Heretical thoughts on the diver's medical form

[Rob9876]

lets be honest. the medical form is not there to protect the diver. it is to protect the shop and the agency. as long as they have a signed form that some dr says you are cleared to dive, then that is one less thing they have to worry about getting sued for.
if you as a diver are taking training and you decide to lie on the medical form, and you are injured or die from one of those undisclosed medical reasons, then thats on you.

So far I've been fortunate that I could honestly answer "No" to every question. I don't like the idea of answering falsely, but it does strike me that:

• If you answer "Yes" then you have to find a doctor to sign off, so the Dive Op and the Agency are protected, while the Doctor (who may be being asked to certify more than most doctors really specialize in) has potential liability exposure. However, it seems to me that under some facts an attorney could possibly argue that the Dive Op and the Agency should still be liable because they both (1) knew of the medical issues on the form, and (2) knew of specific details of the dive site (currents, enclosed spaces, etc.) that the doctor could not have known.
• If you falsely answer "No" then the Dive Op and the Agency are still protected (perhaps even better because of not having any knowledge), and your Doctor is also protected from what could be unfairly assessed liability.

So to me, it seems like the Dive Op and Agency might possibly be better protected from a false "No" than a "Yes" + Doctor signature. Obviously the Doctor is better protected by not having to sign.

I'd come close to saying that the Dive Op and Agency might be better off with a more general statement something like described above, that "I understand the risks of the specific diving that I will be doing with Dive Op and I have reviewed any concerns with my medical providers and I hereby represent that this diving will not be affected by, nor will it worsen, any medical conditions that I may have."

[Disclaimer: For discussion purposes only and not legal advice]

 

[CuzzA]

My health is really no one's business. A better questionaire/liability release would be to ask, "Diving is a physical activity in an environment without immediate medical care. Do you have any medical condition you need to discuss with your doctor before diving?

Answer yes. Okay, provide us with a sign off to dive.

No. Okay, let's learn to dive.

 

[TMHeimer]

Yeah, I agree 100% with both of the last two posts. But that's just too simple....

 

[Edward3c]

I'm posting this in the Basic forum since it applies to all divers, and needs to be understandable to all divers. If it is better in the Medicine section, then it can get moved.

The current diver's medical form - or more precisely - the physician sign off, isn't worth the paper it is signed on. I'm a very experienced diver, and a medical professional, that is asked to sign these forms occasionally. In my case it is apparently healthy divers whose primary physician that can no longer sign them (ie. Kaiser, they will no longer sign any physicals) . So I have to take the diver's word for everything. All I get to do is see the obvious. In my own case I have prior issues that are not progressive and have been fully cleared. If I mention them, even though they have no effect and are more than 30 years past, I have to go find a provider to sign the form (I can no longer have my PCP do it - I'm covered by Kaiser). There is a LOT of incentive for divers to be less than forthcoming on these forms, so unless the signer really knows the diver, they are worthless.

This isn't to say that medical fitness to dive isn't important - it IS REALLY important. We need to change from a required medical sign off (which is only required if the diver has either clear medical issues OR is totally honest on the form) to self-regulation with adequate and understandable information so that the diver will seek evaluation by the appropriate level of medical provider if there are issues. This will take the onus off the dive operator and put it where it belongs - on the diver themselves.

A very rough draft of what I'm envisioning could look like this:

Cardiovascular: After carefully reading the information below I have

O No known cardiovascular issues that will impact my diving
O I have cardiovascular issues and have addressed them with a medical provider and I need the following precautions:_________________________________________________________________
​

Blurb on cardiovascular fitness and diving and a layman's explanation of what is fit enough. An example could be the diver can climb X flights of stairs without resting.

Do this for all the important body systems.

Have one for Covid-19. This is a critical issue. Young, previously healthy, and no longer (or never) symptomatic divers can still have damage that could cause problems with the pressure changes. This needs a strong discussion here.

Have a section on short-term issues ('colds', 'allergies', fatigue, etc)

Finish it off with a signed statement that the diver has had an opportunity to discuss any medical issues with a diving medical provider and self-certifies that they are medically fit to undertake the dives with the above listed precautions.

The dive operator is much more likely to get useful medical information this way. If someone is clearly unfit, the operator can still decline to take them.

I have added a poll. Please vote, but DO NOT consider whether you think the dive industry would use a new form or not.

The U.K. form pretty much does what you proscribe. Any question answered ‘yes’ requires a diving doctor to sign-off. Used by SAA, BSAC and SSAC.

 

[BRT]

I agree with you but I also think that I see @raftingtigger 's point. It would be nice for a first responder to have a bit more insight into the patient. With that in mind, there is more to this than lawyers...

I sign all sorts of releases in the same manner that I sign for software packages. Nobody (who wouldn't benefit from professional intervention) ever reads that endless boilerplate. Yeah, the dive-op can be sued. But, ala Lorena Bobbitt, you get off if the evidence doesn't stand up in court.

Tigger makes a very good point from her medical viewpoint (if I got it correctly). How about some hint as to a likely 'disability' when presented with a totally unknown patient?

Best thing then would be a form where the diver could state their possible issues, relieve the operator from liability for those issues and go diving.

 

[dmaziuk]

I was there about 5 years ago, and the ScubaBoard threads on Australie were all saying about the same thing as you wrote here. We took it all very seriously and did as we were told.

I haven't been back down under in a while and in Cairns: never, so... this is from what I read on the Internet (so it must be true(tm)). My reading of the invisible print is the form itself is not required for non-working dives. However if you show up with a cuneiform tablet signed with a Chinese hieroglyph and insist "it say doctor say I dive good", the op won't accept it. You can go get a writ from a local doctor in local language, or you can get your own doctor fill in the form, in English, with all the i's dotted and t's crossed.

 

[Esprise Me]

I've noticed some liability waivers include language to the effect of "I have had an opportunity to seek legal advice before signing." You don't have to get your lawyer to actually sign off, or even affirm that you talked to one, just represent that you were not put in a position of having to make a snap decision without the chance to run it by a professional. Of course, that's usually not true; even when I book in advance, I rarely get a copy of the waiver until I'm on-site ready to go. At the earliest, I get it right after I've paid. So while part of me likes the idea of self-certification of fitness to dive, part of me thinks that would result in a lot fewer people actually even talking to their doctors, and that might be a bad thing. After all, just look at how many people, having never actually consulted a lawyer, believe those waivers aren't enforceable anyway.

Like a lot of people, I was diagnosed with asthma as a child but grew out of it; I haven't had any symptoms whatsoever since well before I reached adulthood. But the RSTC form asks if you've "ever" had it, which I think is ridiculous. I told the truth a few times and got my doctor's signature, but other times I've just said "no." I would much rather sign something that says I understand the risk and accept it, and release everyone on earth from any liability forever if I get hurt or killed while diving due to complications from asthma.

My husband, on the other hand, has a history of spontaneous pneumothorax. When we were planning our Caribbean honeymoon before I was certified, we decided to try scuba diving. We'd each dabbled in it before; I did a discover dive ten years earlier, and he'd taken a course in high school (prior to his lung collapse). So we were each filling out the forms, but his doctor wouldn't sign off on his, and urged him to see a specialist. The pulmonologist was willing to run some tests to get a better sense of the risk, but warned him that they couldn't rule out the possibility of additional blebs too small for the machine to pick up, any of which could kill him underwater. We decided to stick to snorkeling. Had we been able to sign away the risk without a doctor's input, we probably would have. And maybe that would've turned out fine. Or maybe I'd now be a widow.

It's tempting to throw everything at the feet of personal responsibility, but most people just don't have enough information to properly weigh the risks. What I would really like to see is a slight modification of the forms to better reflect the latest medical understanding (I think the alarm over a history of spontaneous pneumothorax is better supported than the alarm over a mere history of asthma.) Perhaps the form could also be modified so that the physician doesn't certify that the diver is fit to dive, but rather that they have discussed the risks with the patient/diver.

 

[Jcp2]

Let’s imagine that such a form was needed to operate a motor vehicle.

 

[Julius SCHMIDT]

I learned myself how to dive bought the gear prepped the gear waited for the weather got to the site suffering other drivers complied with form prerequisites now also including plague questions my answers to which are all yes because I feel like that every morning, making polite conversation with the crew and suffering more the personalities for hours on the boat to go diving because that's how you go diving, that's diving

my answers to which are all yes

But I don't put that on the forms
Put yourselves at ease get a medical when others make you feel vulnerable

 

[mc42]

Like a lot of people, I was diagnosed with asthma as a child but grew out of it; I haven't had any symptoms whatsoever since well before I reached adulthood. But the RSTC form asks if you've "ever" had it, which I think is ridiculous.

Have you checked out the new form? The question for asthma asks,
“Asthma, wheezing, severe allergies, hay fever or congested airways within the last 12 months that limits my physical activity/exercise.”
I wonder if that would help you? My daughter had various allergies and breathing concerns growing up, including needing a rescue inhaler for sports. The new question makes me feel better about her saying no due to the timeframe and level of severity being specified.

For having this and other questions reworded, such as back problems (who doesn’t have occasional back pain? )I feel the new form is an improvement.