw in more business. Added hassle, expense, irksome demands and at times exclusion isn't conducive to that.

In addition to that, a related issue we go round-and-round about is whether checking 'no' to all questions on the health screening forms is morally reprehensible lying for selfishness, or preserving autonomy and confidentiality and resisting undue intrusiveness and unjust discrimination/burden. I'm talking about minor and/or well-controlled conditions, in some cases cleared by a care giver in the past with no changes but the form expired so it's a technicality, not epileptics, poorly controlled diabetics, etc... There are threads where we've fought that fight at length.

Getting back to your first question, should dive medicals be mandatory? I say no. But I must ask you...what purpose would you be trying to achieve by making them mandatory?
 
6.) No man is an island - the diver might have a spouse, minor children, etc...,
In two recent high profile cases, divers died on dives in which they clearly did things wrong that led to their deaths (not related to dive medicals). In both cases, the surviving family sued, even though common sense would tell you they didn't have a leg to stand on. The cases dragged on and on and on before they finally lost, costing those who were sued a fortune in medical bills. One case involved the National Speleological Society's Cave Diving Section (NSS-CDS) because the divers had gotten access to a facility for which they did not have adequate credentials to dive by lying about only going in to do a good Samaritan cleanup. The NSS-CDS did not have adequate insurance for this, and the suit almost put them out of business for good.

The fact that someone lied on a required medical does not prevent the family for suing the operator or instructor who believed the medical and allowed the dive.
 
I am a definite supporter of dive medicals.
Some people here seem to think, dive medicals are done for the Dive Shop.

The dive medical is just important for the diver to find out about his or her or its risk when having fun with his hobby.

When I do a dive medical, I never attest the ability to dive even when everything is perfect.

I just attest that there are no conditions that would prohibit diving. That goes the other way to. If someone hat multiple conditions he can still get a valid medical and an approval.

But if something happens neither I nor the dive shop are usually liable for whats happened. After all, we are not able so see in the future.
 
I am a big supporter of being aware. Of your own body, among other things.

If you go through life without ever gaining consciousness, a doctor telling you blah-blah-blah won't help you any more than ticking boxes on WRSTC form will.
 
A dive medical shouldn't be mandatory.

Unless there is a remote chance that someone else than the diver is held liable/accountable in case of an incident. Because in that case it's good to have that medical of a diver that falls under your responsibility, as already pointed out:
3.) Dive operators use liability waivers and medical questionnaires to protect themselves from potential lawsuits. Some don't seem to care whether you lie on your form, as long as they either have a form saying you had no issues of a care giver form saying your issues weren't issues for diving. Either way, their butt is somewhat covered.
Unfortunately this doesn't rule out a lawsuit completely (in some judicial systems). Divers can lie on the form, and a doctor-signed dive medical is only valid at the moment the doctor signed the form. It might be legally valid for a one or two years, but never reflects any change in a diver's health.
 
The question is "should dive medicals be mandatory"
I voted no the first post here.
Today I did and passed a dive medical for my own benefit [and less hassle with my dive insurance].

I felt good when the specialist Dr said 'I wish I was as fit as you' , but added 'don't forget about your age Bob'.
From ego boost to deflate in a very shot space of time.
He signed and stamped the form. :wink:
 
I cannot really understand why so many are opposed to mandatory medicals.
If I travel alone and have to dive with an unknown buddy it would be nice to know that he is at least physically capable of finishing the dive. And maybe helping me out in case of an emergency instead of getting a coronary because the situation might be too stressful for him.
 

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