Yes/No requirement for Med form

[tridacna]

Of course I was responding to you, I quoted you responding to me. I stated that the doctor was the one who decides medical fitness and you replied to that with "an instructor signs off", so I was trying to understand what you were trying to say. It seems, based on this response, that you agree that the doctor and the patient/student decide fitness to dive, and the instructor decides if they're willing to teach or not.

I happen to believe that any instructor unwilling to teach someone because they don't have the medical knowledge to understand that the person is fit to dive, despite the student and their doctor saying they do, has a personal issue that is screwing up their ability to do their job. If they think a person lied etc about their medical conditions, that would be a different scenario; but for those who get their doctor's approval for diving I can't imagine a good reason any competent instructor would override the decision about their medical fitness to dive that a qualified professional doctor has made. Others may not agree with that assessment, but I've seen no good reason to think that isn't the most obvious conclusion to come up with for such people's decisions.

We agree on most things. I was referring to the scenario of an instructor with a dubious med condition. If they black out at 30’ with six students, it’s a much more serious event than a student doing so.

 

[mmerriman]

Well aren't you a piece of work given you're not (according to your profile) an instructor?

In PADI's case there is some small print in the Instructor manual

"Exception: Medical requirements may vary from country to country, consult your
PADI Office."

Also there is a nice Paragraph ;-

Risk Mitigation, Professional Judgment
and Responsibility
Conduct risk assessments for your student divers by evaluating
diver, environmental, equipment, physical and psychological
variables (as described in PADI’s Guide to Teaching) during PADI
courses and programs. Always err on the side of caution and
conservatism when making decisions and applying judgment in
your PADI programs.

So basically If I don't feel comfortable I don't have to teach

People lie! I've seen people tick no to fitness issues when they're blatantly obese, of No to being over 45 and smoke, when in fact their DoB says they're over 45 and they're outside having a smoke. (not that I have issues with smokes, only liars)

In my location, there is one Specialist and highly regarded Diver Doctor, whose recommendations I would follow without question.

However lots of physicians give the most minimal "examination" and have no dive knowledge. They are signing a bit of paper, it's me who's going into the water and might have to deal with the incident.

Me. I'm going to err on the side of caution, if someone else feels differently than they can teach that student.

Yup - I'm under no obligation to take on any student even if he has a medical signed by a doctor. Its my livelihood and my reputation if something goes south.

 

[abnfrog]

just because a doctor signed off on it doesn't mean he/she understands diving ...I have seen people manipulate their doctor into signing it ...I have not approved a dos sign off and sent them to a DIVING doctor and he said no f.....ing way ,standards say you have to have it filled out you don't have to accept it...... its on YOU as an instructor and you better be able to defend your position in court as to what a PRUDENT instructor would do

 

[Duke Dive Medicine]

I'll use this example to answer @lowflyer above

You'll fill in the form tick a yes, and then get a Dr to sign a medical note. Now I'm not disputing the Dr (although I've had some flimsy medicals) But it still doesn't help me.

I know nothing about the ailment, so then rather than taking the Dr's note at face value (because no-one has ever lied to their Dr when trying to get a note) I'm obliged to get further information, Whether that's a call to PADI or DAN or my local Dr specialising in dive medicine.

Not just to check if its okay but to see what if anything I need to be watchful of.

Yes I'd rather note be sued by the family (in my area you go to jail while they figure things out) but even more, I'd rather the student has an enjoyable experience.

Yes I'm risk adverse while teaching students. I make no apologies for it

Certainly in the shops where I work, when people book courses they're sent the forms in advance and asked to email forms back to us. If we get a yes, then they get informed about needing a Dr's note before hand, so that we're not in a situation where people are turned away

This seems perfectly reasonable to me. Using @pauldw 's example of hypoglycemia, it can indeed cause sudden grand mal seizures in the presence of high partial pressures of oxygen, e.g. when diving. I've seen it happen numerous times in a hyperbaric setting. It would be helpful for a diving instructor to know that.

Best regards,
DDM

 

[Colliam7]

I'd argue that any instructor that doesn't feel qualified to teach a person who has a doctor's signature saying they're fit to dive is probably not fit to teach anyone to dive honestly.

I happen to believe that any instructor unwilling to teach someone because they don't have the medical knowledge to understand that the person is fit to dive, despite the student and their doctor saying they do, has a personal issue that is screwing up their ability to do their job.

And, you are free to believe that if you wish. But, while it may be valid in isolated instances, it is certainly not a general truth. Emotional reactions do not serve anyone well.

Instructors may decline to work with students for a variety of reasons, including medical reasons. That doesn’t mean that a student is being denied the opportunity to learn to dive, only that an individual instructor decides not to work with them. I may decide not to work with a student diver (as I recently have) because I am not confident that they have the personal maturity to be a safe diver, EVEN IF they nominally meet all specific skill requirements. That does not deny them the chance to become certified, only the chance to have my name on their certification card.

You appear to want to read more into Diving Dubai’s statement than was probably intended, when he said

I know nothing about the ailment, so then rather than taking the Dr's note at face value (because no-one has ever lied to their Dr when trying to get a note) I'm obliged to get further information, Whether that's a call to PADI or DAN or my local Dr specialising in dive medicine.

Not just to check if its okay but to see what if anything I need to be watchful of.

Any instructor taking this approach is acting in the ‘reasonably prudent’ manner in which instructors are expected, in fact required, to act. I applaud him for doing so, for making sure that he understands any nuances of the condition which he needs to consider in the training.

As an example of instructor judgement: An amputee may be ‘medically fit’ to dive (certainly, most are). That doesn’t mean that every instructor will elect to work with an amputee. Some may – VERY REASONABLY – realize that special experience and training is necessary in order for the instructor to provide that amputee student diver with the best training experience, to allow them to get the most out of their training. That instructor may conclude, ‘I am not the best instructor for that student.’ That has nothing to do with the instructor having a ‘personal problem’ about amputees, or being ‘competent’ as an instructor. There is an entire organization (HSA) dedicated to working with student divers with various disabilities, and that organization offers ‘an intensive training course’, in which scuba instructors participate in training scenarios which help them ‘learn to dive and solve problems differently, developing new skills that are needed to safely train Scuba Divers with disabilities.’ An instructor may understandably decide that the student diver would be better served working with another instructor who has completed such training.

 

[yle]

If you're too ignorant of medical conditions to even identify the symptoms, I have absolutely no idea how you have the ego to determine you are knowledgeable enough to overrule an actual doctor's conclusion that their patient is safe to dive. I'm happy to not dive with any person (much less instructor) who's ego is so big as to decide that their complete lack of medical knowledge is more valid than an actual doctor's opinion regarding that doctor's patient's health and abilities. I can only imagine that a massive ego or complete fear of the unknown would be responsible for feeling so entitled as to over-rule an MD's medical opinion as a layperson without medical training, and I don't want to dive with anyone that is either that egotistical or that fearful.

You can hide behind the guise of safety, but the safety was determined by the doctor. But really you're just being the person who is too scared of what they don't understand to bother doing their job as far as I can tell.

Has nothing to do with ego, has everything to do with understanding that my primary role as an instructor is to ensure the safety of my students. Sometimes that means I have to acknowledge that I might not be best equipped to keep them safe underwater. It's actually the opposite of ego. By choosing not to take a student, I'm not "overruling" a doctor. I'm admitting my limitations.

I'm sorry if this makes you angry. Fortunately, your anger won't change my resolve to do what I feel is in the best interest of my students. But thank you for your outrage; your passion for wanting to ensure that everyone is included in scuba diving is admirable.

(Just for clarity, I have never rejected a student and have always done my best to work with all my students to overcome the challenges they've faced in their scuba courses. But I can appreciate why some instructors might choose to do so.)

 

[yle]

and I don't want to dive with anyone that is either that egotistical or that fearful.

Great news for you: I won't be diving with you. Hope you feel better now.

You can hide behind the guise of safety, but the safety was determined by the doctor.

This statement is untrue. The portion of the medical statement that the doctor signs simply says "I find no medical conditions that I consider incompatible with diving." That is very different than "I guarantee this person is safe to dive."

If it helps you get through this ordeal, please continue to be outraged and share your feelings with the group. We all want the best for you.

 

[yle]

If instructors are going to refuse to train a person who has a medical condition but who has been cleared by a doctor, then instructors, by the same logic, should have no medical issues either. So no obesity, hypertension, COPD, old age, high cholesterol, etc., etc.

After all, risk factors for heart attack and stroke in instructors increases the risk that a student at depth could be at risk if the instructor fades out. If an instructor with obesity, for example, won’t train a student with diabetes, he should look in the mirror.

What is good for the gander is good for the goose.

I think what you really mean is that if instructors can refuse to take a student because of a medical condition, then a student should have the complementary right to refuse to take a course with an instructor that has a medical condition.

And in a sense they do: there's nothing stopping a student from inquiring of a prospective instructor about their medical fitness. If the instructor refuses to answer, or provide documentation, the student can reject the instructor. All students have this right, they just rarely exercise it. Just as the vast majority of instructors have no problem accepting a student with a signed medical statement.

 

[yle]

Yes, there are steps to guarantee no hypoglycemia that are simple and take place on the surface before you dive. The information and strategy is sound and I provide it to my patient.

I stand by my original advice: you should become a scuba instructor so you can offer your guarantee to these students, who can also be your patients. Your passion for inclusivity would be a real asset to the diving community.

But simply demanding that others offer your guarantee, no matter how much (in your world) you think such a demand is reasonable, is not going to convince anyone to obey you.

You know what they say: put up or...

 

[Manatee Diver]

As an example of instructor judgement: An amputee may be ‘medically fit’ to dive (certainly, most are). That doesn’t mean that every instructor will elect to work with an amputee. Some may – VERY REASONABLY – realize that special experience and training is necessary in order for the instructor to provide that amputee student diver with the best training experience, to allow them to get the most out of their training. That instructor may conclude, ‘I am not the best instructor for that student.’ That has nothing to do with the instructor having a ‘personal problem’ about amputees, or being ‘competent’ as an instructor. There is an entire organization (HSA) dedicated to working with student divers with various disabilities, and that organization offers ‘an intensive training course’, in which scuba instructors participate in training scenarios which help them ‘learn to dive and solve problems differently, developing new skills that are needed to safely train Scuba Divers with disabilities.’ An instructor may understandably decide that the student diver would be better served working with another instructor who has completed such training.

I wouldn't use an amputee as an example, agencies like HSA and Diveheart are more focused on people with more substantial disabilities that often disqualify them from being able to dive under the Open Water Diver standards. Most amputees OTOH can easily qualify for a standard open water diver certification, heck there are some that have gone all the way to full cave. Speaking from experience cave training organizations aren't lowering the standards for them.