Fit to dive - what should instructors know?

Whether you realise it or not, you, as dive instructors or divemasters, actually play the most important part in assessing whether individuals are actually healthy enough to dive! 

Many divers will never see a doctor about diving fitness, let alone a diving doctor. Therefore, unless they tell you, or complete their health questionnaires honestly, no-one may even know about their health issues.

This makes it even more important that you realise your responsibility in this situation: With some individuals, health problems are obvious; there are those who seem unlikely to survive the exertion of putting on a wetsuit, let alone go diving. Others, however, may be present health concerns in more subtle ways: The diver with a history of heart disease may not appear to pose a problem at first glance; yet 40% of diving-related fatalities are related to cardiac problems. Of course, we realize that as a non-medical person you may feel a little out of your depth in dealing with these matters. It can be very difficult for an instructor to explain to an enthusiastic student why their uncontrolled epilepsy is of grave concern and precludes them from diving. Ultimately, though - and this is the key issue - your judgement on health and safety is not only for the sake of the individual diver, but also for your own sake, that of your other customers & students, and also for the sake of your dive school and dive operation! 

It is also important that you communicate to prospective divers what their responsibilities are. A diver who develops a health-related episode while diving jeopardises the safety and enjoyment of everyone! As such, divers or diving students who deliberately withhold health information that may put others at risk are being negligent and selfish. It is important that this message is conveyed, albeit tactfully, to your customers and students: In our present culture of entitlement and individual human rights, individuals often need to be reminded of their responsibilities towards others.

Given these perspectives, you as an instructor, can also feel assured that saying "no" to a diver with a major health issue is really saying "yes" to the safety of the other divers. Explaining health and dive-safety stewardship in this way should also discourage divers with serious medical conditions from simply doctor-shopping until they get someone to sign them off.  

Nothing can replace the role of a face-to-face discussion with the prospective diver and physical examination by a physician trained in diving medicine. However, DAN is always ready and willing to help you form a sound diving medical opinion on a fitness of an individual to dive.