Medical Privacy Concern

[NudeDiver]

Insulin dependent diabetics run a risk of hypoglycemic shock, that is their blood sugar gets so low due to a combination of meds used to control high blood sugar (by lowering it) and exercise (which lowers it). This manifests as nonresponsiveness, lethargy, inability to think clearly, incoherent responses to questions, unconsciousness and death. All rescues are risky. Rescue risks increase correspondingly with depth. I have seen blood sugar drops measured before and after dives of 100 points. I submit that there is a risk of recovering a divers sinking past 130 ft because of hypo or hyperglycemic shock (both have the same effect).

Uh huh. And what is the difference between a diver who says "no" on the form and gets clearance from a qualified physician, and the person who says "yes" on the form and gets clearance from a qualified physician?

As for things like high cholesterol, this puts you at a higher risk of stroke, and cardiac arrest. Heart attacks are a leading cause of diving fatalities, causing drowning.

Same question as above.

Knowing exactly what conditions exist is of limited use, knowing there is an increased risk is vital.Because the best way to deal with a panic cycle is to kill it before it gets big enough to eat you. So how does everyone know what constitutes an increased risk and what does not? Well, there is a list. It's called a dive clearance medical form.

Uh huh. Same question as above.

I am not a physician, or an attorney. I can't assess fitness, in fact, I can't even say "take a decongestant" without exposing myself to legal liability for dispensing medical advice. What I can do is recognize a problem in the water, and take extra care with a diver with a potential problem.

Ah..now we're getting to something. So, you're not going to recognize a problem in the water if you don't see that form?

Not having that information places me at greater risk because that diver is at greater risk.

I fail to see the logic there.

Does this answer your question adequately? I could expand on this, but this has been thoroughly covered in the industry. Until the law changes, lying places others at risk.

No - and while I do not agree with your logic, I do appreciate your putting together a reasoned response, rather than lather, rinsing and repeating the same thing over and over. So Kudos to you

Many people lie on a medical form. Doing so relases a professional fron most legal liability (no grounds to sue for negligence, provided the pro does not gain the knowledge some other way before the incident)

Well, given that you already have to sign a waiver that practically says "short of putting a bullet through your head, nothing that happens to you is our fault and you can't sue us", that's just fine.

Let's suppose - just for the sake of argument, PADI (or whomever) comes out with a new form and policy tomorrow. The procedure is that ALL students/divers/whomever must take the form to a doctor, get it reviewed, and come back with the form signed by a doctor, below the statement:

I, Dr. Feelgood, have reviewed this form with Joe Diver on Date ABC. I have reviewed the patient's medical history and discussed any issues with the patient to my satisfaction, and hereby advise you that, in my medical opinion, this patient presents no conditions that appear to be contraindications to diving.

The form does not provide any indications about any medical conditions the patient may or may not have.

So, my question is, would you complain wildly to PADI (or whomever) about how the re-designed form is going to put you and everyone else at some highly elevated and unreasonable risk? Really?

 

[Diver0001]

I'm surprised at you. Normally your posts seem well reasoned to me, but on this one, you just seem to be completely out there.

Once again....people do not die because they lie on the form. If you can show me any case where lying on the PADI "health form" has been determined to be the direct and proximate cause of someone's death, please do.

In the meantime - given your propensity to distort arguments and failure to provide rational and logical responses to the direct questions already asked on this issue, I don't see any point in continuing to help you explore the issue. Ah well.

I hear what you're saying....

The point I'm trying to make (albeit perhaps overly forcefully) is that lying on your medical form is a bad idea.

In my (relevant) experience this is bad council, not only for yourself but also for the people who know/love you.

The reason you might find me "out there" is that I've had to clean up these kinds of messes.... and that's not a nice job.

R..

 

[Divenomad]

Liability for negligent conduct is, therefore, the rule, to which no exception is made unless clearly supported by public policy considerations.
In addition to thea person may have a duty to act general duty to use ordinary care, affirmatively to warn or protect others or to control the conduct of others, if a special relationship exists between the actor and either the person to be controlled or the person who needs protection.

my lawyer has informed me that under this statute, i have an affirmative duty to act because as a dive professional I have a "special relationship" with not only my students and those who have engaged my services, but a strong case may be made that I have a duty to act for those in my proximity because of my greater training. When we have emergencies here, you see every dive pro in the water or activating emergency procedures.

Bear in mind that Nudedivers original reply will be read by all new divers in these disparate locations and various jurisdictions, and he spoke very broadly. It appears no thought was given to a post that affects not only him in his legal jurisdiction, but to the OP"s jurisdiction. it is possible that he familiar with the laws of the OP's area, but here, we have a duty to act.

 

[DBailey]

Here is the issue that I am having with the conversation so far...

If a student marks "yes" to a generic, medical condition AND they have the medical release from the doctor, does the shop/instructor/dive operator really care what the person marked as "yes"?

Is the shop going to take special precautions because the person answered yes to medical condition ABC?

 

[OldNSalty]

Here is the issue that I am having with the conversation so far...

If a student marks "yes" to a generic, medical condition AND they have the medical release from the doctor, does the shop/instructor/dive operator really care what the person marked as "yes"?

Is the shop going to take special precautions because the person answered yes to medical condition ABC?

Good question that gets to the heart of the debate.

My guess is no and they are not going to over-ride the Dr.

Sooo...why am I filling out this form again?

Everyone use your own judgment and do what you think is correct. For me, I will keep my medical questions for my family Dr.

 

[Divenomad]

Uh huh. And what is the difference between a diver who says "no" on the form and gets clearance from a qualified physician, and the person who says "yes" on the form and gets clearance from a qualified physician?

Same question as above.

Uh huh. Same question as above.

Ah..now we're getting to something. So, you're not going to recognize a problem in the water if you don't see that form?

I fail to see the logic there.

No - and while I do not agree with your logic, I do appreciate your putting together a reasoned response, rather than lather, rinsing and repeating the same thing over and over. So Kudos to you

Well, given that you already have to sign a waiver that practically says "short of putting a bullet through your head, nothing that happens to you is our fault and you can't sue us", that's just fine.

Let's suppose - just for the sake of argument, PADI (or whomever) comes out with a new form and policy tomorrow. The procedure is that ALL students/divers/whomever must take the form to a doctor, get it reviewed, and come back with the form signed by a doctor, below the statement:

I, Dr. Feelgood, have reviewed this form with Joe Diver on Date ABC. I have reviewed the patient's medical history and discussed any issues with the patient to my satisfaction, and hereby advise you that, in my medical opinion, this patient presents no conditions that appear to be contraindications to diving.

The form does not provide any indications about any medical conditions the patient may or may not have.

So, my question is, would you complain wildly to PADI (or whomever) about how the re-designed form is going to put you and everyone else at some highly elevated and unreasonable risk? Really?

Nope, I'd jump for joy. I hate the damn things. Me hating it does not alter the fact that under the current legal system, I have to deal with it. As i said earlier, until you find some way to alter the system, you advising someone to lie puts others at risk.

And to the diabetic question, yes there is a different emergency response to dealing with a hypoglycemic shocked diver. it can appear as a different condition, CA, stroke, and altered consciousness. In diving, it can manifest like narcosis, or stroke or oxygen toxicity. Ignorant police officers have tased diabetics in shock, mistaking it for belligerence and under the influence, because they did not know the suspect was diabetic.

There is a different protocol for diabetics. The protocol indicates carrying an intramuscular glucose injector while diving. Without knowledge of the underlying condition, a diver would not know this,because their instructor would not think to mention it. The diver would not know that OMS makes a storage tube rated for depth in which it fits perfectly and fits neatly in a bc pocket, the pro would not know glucose was necessary, and proceed with O2, totally useless, while a shocked diver would descend into coma and possibly death.This can happen within a matter of minutes. If everyone knows whats going on, one shot and it's the difference between slightly embarrasing and inconveinant, spending the rest of the vacation lying in the sun, or dying. Because once shocked, the diver can no longer help themselves, and because the instructor didn't give them the information because they did not know of the underlying condition.Diabetic divers can and do dive safely.

You seem to think I'm a fan of all this crap we go through. I'm not. AT ALL. Come up with a legally defensible alternative. In the meantime, please stop posting advice which puts others at risk, because it makes everyone safer if you are at greater risk, and I pay closer attention. Couldn't care less about your history unless it affects an emergency procedure. As stated earlier, it's a matter of awareness.

Nomad

 

[DBailey]

Sooo...why am I filling out this form again.

Mainly to show that you are informed that these medical condition may not mix with diving.

I agree with the concept of the form. I don't necessarily agree with the current layout of the form.

 

[Diver0001]

Here is the issue that I am having with the conversation so far...

If a student marks "yes" to a generic, medical condition AND they have the medical release from the doctor, does the shop/instructor/dive operator really care what the person marked as "yes"?

Is the shop going to take special precautions because the person answered yes to medical condition ABC?

In my experience as instructor... nope.

fit to dive is fit to dive... your bases are covered and that's that.

And that's the way it should be. If a doctor says this person is fit to dive then who am I as layman to doubt that?

I can only pretend on the internet that I know more about my students than their doctor. But in real life if their doctor says they're ok then there will need to be a jade plant growing out of their ear for me to doubt that.

R..

 

[SteveAD]

The medical questionaire is worded so vaguely (do you take prescription meds with the exception of BC or anti-malarials) that I fail to see where there is any issue with privacy. Ok so you take meds, the form doesn't ask whether it's viagra or thorazine.

So, in other words, as has been previously stated in this thread - answering "yes" on the form is all about lawyers, lawsuits and liability and has nothing to do with any sort of medical advantage over simply consulting with one's doctor.

The common use term for this is "Risk Management" and everyone is entitled to choose how much risk they are willing to tolerate.

As an instructor I have absolutely NO obligation to teach anyone. I can decline a student because they have bad breath, or I don't like their t-shirt or attitude or whatever.

Just as it is the students right to choose their acceptable level of risk, it is also the instructors.

If a prospective student comes to me with a medical condition that I feel raises a greater risk than I am willing to accept I will decline that student, regardless of whether or not they get a doctor to sign off on a form.

If I find out that a student lied on their medical, I will remove them from class.

Everyone has the right to accept whatever level of risk they choose, but no one has the right to force higher risk on another. Someone hiding a medical condition potentially incompatible with diving is subjecting everyone they dive with to an unknown greater risk.

 

[RJP]

The question was, do you think it is common for people to do so?

Please tell me, if a person has, say, diabetes, and their doctor clears them to dive, and they go diving with you without telling you that they have diabetes, what the "additional risk" to you is? Same question, but they're taking a prescription medication for, oh, I dunno, allergy to pollen? Or High cholesterol? Or inability to get it up? Or whatever? Thanks.

You - and others - keep changing the damn question back to this nonsense.

No one is saying that the the DM/instructor/shop needs to know the DETAILS of your medical condition. Rather, what at least I am saying is that I would like to know that you were honest on the form. If your answers were all honest "NO" answers, that's fine. Let's go diving. If you answered YES to something, and then got a doctor's clearance, that's fine. Let's go divng. What is not fine is lying on the form and then diving with me when you shouldn't be diving.

That's the point.

I'm not sure why my 5 year old understands the issue here...